Sex after Heart Disease?

In this week’s edition of the journal Circulation, the American Heart Association published the first ever scientific statement on sexual activity in patients with heart disease. It’s a solid, common sense guideline.

See my comments for a HealthDay’s news release on the topic here:

Here are some of the common questions we hear on the topic…

1. Should I have sex if I have heart disease? Well, it depends. Most people will be just fine. If you’re in good shape, physically active, and don’t have active symptoms of heart disease, you’re probably can safely engage in sexual activity. On the other hand, if you have chest pain, shortness of breath, or other symptoms of heart disease, you should discuss this with you doctor first. Your doctor may decide to order more tests (such as a stress test) to decide whether it’s safe for you.

2. How soon after my stent or bypass surgery can I resume sexual activity? The guidelines are quite clear on this. After an angioplasty or stent, if the catheter site is well-healed, you should wait about a week. After bypass surgery, 6-8 weeks is a reasonable amount of time to wait assuming the incision site is well-healed.

3. Who is at the greatest risk? Men, more often than women. And in a rather uncharacteristically humorous manner, the statement cites data indicating that of those people who died having sex, the majority were having extramarital sexual activity, in most cases with a younger partner in an unfamiliar setting and/or after excessive food and alcohol consumption.” So behave yourselves.

4. Can I use Viagra? Physicians understand that the pills we use to treat the heart, and just having heart disease at all, can decrease sexual desire and lead to erectile dysfunction. Within limits, we may be able to adjust your medications and/or prescribe medications to help with sexual dysfunction in men and women. But if you are prescribed PDE5 inhibitors (such as Viagra) for erectile dysfunction need to understand they cannot use nitrate medications (e.g., nitroglycerin, isosorbide, etc.) at the same time. If by chance they develop chest pain during sexual activity with recent use of these types of pills, they need to notify the emergency medical technicians and doctors that they have recently used these medications.

As a last point, some studies have suggested that men who engage in regular sexual activity may actually have a lower risk of having a heart attack. On the other hand, episodic sexual activity may actually be risky. If your going to have sex, do it regularly! But check with your doctor first!


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