Sexual Health

When people think about which medical conditions are most likely to have negative effects on sexuality and sexual expression, heart disease is usually at the top of the list.

However, one of the biggest myths about heart disease is that sex damages heart muscle and heart health. In fact, research suggests that having sex at least twice a week can help to prevent heart problems.

Sex Isn’t Bad For Your Heart

While most cardiac patients can resume normal sexual activity after recovery, the perception of how sexuality is affected by heart disease is enough to cause emotional issues. Feeling that sexual activity after a heart attack will be stressful or possibly even life-threatening is enough to make couples avoid sexual intimacy completely. In reality, sex causes about the same about of exertion as climbing a flight of steps or a brisk walk. So, if you can walk around the block, you can still manage to be sexually active.

Being afraid of harming the heart or having a heart attack in the middle of sex can keep heart disease patients from even exploring sexual expression. The fact is that there is very little chance of a person having a heart attack during sexual activity.

Emotional and Relationship Issues

Depression is a common occurrence after heart attacks or cardiac surgery. Fear of how their sex life may change or be limited often causes detachment from significant others. Depression can also decrease sex drive further complicating the issue of restoring intimacy and sex in a relationship.

For some heart disease patients, scarring from surgery can lead to self-consciousness around their bodies, which can lead to fears of or anxiety around intimacy. Another factor that can put a damper on erotic feelings of intimacy is when a patient’s partner assumes the role of caregiver. While this is often normal and necessary, the change in roles from lover to caregiver can lower sexual desire and attraction. Being put in the position of a “patient” may make those with heart problems feel less attractive and sexual.

There is also the issue of time: care may take up quality time that was once reserved for romance. On the other side, if the caregiving partner starts to build up resentment for being put in the situation, those feelings can often change the dynamic of the sexual relationship.

Working with Your Doctor

Lack of initiation of discussion about sexuality issues by health care providers can leave patients and their partners feeling lost and woefully unprepared when trying to deal with sexual issues and accompanying fears. Giving patients the standard answer for when sexual activity may be resumed—“when you can climb two flights of stairs without discomfort”—is a start, but is also not enough. Patients want to know not only when they can have sex again, but also want reassurances about the long-term safety of sex. 

Cardiac patients and their partners should make it a point to bring up the topic of sex with their health care provider and advocate for receiving detailed information about how sexuality may be affected by heart disease.

Tips for Better Sex With a Heart Condition

A few tips to keep in mind about sexual activity after a cardiac event include:

  • Don’t engage in sexual activity when already tired.
  • Keep the room at an even temperature. If a room is too hot or too cold, your heart has to work harder and heart rate can increase.
  • Don’t have sex after drinking alcohol. Alcohol can decrease sexual functioning on its own, and it can make the heart beat faster. Wait at least three hours after drinking to have sex.
  • If you know you are going to engage in strenuous activity later in the day, do not have sex.
  • Avoid caffeine and nicotine. Both constrict blood vessels, forcing the heart to work harder. If you do smoke or ingest caffeine, wait at least two hours before engaging in sexual activity.

Remember that it’s OK to say no. If someone doesn’t feel like having sex, they don’t have to. We all need a break once in a while. However, it’s important to talk with partner about feelings related to sexuality and heart disease. Good communication is the first step in getting back on track to a good sex life.

Most importantly, never have sex when experiencing chest pain. If chest pain occurs during sexual activity, stop immediately and seek the help of a health care professional.