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Many people find that their sexual relationships change for a short while after suffering from a heart attack. This article outlines whether sex is dangerous for coronary heart disease patients.

If you have recently been diagnosed with coronary heart disease, suffered from a heart attack, or have had heart surgery, it is normal to feel apprehensive about having sex again. What do you need to know?

Is it safe to have sex again after having a heart attack?

Sex is as strenuous as walking fast or going up two flights of stairs. If you find that you can do these activities without experiencing angina (chest pain) or being short of breath, that tells you that you are likely fit enough to have sex again. If you can do these exercises, the risk that you may trigger some sort of cardiovascular event by engaging in physical intimacy is very low.

Is it safe to have sex again after undergoing heart surgery?

Once you have undergone heart surgery, you need to let your breastbone heal for a while, which usually takes about six to eight weeks. After that, you can try having sex. You should make sure to not place any type of pressure or stress on your chest so that it can sufficiently heal. If you do have sex, stick to positions in which you are comfortable.

You should stop having sex, however, if you experience any discomfort or have any signs of a potential oncoming heart attack, such as being breathless or suffering chest pain. Contact your doctor immediately if that is the case. Additionally, avoid having sex after finishing large meal, have had some alcohol, or are very tired.

What are the risks associated with having sex when you have coronary heart disease?

Many people who suffer from coronary heart disease become scared that having sex will trigger a heart attack. The good news is, despite what is shown consistently in media, heart attacks and other cardiac events rarely occur during sex because people usually only exert themselves for a very short amount of time. Studies have shown that your risk of suffering from a heart attack during sex is very low. Sex actually ranks low in terms of physical intensity — it is the equivalent of doing housework or climbing two flights of stairs, both of which are considered fairly safe activities.

Many people with coronary heart disease are also concerned about experiencing angina either during or following sex. Although this kind of angina has a special name, angina d'amour, it occurs quite infrequently and only accounts for about five percent of all angina attacks. Furthermore, it is very rare for people who exercise regularly to experience any symptoms of angina or chest discomfort during sex.

Finally, many patients who have an implanted cardiac defibrillator worry that the device will deliver some sort of shock to the heart during sex. Even if this does happen, it will not harm or cause pain. However, if you do experience a shock during sex, talk to your cardiologist.

So, I have just had a heart attack: How do I know I can start having sex again?

While having sex is safe for most people who have been diagnosed with coronary heart disease, if you have recently experienced a heart attack or have had a change in your heart status, you should get an evaluation from your doctor to get the OK to start having sex again.

Who should abstain from having sex?

Patients in “high-risk” categories should avoid having sex until their condition is treated and they get the green light from their doctor. You're high-risk if:

  • You have uncontrolled high blood pressure.
  • You have unstable angina.
  • You have advanced heart failure.

Can my medicines affect my libido?

Certain heart medications can reduce your libido, reduce vaginal lubrication, or affect your ability to get or maintain an erection. Antidepressants can also affect your sexual desire and your ability to have an erection or an orgasm. Fortunately, many of these problems can be solved. For example, you can buy lubricants from a pharmacy. Additionally, if your blood pressure medicine is causing you erectile dysfunction, you can plan to have sex before you take it. If your medication is significantly affecting your ability to have a good sex life, talk to your doctor about ways to address it.

Tips to get back to having and enjoying sex with your partner

These are some tips that you can keep in mind when it comes to having sex after experiencing a cardiac event or undergoing surgery:

  • Communicate with your partner about your fear and anxiety. It can help you two feel closer and your partner can help address your concerns.
  • Take things slowly as it can take a while for your sexual relationship to revert back to what it used to be.
  • Don’t put too much pressure on yourself, as that can also affect your libido and ability to get aroused.
  • Find a time when both you and your partner are relaxed and then initiate sex.
  • Wait for two hours after you have eaten to have sex.
  • Be in a comfortable position when having sex.
  • Start off with cuddling and kissing and progress from there. Go slow.
  • If you are having issues having sex, talk to your doctor as they can direct you to educational resources about sex and heart disease or help redirect you to a couples counselor.

  • Taylor Jr, H. A. (1999). Sexual activity and the cardiovascular patient: guidelines. The American journal of cardiology, 84(5), 6-10.
  • Jaarsma, T., Dracup, K., Walden, J., & Stevenson, L. W. (1996). Sexual function in patients with advanced heart failure. Heart & Lung: The Journal of Acute and Critical Care, 25(4), 262-270.
  • Hall, S. A., Shackelton, R., Rosen, R. C., & Araujo, A. B. (2010). Sexual activity, erectile dysfunction, and incident cardiovascular events. The American journal of cardiology, 105(2), 192-197.
  • Photo courtesy of SteadyHealth

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