HEALTH TALK: Is sex O.K. after a heart attack?

Dr. Victor Emanuel MD
Dr. Victor Emanuel MD

I’m pretty sure this is a topic that will interest a wide cross-section of the patient population. It just happened to cross my mind to write a few words after a discussion with a colleague about it a week ago.

So, you’ve had a heart attack, and suddenly your outlook on sex is very different. You used to relish intimacy and pleasure with your partner. But now it seems like a scary proposition. Could sex trigger another heart attack? Will your sex life ever be the same?

Let’s look at some possible questions you may have, and the answers to them.

What worries heart patients when it comes to sex?

After a heart attack, some men and women fear that any type of sexual activity will provoke another one. People feel that if they’ve had a heart attack. It’s not a good idea to stress their bodies with sexual activity. But less than 1% of heart attacks come from having sex. It makes sense to think of sex as a form of exercise.  If your doctor clears you for physical activity, you’re also likely safe for sex.

Are patients embarrassed to ask a doctor about sexual concerns?

Generally, yes. And many doctors are embarrassed too. But sexual issues are important to discuss. Doctors have to read their patients well. You have to get a sense of their comfort level with you and how willing they are to talk about personal issues. When the doctor does bring it up, it shows it’s ok to talk about sex. Sometimes the patient is surprised – or even relieved – that the doctor raises the subject because it means they don’t have to.

Do cardiac rehabilitation programs address sex?

They may do that indirectly. When heart patients worry about sexual function, a lot of their concerns are related to confidence and fear. After a heart attack, they feel that if they try to go for a run, they’ll drop dead. Cardiac rehab, through structure and supervised exercise programs, teaches people that it’s ok for them to exert themselves and get back in the game. Once they have that confidence, they can go out and use it, whether it’s on the treadmill or in the bedroom.

What are some of the warning signs to stop sex right away?

Similar to any type of exercise, if you begin to feel symptoms such as chest pain, abnormal shortness of breath, fatigue, dizziness, or palpitations, it definitely makes sense to slow down what you’re doing, whether you’re a man or a woman. If you’re pretty certain it’s angina, which is temporary pain or pressure in the chest when the heart doesn’t get enough oxygen, it might help to take your nitroglycerin.

The exception to that advice is for men who use medication for erectile dysfunction – it’s dangerous to take nitroglycerin, too. Your blood pressure can fall to dangerously low levels, and there’s an increased risk of heart attack and even death. If you’re on an erectile dysfunction drug and have heart related symptoms during sex, get to a doctor.

Do some men and women lose sexual interest after being diagnosed with heart disease?

Yes, they do, and it’s often related to the emotions that follow a diagnosis of heart disease. It influences people’s lives in many different ways, and sexual activity is one of them. A new diagnosis of heart disease – or even a surgical scar – can make people feel less attractive. Some drugs have side effects that diminish sexual interest and performance. When patients feel angry and frustrated, it affects not only their sex lives but also their “couple” relationships.

For many people, heart disease is the first significant diagnosis they ever have. Think of individuals in their 40’s or 50’s who have a sudden heart attack; they didn’t know they had this disease process going on, and now they do. That realization of mortality and potential limits and imperfections is really hard to take. Many people with heart disease feel that shift so abruptly. They question themselves and what they’re capable of doing. And that’s part of the reason there are anxieties and concerns about sexual activity. We know depression is extremely common after a heart attack, especially for women.

Sex is obviously part of an overall healthy life – and it’s also a sign of a healthy heart.

This is true. It shows that you’re capable of doing physical activity in which your heart rate and blood pressure go up.  In a sense, you’re doing a stress test on your heat. If you tolerate that well and you feel good doing it, it suggests good things about your overall level of fitness and therefore your risk of heart disease.

Sex can also be a good sign of healthy relationships and social supports. It shows you have the opportunities, frankly, and that you’re interested and engaged. When you really think about it, sex is a barometer for overall health.

See you next week.

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6 Comments

  1. Anonymous
    May 30, 2013

    Most of those comments seems off topic….seems like a forum for maypwee…stick to the topic…..knowledge is power…

  2. LaPte
    May 29, 2013

    I just returned from Dominica and there are medical issues that needs to be addressed immediately – like Diabetes and the epidemic of Alcoholism that has taken over our youths. Supposedly, young able body men sitting by the roadside drinking hard rum day in and day out with no vision of a better tomorrow. These are medical problems that needs to be addressed. The ammount of ‘paro’ around the island is also a medical issue that needs to be addressed. Wake up people, wake up!!!!

    • DA Massive
      May 30, 2013

      Another hypocrite on the loose. The good doctor has already addressed several of these issue. Go get a life.

  3. Soft Touch
    May 29, 2013

    Sex Improves Heart Health

    A 20-year-long British study shows that men who had sex two or more times a week were half as likely to have a fatal heart attack than men who had sex less than once a month.

    And although some older folks may worry that sex could cause a stroke, the study found no link between how often men had sex and how likely they were to have a stroke.

    • iu
      May 29, 2013

      AND YOUR POINT IS ??????
      wHO ASKED YOU FOR YOUR OPINION
      the person husband you have their in belles
      stop it
      bomb you making
      all of a sudden you turn doctor of sex
      get work to do
      lazy stop your foolishness
      go re-do your cxc dounce kiat
      let doctors do their work
      worthless SOFT TOUCH

      • Soft Touch friend
        May 29, 2013

        Is my friend the only one with a married man? The man loves the woman to death. Not because she is my friend. He wont leave her alone. He said he is addictd to her. He is enjoying stuff that he has never experienced in his life. Give the young woman a break. Dont u know all married men now have an extra woman? Stay there. hahahah Go do yr homework. Some of those wives turn off those men. They need to do their hair, nails and need a complete make-up. Have a great and productive day. Find something worthwhile to do

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