If you have coronary artery disease (CAD), also known as ischemic heart disease or coronary heart disease, you may wonder whether certain physical activities are safe. Hiking. Running. Golf. Sex?
Some people with CAD, as well as doctors, may hesitate to bring up the last subject. But sex is safe for many people with CAD, and it’s important for your quality of life, says Jonathan H. Whiteson, MD, medical director of cardiac rehab at NYU Langone Health.
“Having sex is defined in many different ways. I prefer the term ‘intimacy.’ It’s very important for people with heart disease to know that they can be intimate again, whether that’s with a partner or on their own,” Whiteson says.
The first step is to check that your heart disease is stable. That typically means any symptoms, such as angina, or chest pain, are manageable and not getting worse. CAD is not considered stable if you recently had a heart attack, a heart procedure, or are having symptoms of worsening congestive heart failure.
Is Your Heart Strong Enough for Sex?
If you bring your spouse or partner to a cardiology appointment, don’t be surprised if they’re the first to bring up sex. “Often, it’s the partners who bring up intimacy,” Whiteson says. “I get asked all the time, ‘Can having sex harm my partner?’”
The answer: It depends on the person. As a general rule, though, “if you can walk for 5 to 10 minutes and climb a flight of steps at the end of it, then intercourse and orgasm is likely safe,” Whiteson says.
And if you can’t? Cardiac rehabilitation can help.
That’s a medically supervised program that focuses on exercise, heart-healthy habits, and stress reduction. Since many people first learn about their CAD after a heart attack, they seamlessly transition into a program. You can still participate even if you haven’t had an acute event, but you may need to ask your doctor for a prescription. Either way, most insurers will cover the cost if you have CAD.
The American Heart Association’s scientific statement on sexual activity offers these guidelines:
- If you have frequent or very painful angina, a type of chest pain caused by poor blood flow to the heart, wait to have sex until your doctor says your condition is stable.
- It may be safe to resume sexual activity as soon as a week after a mild heart attack, as long as you don’t have cardiac symptoms such as chest pain.
- Sexual activity may be OK 6-8 weeks after standard coronary artery bypass surgery if your incision is well healed.
Ways CAD May Affect Your Sex Life
Even if you’re physically ready, CAD may dampen your sexual desire or make it harder to get aroused or have an orgasm. If you’ve been having trouble getting an erection, it might be related to the same thing putting your heart at risk: clogged vessels that limit blood flow, says Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine. But he points out that your erectile dysfunction (ED) might be due to other problems, such as:
- Complications from diabetes, which is also common in CAD patients
- Psychological factors, including fear of a heart attack
- Medications, including certain antidepressants
Erectile dysfunction can often be reversed or improved, either with ED medication or by better treating your underlying conditions.
Meanwhile, depression is common among both men and women with CAD, and this mood disorder may lead to trouble with arousal, lack of interest in sex, and inability to orgasm. If you think you might be depressed, talk to your doctor. Some treatments for depression, such as regular exercise, can do double-duty by strengthening your heart.
Anxiety is also common in people with CAD. You might worry, for example, that sexual intercourse might trigger a heart attack. But as long as you’re physically healthy enough to have sex, climaxing is unlikely to be dangerous.
As Whiteson points out, “the heart doesn’t know if you’re having intercourse or if you’re walking around a track.”