Is There Sex After Heart Disease?

You've been treated for heart disease. You've followed your doctor's orders to a T. Now she says you're ready to get back to normal life. But does that include sex?

You know that clichéd yet haunting scene. Someone's having a fine time in bed. Then he clutches his heart and slumps over -- and then it's, well, over. But here's the truth: You're more likely to have a heart attack while arguing with your mate than during sex, says Richard A. Stein, MD. He's a cardiologist at New York University School of Medicine in New York.

The media helps feed the idea that having sex after heart disease is risky. "The story goes back a long time," Stein says. "The mythology is that at the time of sex, the time of orgasm, you have enormous cardiovascular effort and you put yourself at sudden risk of heart attack."

But sex is really no harder on the body than climbing a few flights of stairs or briskly walking four or five blocks.In fact, lots of people get the green light for sex within a week after they leave treatment, says Erin Michos, MD. She's an associate professor of medicine at Johns Hopkins University in Baltimore. "Patients with heart disease that are stable are generally at very low risk," she says.

Still, the subject makes many people afraid. But if you replace your fears with these tips, you can be snuggling again quicker than you think.

Get a Stress Test. This is sometimes called a treadmill test. You'll work out on a piece of equipment such as a treadmill or stationary bike while your doctor measures how well your heart keeps up with your body. There are several benefits to this:

  • You'll see firsthand what you can do, and you'll feel more confident.
  • If your spouse or partner goes along, they'll see your progress and feel more at ease about your physical health and strength.
  • Doctors often prescribe some type of cardio rehab after treatment. This test can double as a fitness check for rehab and for sex.

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Be Open With Your Doctor. Most patients don't ask outright when they can start having sex. And many doctors don't freely offer that information. This creates an air of mystery or discomfort that helps no one.

Just because your doctor doesn't bring up sex doesn't means it's off the table. They could have their own hang-ups. For instance, a young doctor counseling an older couple might "see" his parents instead, without being aware of it, Stein says. "The doctors need to be comfortable," he adds.

A task force is working to help doctors improve their skills when it comes to counseling patients about sex, Michos says. Their guidelines include not only follow-up physicals, but also advice and insights specific to the patient. This could include ideas for sexual positions that might work best for a couple or ways they can be intimate without having intercourse.

Light the Flame at Home. This isn't the best time to get fancy. At first, it's best to avoid having sex in a different place than you're used to. And if you're not married or in a monogamous relationship, try to stick with the same partner. The reason is simple. Being in a strange place or with a new person adds stress.

You should also avoid a heavy meal or alcohol before sex. Both can affect blood flow. Having a couple of drinks, or being anxious, "works against" you, Stein says.

If you think you need drugs to treat erectile dysfunction, ask your doctor. But you also need to be sure not to mix them with nitrate drugs, which are used to treat heart pain. That combo can be deadly.

Relax. Your chances of having a heart attack during sex are small. Some people are more likely than others to have one in the bedroom, Stein says. "In reality, those are the same people who have the heart attack after a fight with the boss or when going to a game and getting riled up."

But if you have chest pain or find your heart isn't beating regularly, call your doctor right away and get checked out.

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Put Sex in Its Place. It's natural. And it's an important quality of life issue for men and women, "a sign of healthy, intimate relationships," Michos says. Studies show that decreased sexual function is often linked to anxiety and depression.

"When you have sex, the world doesn't move," Stein says. For a couple who isn't having pain and can handle mild exercise, "sexual activity is absolutely a safe thing to do."

WebMD Feature Reviewed by James Beckerman, MD, FACC on December 15, 2015

Sources

SOURCES:

Richard A. Stein, MD, cardiologist, NYU Langone Medical Center; professor, New York University School of Medicine, New York.

Erin Michos, MD, associate director of preventive cardiology, Ciccarone Center for the Prevention of Heart Disease; associate professor of medicine, Johns Hopkins University, Baltimore.

American Heart Association: "Sex and Heart Disease."

National Heart, Lung, and Blood Institute: "What to Expect During Stress Testing."

American Heart Association: "Sex and Heart Attack: Talk with Your Doctor."

National Institute of Alcohol Abuse and Alcoholism: "Beyond Hangovers: Understanding Alcohol's Impact on Your Health."

Harvard Health Publications: "Are Erectile Dysfunction Pills Safe for Men With Heart Disease?"

Levine, G. Circulation, published online 2012.

 

 

 

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