'Sex Talk' Eases Fear of Sex After Heart Attack

More Patients Rekindle Sex Lives if Their Doctors Discuss When It's Safe to Resume Sex

From the WebMD Archives

May 21, 2010 -- People who are sexually active before a heart attack tend to be less so after recovering, especially if they don't have the "sex talk" with their doctors, new research shows.

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.

The study was reported this week in Washington, D.C., at an American Heart Association meeting examining care and outcomes following heart attack and stroke.

"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."

Continued

Doctor-Patient Discussions

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.

In addition to fear about triggering a second heart attack, loss of libido or sexual satisfaction caused by depression or heart medications are common concerns among patients.

"It is important to discuss these issues," she says. "If the doctor doesn't bring it up, the patient definitely should."

WebMD Health News Reviewed by Elizabeth Klodas, MD, FACC on May 21, 2010

Sources

SOURCES:

American Heart Association 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke, Washington, D.C., May 19-21, 2010.

Stacy Tessler Lindau, MD, associate professor of obstetrics/gynecology and medicine-geriatrics, University of Chicago.

Murray A. Mittleman, MD, associate professor of medicine, Harvard Medical School, Boston.

Nieca Goldberg, MD, cardiologist specializing in women's care; medical director, NYU Women's Heart Program.

News release, American Heart Association.

Muller, J.E. The Journal of the American Medical Association, May 8, 1996.

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