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Sex After a Heart Attack

How Having a Heart Attack Can Actually Improve Your Sex Life

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Updated February 11, 2010

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

A heart attack can change your sex life forever. This may sound scary, but if you consider the fact that a great many of us are dissatisfied with our current sex lives, changing it may be one of the good things to come out of a traumatic experience like a heart attack. Just as a heart attack becomes the impetus for people to make changes in their diet, exercise, and stress levels, it can be the motivating factor in improving your sex life too.

Everything I know about sex and heart disease I learned from health educators, and I was curious about how medical doctors understand sex after heart attacks. So I turned to an article from UpToDate, an electronic reference used by many physicians and patients looking for in-depth medical information:

"Sexual activity is an important component of quality of life and thus is of great concern for both patients with heart disease and their physicians. Cardiac patients are often fearful of triggering myocardial infarction (MI) during intercourse and may therefore have sex less frequently. Another component of this problem is that patients seeking medical attention for sexual dysfunction often have concomitant cardiovascular disease."

How Risky Is Sex After a Heart Attack?

The answer to this depends on many factors including your general health, your heart health, your sexual health, and your mental health. It also depends on how you define sex. Your doctor may not volunteer this information, but they are in the best position to help you understand your level of risk. There is a simple exercise stress test to assess whether you are at any particular cardiac risk during sexual activity. Walking at about 4 MPH on a treadmill stresses the heart about the same as sexual intercourse that produces orgasm and a standard, submaximal stress test (the kind that should be done before you leave the hospital after a heart attack) achieves this level of exercise.

Exercise and Sex After Heart Attack

Maintaining a good exercise routine (developed in consultation with your doctor) is one of the most important ways you can reduce the risk of another heart attack and move along in your recovery. If sexual activity poses any risk at all, exercising regularly is one way to reduce that risk (so next time you don’t want to get up to do your exercises, think about all the sex you can have if you do).

You may read or hear that having sex isn’t much more strain on the heart than exercise and that sex is really just like any other kind of exercise. This is partly true. Having sex may not put more strain on the heart than quickly climbing two flights of stairs, but there can be an emotional component to sex that intensifies your physical response. You may also be more likely to get carried away and not pay attention to how much strain you’re putting on your body when having sex as opposed to exercise. This doesn’t mean you need to avoid sex. It does mean that you may have to be more conscious and communicative with your partner about the sex you’re having.

The Good Sex News

Surviving a heart attack isn’t just about fear and loss, there’s good news too; if you’re open to it. The good news is that you now have an excuse to talk to your partner about sex. Few of us communicate our sexual likes and dislikes honestly to our partners. We may find ourselves sore after sex because we stayed in one position too long, we may do things that seemed like a good idea at first but ended up either numbing, or boring, or painful.

After a heart attack ignoring your body’s requirements and desires isn’t a luxury you can afford. If you want to take care of your health and have great sex you and your partner have to talk about what works and what doesn’t, what feels good and what doesn’t, and if you run out of options, together you need to get creative with sex. Your doctor is probably not going to be able to help much with this element of heart attack recovery, but they can help with referrals to a physiotherapist, a social worker, or possibly a sex therapist for support.

What Are You Willing to do For Sex?

Making change in your life isn’t easy. After a heart attack you may have had to make changes in your diet, in how much you exercise and work, and in how you deal with stress. Like it or not, you’ll probably also have to make some changes in your sexual relationship. An obvious example is changing what you think of as sex. If “real sex” to you is intercourse, you may find you have to wait a long time before you get to have sex again.

If you’re willing to expand your mind a bit, you’ll find that you can have sex much sooner, and you may even discover ways of feeling pleasure that you had never tried before. Heart attacks can be traumatic emotionally as well as physically, and you may feel like you don’t have it in you to make changes to your sex life. That’s your right, and you also don’t need to rush. What you do need to know is that it’s never too late and your never too old to experience sex in a different way; and if you’re lacking motivation to have those sometimes difficult conversations with a partner or health care provider you may want to ask yourself what you’re willing to do for sex.

Heart Attacks and Sexual Dysfunction

In one study between 50 and 75% of patients who have had a heart attack report some sort of sexual dysfunction (including difficulty getting and maintaining erections, reduced interest in sex, reduced sexual satisfaction, difficulty achieving orgasm, and more). Often times sexual dysfunction was there before the heart attack, but only gets dealt with after. There are many successful treatments for sexual dysfunction and once you’ve identified it as a concern and you’re willing to talk with your doctor and partner about it, you can likely do something to change it.

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: December 2009.

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