Heart disease and intimacy

When Is It Safe?

Both you and your doctor may be concerned that having sex will bring on a heart attack. Your doctor will be able to tell you when it is safe to have sex again.

After a heart attack or heart procedure:

• You may have an exercise test, to see how your heart reacts to exercise.
• Usually, for at least the first 2 weeks after a heart attack, sex is not safe.

Make sure you know the symptoms that could mean your heart is working too hard.

• Chest pain or pressure
• Feeling lightheaded, dizzy, faint
• Nausea
• Trouble breathing
• Uneven or fast pulse

If you have any of these symptoms during the day, avoid sexual contact and talk to your doctor. If you notice these symptoms during or soon after having sex, stop the activity and talk to your doctor.

Are You Able to Be Intimate?

After heart surgery or a heart attack, your health care provider may say it is safe to have sex again.

But these health issues may change the way you feel about or experience sex and close contact with your partner. You may notice that you:

• Are worried about having a heart attack during sex
• Have less interest in having sex or being close with your partner
• Feel having sex is less enjoyable
• Feel sad or depressed
• Feel worried or stressed
• See yourself as a different person now

Your partner may be afraid to have sex with you. He or she may have the same feelings you are having.

Women may have trouble feeling aroused. Men may have trouble getting or keeping an erection, or have other problems. Your health care provider can help you find out what is causing the problem and suggest ways to deal with it.

Talk to Your Health Care Provider

If you have any questions or concerns about intimacy, talk to your health care provider.

• It may not be easy to talk about such private things, but there may be a treatment that could make it better.
• If you find it hard to talk to your heart doctor about these topics, talk to your primary care provider.

If you are depressed, anxious, or afraid, medicine or talk therapy may help. Classes in lifestyle change, stress management, or therapy may help you, family members, and partners.

If the problem is caused by side effects of medicine you are taking, that medicine may be adjusted, changed, or another medicine added.

Men who have trouble getting or keeping an erection may be prescribed a medicine to treat this.

• These include medicines like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis).
• These may not be safe if you are taking other medicine. Do not take these medicines if you are taking medicines called nitroglycerin or nitrates.
• Do not buy these through the mail or another doctor who does not know your full health history. To get the right prescription, talk to the health care provider who knows your health history and all the medicines you take.

When to Call the Doctor

If you have new symptoms of heart trouble (see above) during sexual activity, stop the activity. Call your doctor for advice. If the symptoms do not go away within 5 - 10 minutes, call 911.

References

Morrow DA, Boden WE. Stable ischemic heart disease In: Bonow RO, Mann DL, Zipes DP, Libby P, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 57.

Update Date: 6/19/2012

Updated by: David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine. David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.