Background: To investigate the overall sexual functioning and disease specific sexual problems in congenital heart disease (ConHD) patients, for both genders and different cardiac diagnostic groups, and compare these with Dutch normative data. Also disease specific sexual problems were investigated. Methods: From a longitudinal cohort of patients, operated for ConHD between 1968 and 1980, 254 patients (median age: 40, 53.4% male) were included in this study: atrial septal defect (n = 72), ventricular septal defect (n = 71), pulmonary stenosis (n = 30), tetralogy of Fallot (n = 53) and transposition of the great arteries (n = 28). Patients completed internationally validated, generic questionnaires and also disease specific instruments on sexual functioning. Results: Patients showed a delay in starting sexual activities compared with peers. Females with ConHD scored significantly worse compared with normative data on all scales of sexual functioning, indicating a broad range of sexual problems and 15% showed clinical levels of sexual dysfunction. Of the males, 14% suffered from erectile dysfunction. Males with ConHD scored worse on erectile function, orgasmic function and satisfaction regarding their sexual life compared with normative data. No diff Conclusions: This study shows that sexual functioning is impaired in adults with ConHD. Providing information to patients about sexuality, pregnancy, delivery and heredity should be improved, and given at young age. Crown Copyright (C) 2013 Published by Elsevier Ireland Ltd. All rights reserved.