Having sex after a heart attack - what you need to know

Don’t be shy to ask your cardiologist about having sex after a heart attack.

Is it safe to have sex after a heart attack?

Sex is an important part of many couples’ relationships. Following a heart attack you or your partner may understandably have questions. I suspect embarrassment keeps many patients from asking, but it’s an important topic to address with your physician.

Sexual activity has definite physical effects on the heart. It makes your heart work harder, increases the heart rate, elevates blood pressure, and causes an increase in oxygen consumption.

But exercise has all of the same effects, and an exercise program – begun slowly and gradually increasing in intensity – is a key part of cardiac rehabilitation.

In other words, it’s good for your heart to work a little harder at times. So the short answer is: Yes – many people can eventually resume sexual activity after experiencing a heart attack.

There are no standard guidelines for when it’s OK to resume sexual relations because the answer depends on the severity of the heart attack and the progress made during the recovery period. A patient who had a mild first heart attack and had a stent inserted shortly afterward may be able to resume intimacy with a partner within a couple of weeks.

In other situations, recovery – and the ability to resume having sex – will be slower. Someone who had a massive heart attack and is dealing with heart failure, for example, may find sexual activity too challenging.

Heart medications and drug

The ability of the heart to cope with increased demand is only part of this story. Medication interactions also must be considered.

Men, particularly older men, may use medications such as Cialis, Viagra, and Levitra to help them overcome erectile dysfunction. Unfortunately, these drugs can have interactions with medications that are prescribed for heart conditions.      

Drugs called nitrates are commonly prescribed for relieving angina, or chest pain brought on by exertion. Nitrates act by expanding blood vessels. Drugs for erectile dysfunction also affect blood flow, and the two drugs should never be taken together.

Other drugs that are commonly prescribed for heart disease, such as drugs to reduce blood pressure and some drugs prescribed for atrial fibrillation, also can have dangerous interactions with drugs for erectile dysfunction.

Hearts and minds

Psychological factors also may play a part in resuming sexual activity after heart failure.

The enormity of a new diagnosis of heart disease can make patients or their partners fearful that sex could trigger another event. Patients rarely ask me about sexual activity when I meet with them during the initial period following a heart attack. They are too busy processing what has happened. When it arises, the topic is usually mentioned during follow-up visits.

The best way to deal with all of these issues is to ask the medical professionals involved with your care. Your cardiac rehabilitation specialist should be able to advise you if there are medication issues to consider. If anxiety is an issue despite your cardiologist telling you your heart can handle the stress, consider consulting a licensed counselor.

Don’t be too shy to ask your cardiologist about this or related issues. You’re not the first to wonder if and when it’s safe to resume sex after heart problems.