Sex and Heart Disease

Readjusting to everyday life can be tough for heart disease patients. You wonder about everything: Should I eat this food? Can I do that activity? Can my body deal with the stress? Among the many questions is whether heart disease, also called cardiovascular disease, will affect your sex life — or if it’s safe to have sex at all.

If your cardiovascular disease has stabilized, it is probably safe to have sex.

According to a new scientific statement issued by the American Heart Association, it is probably safe to have sex if your cardiovascular disease has stabilized.

“Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners,” said Glenn N. Levine, M.D., lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston.

Cardiovascular events — such as heart attacks or chest pain caused by heart disease — rarely occur during sexual activity, because sexual activity is usually for a short time. “Some patients will postpone sexual activity when it is actually relatively safe for them to engage in it,” said Levine, who is also director of the Cardiac Care Unit at the Michael E. DeBakey Medical Center in Houston. “On the other hand, there are some patients for whom it may be reasonable to defer sexual activity until they’re assessed and stabilized.”

If you have unstable cardiovascular disease or if your symptoms are severe, you should be treated and stabilized before having sex, said Levine, who’s also a volunteer with the American Heart Association.

Ask your doctor before resuming sexual activity.

Don’t be shy about starting a conversation with your doctor about heart disease and your sex life.

Here’s what you need to know if you’ve been diagnosed with cardiovascular disease:

Ask your doctor to evaluate you before resuming sexual activity.

• If you’ve had heart failure or a heart attack, cardiac rehabilitation and regular physical activity can reduce the risk of complications related to sexual activity.
  
  
• If you’re thinking about starting birth control or getting pregnant, be sure to talk to your doctor first.
  
  
• If you’re experiencing sexual dysfunction, check with your doctor to see if it could be related to cardiovascular disease or to anxiety, depression or other factors.
  
  
• Don’t skip the medications that could improve cardiovascular symptoms because you’re concerned they could impact your sex drive or function. Your heart health should come first!
  
  
• Drugs to treat erectile dysfunction are generally safe, although they shouldn’t be used if you’re receiving nitrate therapy for chest pains due to coronary artery disease.  They also shouldn’t be administered 24-48 hours of using an erectile dysfunction drug (depending on the drug used).
  
  
• If you’re a post-menopausal woman with cardiovascular disease, it’s generally safe to use estrogen that’s topically or vaginally inserted for the treatment of painful intercourse.

More research is needed on sexual activity in specific cardiovascular conditions, particularly in relation to women and older adults.