Sex and Heart Attacks

Sex and heart attacks: What if you had a heart attack a few months ago and are doing well and exercising on a regular basis. You want to have sex again, but you are afraid that having sex might kill you.  The doctor says that everything is fine, but the last thing you want to do is die in bed making love!

For men, there is a connection between the blood flow in the heart and the blood flow in the penis.   If a man has erectile dysfunction, there is a possibility he is developing cardiovascular problems at the same time (does not wake up with an erection).  If a man has angina or has had a heart attack or a stroke, his chances of having erection problems doubles or triples. Eating well, losing weight and exercising can decrease a man’s risk for heart disease and also a man’s risk for erectile dysfunction.

The good news is that most people who have had a heart attack can safely have sex again.   Ultimately it will be up to your cardiologist to determine whether it’s safe to have sex again. Most people can start having sex again 3 to 6 weeks after their condition becomes stable following an attack.  And once sex is resumed, start slowly.  This is the time for good communication.  The closeness and intimacy that cuddling and lovemaking provide for both you and your partner may also turn out to be a major positive in not only the physical healing but also the psychological healing.

If heart disease is involved, you or your partner might be anxious about the effects of  having sex on the heart.   Sex can increase the heart rate and blood pressure, which means that the heart has to work harder. For someone with coronary heart disease, this could lead to breathlessness or chest pain.

Many doctors say that if you can walk about 300 yards on the flat or climb two flights of stairs briskly without getting chest pain or feeling breathless, it is probably safe to resume sexual activity again.   After successful angioplasty, sexual activity can be safely resumed after a few days.  After cardiac surgery, sex can start again as soon as you feel able – it may take over four weeks until you feel ready. Surgery might have left you with pain in your chest.  This, as well as the coarse chest hair that male patients develop, can lead to discomfort for both partners. Sometimes placing a soft cushion or towel between you can help.

If you get angina during sex, you may like to discuss this with your doctor who may suggest taking nitrate drugs such as glyceryl trinitrate (GTN) spray beforehand. You could keep your nitrate spray by your bed as a safeguard.  If you experience breathlessness during sex, it is best to consult your doctor, as he or she may be able to prescribe medication to help with this.

Try not to have sex for at least two hours after having a meal or a hot bath, as this can put extra strain on the heart. You may also be less likely to get symptoms after a good night’s sleep, because you will be more relaxed.  Make sure the bedroom is comfortable and warm, as the cold can bring on an angina attack. If your breathlessness is very limiting, you may need to depend on your partner taking a more active role in sex, or use the least stressful position possible.

You might notice a change in your libido after a heart attack or surgery. Anxiety and medications may affect your sex drive, causing a loss of interest in sex. Your physician will be able to share with you the side effects of the different medications that you are taking.  Talking with a sex therapist can help you manage the anxiety that goes along with having had a heart attack, and give you tips on ways to recover, sexually and emotionally.

It is quite normal for you and even your partner to be scared about resuming sex.   The two of you should focus on being loving, gentle and caring with each other.  Be romantic with soft music and candlelight dinners.  And most importantly, speak honestly with your partner about your sexual changes.  You both will be much happier, and together, you can make things better. Sex and heart attacks can go together