Sex After a Heart Attack

Medically Reviewed

If you have a heart condition, you’ve no doubt talked to your doctor about everything from what to eat for breakfast to how to manage stress. But here’s one subject you might have felt too uncomfortable to bring up—intimacy in the bedroom.

Sexual activity is an important health component that you shouldn’t ignore or abandon. Your doctor can, and should, counsel you—and your partner when appropriate—about how and when to resume a healthy sex life.

In 2012, the American Heart Association (AHA) issued sexual activity guidelines for patients with cardiovascular disease. But studies have shown that many patients feel they’re not getting adequate education on the topic from their doctors. A study of 17 women, ages 43 to 75, published online by the Journal of the American Heart Association in July 2013, found that when women spoke with their doctors about resuming sex, they were unhappy with the quality and vagueness of the information they received.

This lack of advice prompted the AHA, together with the European Society of Cardiology Council on Cardiovascular Nursing and Allied Professions, to release its first consensus statement for healthcare providers on the best ways to advise patients about resuming sexual activities after a cardiovascular event. Both groups are encouraging doctors to make sexual counseling part of their routine practice. The recommendations, published online by Circulation in July 2013, were developed from evidence-based research.

Getting back to the bedroom

While sex before a heart condition might have been easy, things change after any coronary diagnosis or event. Thoughts may run through your head, such as: “Does my partner look at me differently? Will the exertion trigger another heart attack?” This is normal.

Your doctor can help you gain confidence by counseling you about ways to resume sexual activities gradually, starting with hugging, kissing and fondling; the importance of a familiar setting to minimize stress; ways to ease your partner’s overprotectiveness; the use of foreplay; and recommended positions.

If you’re concerned about your physical ability, your doctor can assess your cardio- vascular risk. He or she may schedule a cardiac stress test to determine whether your heart is strong enough to resume sex. Sexual intercourse requires about the same amount of physical exertion as walking on a treadmill at 3 to 4 miles per hour or climbing two flights of stairs. If you can do these or comparable activities without experiencing symptoms—such as an irregular heartbeat, a spike in blood pressure, angina (chest pain) or difficulty breathing—then you’re probably healthy enough to have sex. Your doctor may also suggest regular physical activity like brisk walking before returning to sexual activity.

Sexual activity is generally safe for most people with stable heart disease. If heart disease is unstable or symptoms severe, patients should postpone sexual activity. After an uncomplicated heart attack (with no serious consequences like unstable heart failure or arrhythmia), most people can safely return to the bedroom in one or two weeks. Patients who’ve had cardiac surgery can generally resume sexual activity in six to eight weeks.

One step at a time

It’s normal for men and women who’ve had heart attacks to experience some sexual difficulties. In most instances, these issues subside. Tell your doctor if you’re experiencing any sexual dysfunction such as erectile dysfunction (ED) or loss of libido. Depression is common after a heart attack and can lower libido; your doctor may refer you for counseling. Some cardiovascular drugs, such as diuretics and beta-blockers, can cause ED. Your doctor may be able to adjust or switch the drugs affecting your sex drive or mood. (But never stop taking drugs on your own.) Report any other symptoms you experience during sexual activity (chest pain, shortness of breath, a rapid or irregular heart rate, dizziness) or after (insomnia or fatigue the next day) to your doctor.

Don’t be embarrassed to broach the subject with your doctor. Opening the lines of communication with your doctor and your partner is the first step to getting your sex life back.