Sexual Health and Heart Disease

Sexuality is a fundamental part of being human. It’s a big part of our quality of life and a significant source of pleasure and intimacy. Resuming a healthy sexual relationship is a priority for both patients and their partners.

Concerns about sexual activity are common among people living with heart disease or recovering from a cardiac event. Talk about your questions and concerns with your health care provider. He or she is used to discussing these matters and will answer your questions in a professional and understanding way.

Steps to Resuming a Healthy Sexual Relationship

Many people are concerned about sexual activity after a heart attack or when they are living with heart disease or heart failure. It’s important to know that sexual activity is like any other physical activity and actually requires less exertion than many activities such as bicycling, golf or gardening.

If you can walk at a reasonable speed (3 miles per hour) on level ground or climb 20 stairs relatively easily, then the exertion of sex is unlikely to affect your heart health.

Nonetheless, there are some things you can do to make the experience safer and positive:

  • Plan sexual activity for a time of day when you have the most energy
  • Avoid sex after a large meal to give yourself time to digest
  • Limit alcohol use and always avoid tobacco, as both can affect sexual function
  • Choose less stressful positions and techniques
  • If sex gives you chest pain or causes shortness of breath, speak to your doctor

If you do experience shortness of breath or chest pain during sex, stop, rest and speak to your doctor. If pain persists, call 911.

Sexual Activity After a Heart Attack

If you’ve had a heart attack, your doctor may recommend you wait for one to six weeks before resuming sexual activity, depending on the attack’s severity and your treatment. After this point, the risk of having another heart attack is very low and becomes lower yet with exercise and medication.

Sexual Activity After Surgery

Recovery from surgery is one of the few times that you may have to postpone the resumption of sexual activity.

Extreme fatigue after surgery is very common and may understandably delay your desire to resume sexual activity.

Open heart surgery causes significant trauma to your chest. Bones and incisions both need time to heal. As you resume sexual activity, remember to use a position that doesn’t require you to hold yourself up by your arms for at least six weeks, as that may put too much pressure on your chest.

Living with Heart Disease

There is no reason to avoid sex if you live with a heart condition such as stable coronary artery disease, heart failure or atrial fibrillation. The same cautions apply as they do for sex following a heart attack or other cardiac event, such as being well rested, not eating too heavily and avoiding alcohol and tobacco.

If you are experiencing sexual dysfunction, there are medications and other interventions that can help. Speak to your physician about your problems in this area as you would for any other problems.

Sexual Dysfunction and Men

When men think about sexual dysfunction, they usually think about erectile dysfunction (ED). Many men may have had ED before a cardiac event, while some may experience it afterward due to their medications.

Medication for ED is generally safe to continue using, with one exception – if you take nitroglycerin, you need to take precautions regarding the timing of ED medication with your nitroglycerin medication. Your physician will give you the information you need.

Talk with your doctor if you think your medications are causing ED. You may have to try a different ED medication or a different dose. If that doesn’t help, ask for a referral to a urologist specializing in ED, as there are other treatments available.

Sexual Dysfunction and Women

Sexual dysfunction among women is more complex than with men, as women respond to different stimuli. Anti-depressants can interfere with libido as well. Your doctor can explain some of the different options for dealing with female sexual dysfunction. You may also find it useful to talk to a psychologist about the emotional aspects of sexual desire.