Sex and heart disease: Can the two be mended?

Among the questions that remain unasked of the doctor by most patients, one of the foremost involve the effect of medications and the ailments that they are used to treat upon the activities of daily life, one of which is sexual activity, at almost all ages. This sometimes leads to misunderstanding and sometimes bizarre or fascinating behavior (depending upon your viewpoint). Examples of such behavior are everywhere.

One patient that I took care of during a heart attack was so afraid that he would "lose his potency and ability" that he called in his "lover" to the coronary care unit so that he could have immediate sex right there (with the monitors attached, and not bothered that the nurses were present) while he still had chest pain. Another went on a binge of sexual activity before buying the blood pressure lowering pills that I had prescribed fearing that "it would be the last time." These issues are easy to treat by simple reassurance if they are discussed with a physician or other health care provider, but often embarrassment prevents such discussion. This is a shame because almost all patients I have treated for any kind of heart disease retain the capacity for normal enjoyment of sexual activity.

Interestingly, many ailments and exposures can affect sexual activity, as can some of the things that we put in our systems. The human being is exposed to many things in the activities of daily life that will suppress or affect the ability to experience the pleasure of sexual activity. Unfortunately, sometimes we forget this. Occasionally, though, there is someone who does not want us to realize this. Want an example? Do you really believe that cigarettes have no effect on your ability to enjoy sexual activity? Do you really think that a smoke after sex increases your pleasure as the cigarette companies have managed to depict in films and commercials. It is interesting that a set of advertisements from the American Heart Association were rejected by television stations as being too graphic when they depicted the "Marlboro Man's" impotence. However, smokers do have a much higher rate of male impotence than non-smokers. And do you really believe that women aren't affected? Do you really think that kissing a mouth that tastes like cigarette ash stimulates pleasure?

Many medications affect abilities to enjoy sexual activity; these of course include newer medications made for that purpose such as the ever popular Viagra, Cialis, and Levitra, which work fairly well to improve male capacity for erection, but do not seem to work for females. Many more studies have been done for males than females in this regard because it is easier to measure the male capacity for tumescence needed for penetration and ejaculation than it is to measure a woman's ability to achieve orgasm by usual tests. In science, it is hard to deal with things that cannot be measured, and few would admit to "faking it."