Understanding sex is vital. It is a crucial part of resuming a normal life.
Some common worries are as follows:
- Both of you may fear sudden death from a heart attack during intercourse.
- Do men become impotent or sterile after a heart attack?
- Minor symptoms may arise such as rapid pulse, minor angina and slight shortness of breath.
- Impotency of sterility is not caused by a heart attack. If you have concerns about medication and its side-effect, consult your doctor. This first time intercourse is attempted after a heart attack, you might become very aware of unusual feelings. These symptoms are most common right after orgasm. Discomfort during intercourse the first time does not mean there will be a recurrence each time.
- The amount of physical exertion required for sexual relations can almost always be tolerated without endangering the heart. It is often compared to briskly climbing two flights of stairs or briskly walking a city block. Remember that sexual intercourse represents only a small segment of the total experience. Foreplay, ie. caressing, can provide fulfillment.
- It you have any concerns around the issue of sex, consult your physician and/or cardiac rehabilitation nurse.
Yes, you can. In most cases, your heart disease won't cause any physical changes that will affect sexual interest and performance.
A lot of people think that it isn't safe to have sex after heart disease.
- 25% of people stop sexual relations completely
- Up to 50% change their usual habits and patterns, leading to less pleasure and more frustration.
The greatest problems seem to be result of worries, anxiety and misinformation. If you can walk up two flights of stairs without angina or shortness of breath you should be able to have sex without difficulty. If you can't walk the two flights of stairs you may have to make some changes in your sexual activity. Ask your doctor or nurse if you are unsure about a safe level of sexual activity.
For ages, the heart has been the symbol of love, tenderness and caring. Yet when the heart is damaged, little is said about getting back to the act of loving – sexual intercourse. Since little is said, one may think the worst.
After a heart attack, many may fear that their sex life is over. They think that sex will put too much stress on a damaged heart. Movies and books often feed this fear. They are full of scenes where the person who has a heart problem dies in the arms of a loved one. There is even a legend that Attila the Hun died during sex.
Over 80% of people who have had heart attacks return to most of their daily activities. This includes a return to sex. For most people, this is 4 to 6 weeks after a heart attack. So you see, sex is not as risky for your heart as you may think. As a matter of fact, the number of heart attacks brought on by physical effort is fairly low.
If you have had heart surgery (but not a heart attack), you can have sex soon afterwards. How soon will depend on the healing of the breastbone and chest incision. You may want to postpone sex until your chest feels less sore, but this is up tot you. It most often takes 4 to 6 weeks after surgery to get your strength back and about the same time for the breastbone to mend.
Recovery will not be the same for each person. How fast a person recovers depends on the extent of the surgery and the type of medicines taken.
In the absences of a heart attack, there is not restriction about sex after a cardiac cath or balloon procedure. You will only need to wait until the puncture site has closed. Twenty-four hours is the usual time.
Many activities can raise your heart rate. Climbing stairs and walking are 2 of the most common. During these, your heart rate beats from 107 to 130 times a minute. If you don't get short of breath, have chest pain or get tired when climbing 2 flights of stairs or doing something like it, your heart can meet the demands needed for sex.
For most people, the time used to have sex is fairly short. The average, middle-aged person having sex with the same partner, twice a week, has a total time from arousal to resolution of 10 to 16 minutes. During this time, the greatest stress on the heart lasts only 4 to 6 minutes.
Sexual activity can be thought of as having four stages or phases
- Arousal
- Heart and breathing rate start to go up
- Blood pressure goes up
- Skin begins to develop a flush
- Plateau
- All of the previous changes, just more so
- 2nd heaviest workload for the heart just before orgasm
- Orgasm
- maximum increase in blood pressure, heart and breathing rates
- heaviest workload for the heart; lasts about 15-30 seconds
- Resolution
- heart and breathing rate and blood pressure quickly return to normal
- 2nd heaviest workload for the heart just after orgasm
From late in the plateau stage to resolution usually lasts only about 10-20 minutes.
If you can climb two flights of stairs or walk several blocks briskly, you can safely resume your usual sex life.
WARNING: the short amount of time involved in a sexual act removes it from being a good way to improve cardiovascular fitness. So keep riding that bike, or walking that treadmill.
- for about three hours after eating a large meal or drinking a lot of alcohol
- when you've just finished or are going to start some kind of strenuous activity such as chopping wood, shoveling snow, going for a brisk walk
- when you're already tired
- when you're angry, depressed, anxious or tense
- when you're pressured for time
- in an uncomfortable setting (very hot or cold rooms, or Volkswagens)
- sexual activity causing angina if nitro has been taken to prevent angina
- angina reoccurring after a routine of nitro to relieve angina has been successfully followed
- increase heart and breathing rates 20-30 minutes after sexual activity
- prolonged fatigue after sexual activity
If you have any of these unusual signs, stop sexual activity until you have an opportunity to talk to your doctor about them.
TO BE SAFE: Never put your heart under a double workload
As we age there is a natural decrease in sexual ability. Men often find that it takes longer to develop an erection, and longer to achieve orgasm. Women sometimes find a decrease in vaginal secretions, leading to discomfort during intercourse. Dryness can be remedied through using water based gels such as KY Jelly (absolutely not Vaseline). Some of the changes you experience sexually may be a normal part of the aging process and not related to heart disease. However, men and women can have fulfilling sexual relationships throughout their lives.
Some medications can cause a lack of interest in sex or affect sexual ability. For example:
- meds for high blood pressure
- tranquilizers and sedatives
- anti-arrhythmic
- beta blockers for the heart
You may notice changes within days of starting on these meds or it may take months. But if you do find that you have lost interest in sex or if you have become impotent, talk to your doctor about it. It may be that the medications can be changed or the dosages adjusted.
NEVER stop taking the medication or adjust the dosage on you own.
There is some controversy about whether some positions are easier on the heart than others. However, there isn't a definitive answer. You should use positions that you are comfortable with; if there are problems, experiment until you find a position that works for you.
WARNING: Anal intercourse is very dangerous for men and women who have heart disease. This form of intercourse does put extra stress on the heart because it may affect either heart rate or rhythm.
Misconceptions affect everyone who holds them. It may be that your partner has a lot of unfounded fears about sex and heart disease. It is important that you talk to each other and share your feelings, fears and thoughts. If either one of you is unsure about the facts, counseling may help.
Some people feel that they have to prove themselves sexually after having heart disease. Try to avoid this "sex marathon". Generally the best idea is to slowly pick up your usual patterns and habits.
Many people have sexual problems and lack of interest after heart disease. Don't expect them to return to your normal interest and ability right away. It may take time and several tries. It may be helpful to get back in touch with each other gradually. Express your love through gestures and touching, and gradually move back into your sexual relationship. Many couples find that their confidence is increased by mutual masturbation before attempting intercourse. Sexual activity is an expression of love. Try and concentrate on the feelings you and your partner are sharing, instead of the performance capabilities you expect.
Disclaimer
Reviewed by Alberta clinical experts. Brought to you by HealthLink Alberta. Copyright.
This material is designed for information purposes only. It should not be used in place of medical advice, instruction and/or treatment. For more health advice call Capital Health Link at 780-408-LINK (5465) 24 hours a day, seven days a week. In Alberta, call Toll-free: 1-866-408-LINK (5465)
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