In a survey of heart attack patients, only about half of men and a third of women said their cardiologist discussed when it would be safe to resume sex prior to hospital discharge. Just 40% of men and 20% of women reported talking about the issue with a doctor in the year after their heart attack.
The survey also shows that sexual activity declined for both men and women during the year following a heart attack.
After adjusting for multiple factors, the researchers found that men were 30% more likely and women were 40% more likely to report a decline in sexual activity when their doctors failed to discuss sex with them after a heart attack.
"We found that one important difference between people who did and did not resume sexual activity after a heart attack was whether their doctor discussed the issue with them at hospital discharge," study researcher Stacy Tessler Lindau, MD, tells WebMD.
Safety of Sex After Heart Attack
Most people can safely rekindle their sex lives within a few weeks of having an uncomplicated heart attack, as long as they feel up to it and are able to engage in other moderate activities.
But many patients fear that sex will bring on another heart attack. And even when they are not afraid, their partners often are.
But the risk is so small it could be considered negligible, Murray A. Mittleman, MD, of Harvard Medical School tells WebMD.
The chance that sex will trigger a heart attack is about two in a million in a healthy person without heart disease. In people with heart disease, that risk increases to one in 50,000, but this is still extremely low. And no increase in risk is seen in heart attack survivors who exercise regularly.
"Exercise is very important following a heart attack for all sorts of reasons, and this is one more," Mittleman says. "Exercise virtually eliminates the risk of having a heart attack associated with sexual activity."
The latest study included 1,184 men and 576 women surveyed one month and one year after having a heart attack. The average age of the men was 59 and the average age of the women was 61.
Men were more likely to report being sexually active prior to having their heart attack, and they were more likely to be married than the female heart patients. But even after adjusting for these differences, patients hospitalized for a heart attack who had a discussion with their doctors about sex were more likely to have sex during the following year.
Lindau says doctors are often reluctant to discuss with their heart patients the issue of sex after a heart attack, especially if those patients are older. They may also assume, often incorrectly, that there is no need to broach the subject, she adds.
"There is no role for profiling in this discussion," she says. "And I have never found a patient to be offended or embarrassed when I raise the topic of sexuality. Some tell me it is not an issue for them. But bringing it up shows that I am not making judgments, and it makes it easier for them to talk about it if it does become an issue in the future."
New York cardiologist Nieca Goldberg, MD, who specializes in treating women with heart disease, says she typically talks to her heart attack patients about sex while discussing physical activity in general.
"It is important to discuss these issues," she says. "If the doctor doesn't bring it up, the patient definitely should."