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."
Some medicines depress the desire for sexual activity (libido), some, though, actually increase this desire. This is of human organism's design to achieve propagation of the species. The hormonal system causes us to secrete pheramones that appeal to the opposite sex, and stimulate sexual enjoyment especially during the time of the month during that a female may become pregnant. Not sure that this is natural? Watch what happens to dogs in the neighborhood when a female goes into "heat." Hormone supplementation in the human female can mimic this effect whether used for birth control or to prevent the symptoms of "the change." How does this affect you? The prescription of hormones for women to promote bone density, or suppress the symptoms of menopause can alter things either when drugs are started, or when stopped.
Medications utilized for depression can also stimulate or suppress longing for sexual release. Unfortunately there has been experimentation by "designer drug" manufacturers (read illicit here) to provide drugs that either stimulate sexual desires, or lower inhibitions. These have invaded places where the young and indiscriminate gather. They range from date rape drugs to those that are smoked, snorted, swallowed or injected to alter consciousness and decrease inhibition. These drugs have cardiovascular (as well as other) consequences, and I have seen death result from their use.
Many medications that we prescribe can affect sexual performance. Often these medications can be taken for a prolonged period of time and the patient is not aware of the issue and has accepted disability. (An aside here: disability is defined as the loss of an ability that was previously present, this apparently is the reason that drugs such as Viagra are covered by health care insurers and birth control pills for women aren't, because one is used for the treatment of a disability, the other isn't). I have received calls from elderly spouses complaining of the return of too much sexual function and desire when certain medications were discontinued.
If you note difficulties with sexual function, discuss these with your doctor. In almost all instances, your medication regimen can be altered to your benefit.