• Sex After A Heart Attack

    IMAGE Love can cause heartache and even heart break. These are mere figures of speech, but what about people who have had a heart attack or heart surgery? Can someone with heart disease safely have sex?

    Understanding Heart Disease

    Imagine the heart as a pump. It receives incoming blood from the whole body through the veins, then pumps it back out to the body through the arteries. It regulates its pumping action with a complex arrangement of electrical controllers called pacemakers. The term heart disease can encompass any condition that affects the blood vessels, the pacemakers, or the heart muscle itself.
    A significant component of heart disease is atherosclerosis, or narrowing of the arteries. When arteries become clogged with plaque, caused by the build-up of fatty materials, blood flows less freely. And the tissues supplied by those arteries can die from lack of oxygen and other nutrients. When the tissue being supplied is the heart, the resulting condition is known as a myocardial infarction, or heart attack.
    The survival and well-being of people after a heart attack depends on how much of the heart muscle dies. The prognosis for people who have had a heart attack is drastically improved over previous decades, due primarily to advances in medicine, such as bypass surgery, angioplasty, and coronary stenting.

    Resuming Sex After a Heart Attack

    The American Heart Association (AHA) provides guidelines on sexual activity for people who have heart disease. The AHA points out that if your heart condition is stabilized, it is probably safe for you to have sex. Your doctor can discuss this important issue with you and give you a timeline as to how long you should wait until you have sex. This timeline depends on factors like your diagnosis, the type of treatment you had, and the results of an exercise stress test.
    Once your doctor has given you clearance to have sex, keep these tips in mind:
    • Talk to your partner about your feelings. If you are anxious about having sex again, it is important that your partner knows this. The two of you can work together and decide the right time to resume sexual activity.
    • When you do feel ready, slowly ease into having sex again.
    • Sex should be stress-free. Pick a time when you and your partner are relaxed. Also, choose a place that is peaceful and free of interruptions.
    • Take your medication as prescribed.
      • Note: If you are man and take medication for erectile dysfunction, like sildenafil (Viagra), make sure your doctor knows about this. These medications are generally safe if you have a stable heart condition, but they can interact with other drugs, like nitrates.
    • If you are a women who has not gone through menopause, make sure you use an effective birth control.
    • Watch for cardiac symptoms, like chest pain, clammy skin, nausea, and weakness.
    • If you are having sexual problems, such as pain during intercourse in women, discuss this with your doctor. Your sexual health is part of your overall well-being, so it important that you do not ignore these symptoms.
    Also, remember that it is normal to feel some anxiety about having another heart attack, but the risk is extremely low. The more you learn about your condition and your treatment plan, the better you will feel about returning to normal activities, including sex. However, if feelings of anxiety or depression are negatively impacting your life, tell your doctor right away. You can be referred to a therapist who can help you work through your thoughts and emotions and develop effective coping skills. You and your partner can also be referred to a sexual counselor. By taking good care of your physical and mental health, you can recover from your heart attack and again share intimate moments with your partner.

    RESOURCES

    American Heart Association http://www.heart.org

    National Institute on Aging http://www.nia.nih.gov

    CANADIAN RESOURCES

    Canadian Cardiovascular Society http://www.ccs.ca

    Heart and Stroke Foundation of Canada http://www.heartandstroke.ca

    References

    Acute coronary syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 25, 2014. Accessed March 27, 2014.

    Heart attack: tips for recovering and staying well. American Academy of Family Physicians Family Doctor website. Available at: http://familydoctor.org/familydoctor/en/diseases-conditions/heart-attack/treatment/tips-for-recovering-and-staying-well.html. Updated March 2014. Accessed March 27, 2014.

    Levine GN, Steinke EE, et al. Sexual activity and cardiovascular disease: a scientific statement from the American Heart Association. Circulation 2012;125(8):1058-1072.

    Sex and heart disease. American Heart Association website. Available at: http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Sex-and-Heart-Disease%5FUCM%5F436414%5FArticle.jsp. Updated March 2, 2012. Accessed March 27, 2014.

    ST-elevation mycardial infarction (STEMI). EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated March 25, 2014. Accessed March 27, 2014.

    8/12/2014 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Steinke EE, Jaarsma T, et al. Sexual counseling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Applied Professions (CCNAP). Circulation. 2013 Oct 29;128(18):2075-2096.

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