Is your heart ready for sex?
When is it safe to resume intimacy after a heart attack or surgery?
- Reviewed by Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
Not only does sex feel good, it's also good for your heart. Maintaining an active sex life helps lower blood pressure, improve circulation, and boost levels of oxytocin, a hormone that relieves stress. But how do you know if your heart is healthy enough for sex after stressful events like a heart attack, heart procedure, or heart surgery?
"Most men can resume their usual sex life after dealing with these heart issues," says Dr. Jason Matos, a cardiologist with Harvard-affiliated Beth Israel Deaconess Medical Center. "Of course, it depends on the person's prior level of fitness and the specifics of the heart event. By following their doctors' guidance on increasing exertion gradually during recovery, men can reengage in an active and enjoyable sex life."
Sex after a heart attack
Most men can resume regular sexual activity after a heart attack once they can engage in mild-to-moderate physical activity without experiencing marked fatigue, chest pain, or shortness of breath, according to Dr. Matos. A good benchmark is 10 to 20 minutes of brisk walking or climbing two flights of stairs without stopping. "However, this can depend on the severity of the person's heart attack and other related health issues," says Dr. Matos. "Your doctor may adjust this guideline based on your condition."
Some couples avoid intimacy because of the fear of having another heart attack or damaging the heart during intercourse. But sex is not regarded as a vigorous activity. (See "How strenuous is sex?".) "Still, always stop during intercourse if you feel symptoms like chest pain, shortness of breath, or dizziness," says Dr. Matos. Don't be surprised if it takes a while to feel comfortable again engaging in sex. Be open with your partner if you experience performance issues or less enjoyment. If your doctor doesn't ask about your sex life, feel free to raise the subject and ask for advice.
How strenuous is sex?During intercourse, a man's heart rate rarely gets above 130 beats per minute, which is equal to mild-to-moderate-intensity exercise. As for oxygen consumption, having sex is similar to raking leaves or playing Ping-Pong. Sex also burns about five calories a minute, on par with casual walking during a round of golf. |
Sex after angioplasty
The timing to resume sex varies after angioplasty with stent placement (a procedure used to open a blocked heart artery and restore blood flow). It depends in part on where the doctor inserted the catheter that carried the stent to your heart. When a catheter is inserted in the upper leg, you need to wait longer before physical activity (including sex) than if the catheter went through an artery in the arm.
Another factor is the reason you had the procedure. If you had the angioplasty electively to relieve symptoms of chest pain with exertion (angina), you likely can resume sex within a week after the procedure. If it was performed during a heart attack to limit heart damage, your doctor will likely recommend you wait a bit longer.
Sex after heart surgery
The general approach to sex after a heart attack also applies to coronary artery bypass surgery or open-heart surgery. However, you should delay sex until your breastbone has healed, which usually takes a minimum of six weeks. For several months after surgery, you should avoid positions that place stress on your chest.
Heart medications
Some heart medications also can affect sexual activity, and you should check with your doctor if problems arise. For instance, beta blockers such as metoprolol (Lopressor) can lower libido, contribute to erectile dysfunction, and sometimes delay ejaculation. "But a man's energy level usually improves over time," says Dr. Matos. Your doctor may prescribe a nitrate medication, such as nitroglycerin and isosorbide, to relieve or prevent chest pain. They work by relaxing coronary artery walls, thereby increasing blood flow. However, they should not be taken along with erectile dysfunction drugs, such as sildenafil (Viagra) or tadalafil (Cialis), because the combination can cause a dangerous drop in blood pressure.
Other issues
You should also address any lingering heart disease risk factors, such as high blood pressure and excess weight. "It's not that you can't have sex with these issues, but it's better for your health to get them under control," says Dr. Matos. If you have other heart conditions, like an abnormal heart valve, heart failure, or an uncontrolled abnormal heart rhythm, speak with your doctor about when to resume sex.
Image: © BlackCAT/Getty Images
About the Author
Matthew Solan, Executive Editor, Harvard Men's Health Watch
About the Reviewer
Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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