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Myths About Sexual Activity and Heart Disease

Common Misconceptions about the Sexual Impact of Heart Disease and Heart Attack

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Updated December 03, 2009

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Once heart disease becomes part of your life it becomes part of your sex life, too. The problem is that few of us talk about it and the combination of fear and ignorance of sex in general plus fear and ignorance around heart health leaves us with access to far more myths about sex and heart disease then solid information.

I wanted to find out what the medical profession has to say about sex and heart disease, so I turned to an article from UpToDate, an electronic reference used by many physicians and patients looking for in-depth medical information. The article begins by setting the record straight on risks associated with sex and heart attack:

What Should Patients Do? Advice from UpToDate

“Sexual activity is associated with a moderate hemodynamic stress and increases the risk of myocardial infarction (MI). However, the absolute increase in risk is very small. In addition, risk modification can be accomplished with regular physical activity and possibly aspirin and beta blocker use. Thus, patients with heart disease who are not deemed to be at high risk should be able to be sexually active after appropriate risk stratification and optimization of therapy and can be safely treated for sexual dysfunction.”

Clinical writing has a way of making even good news sound kind of severe (“appropriate risk stratification” sounds more like something that would cause embarrassment at a bank then something your doctor can do) but the bottom line from medical research, and what physicians should be telling their patients, is that having a diagnosis of heart disease, or having survived a heart attack, doesn’t mean an end to your sex life. Here are a few other common myths about sex and heart disease that are well worth dispelling.

Myth: People with heart disease should be fearful of sex.
Fear is one of the greatest barriers to healthy and pleasurable sex after a heart attack, often more of a barrier than the physical changes related to heart disease. Being fearful of sex after a heart attack is usually a response to being ignorant of how sex works, how your heart works, and what the true risks are. If you find yourself not initiating sex because you’re afraid it will hurt you or your partner, start by talking with your partner about it. Then one or both of you should go and talk to the doctor who is treating the condition.

Myth: Having heart disease requires that you reduce your sexual activity.
It’s commonly thought that sexual activity represents a workout like no other. Research suggests otherwise. In terms of physical exertion having sex is like walking briskly up two flights of stairs (one doctor also compares it to playing golf while carrying the clubs). After a diagnosis of heart disease, or following a heart attack you will likely have to change many of your old habits, including what you eat, how much you work and sleep, and how you exercise. Sex is way down on the list of risk factors that need to be adjusted to reduce your risk of a heart attack. Maintaining a good exercise regime in consultation with your physician not only provides a greater reduction in risk than having less sex, it also makes having whatever sex you’re having less risky.

Myth: People with weak hearts have to avoid “kinky" sex.
When medical texts refer to “sex” it almost always means intercourse. Only recently has information for physicians and patients begun to acknowledge other kinds of sexual activities, and we don’t yet have any empirical research on how activities like oral sex, anal sex, fantasy role play, or BDSM may differ from intercourse in terms of heart health. There’s no evidence that what you consider “kinky sex” is any riskier than what you call “normal” sex. When in doubt, the best thing to do is talk to your doctor. It can feel embarrassing (and you may make them blush) but hopefully it will result in you getting answers that you can use to keep your sex life as interesting and vibrant as you want it to be.

Myth: After a heart attack you have to wait 6 to 8 weeks before resuming sexual activity.
Actual risk of a heart attack depends on multiple factors (your heart health, your general health, your attitudes toward sex, etc). This means that the period of time you need to wait before having sex again is completely individual. Regardless of your risk category there are things you can do to reduce your risk, which may mean you can start having sex again. Finally, and most importantly, “having sex” means many things. You may have to wait 8 weeks before engaging in a quickie in a public washroom, but that doesn’t mean you have to wait 8 weeks to begin sexually connecting to others. Unfortunately if you have a doctor who isn’t that comfortable talking about sex, let alone distinguishing the kind of orgasm you have from intercourse versus the kind you have from non-penetrative sex, you may get the standard 6 to 8 week line with no opening for questions.

Myth: Your doctor will tell you what’s risky and when you can resume sex after a heart attack.
About two-thirds of people who have cardiac surgery leave the hospital without receiving any counseling on sexuality. The research and information is available but the reality is that most doctors still receive little to no training on talking about sexuality with patients. As a result, many will avoid the conversation altogether, or simply offer a pamphlet with generic information on the way out the door. It’s not that your doctor doesn’t care, but there’s a good chance that they won’t prepare you for the real risks or rewards of a timely resumption of sex after heart surgery or heart attack. This may mean you have to take the lead and start a conversation with your doctor about sex and heart disease.

Want to learn more? See UpToDate's topic "Sexual activity in patients with heart disease" for additional in-depth medical information.

Source:

Sauer, W.H. & Kimmel, S.E. “Sexual activity in patients with heart disease.” UpToDate. Accessed: November 2009.

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