Heart attack survivors may be hesitant to hop in the sack. After a heart attack, many people wonder whether it will be safe to resume sexual activity, and if so, when. Sex and Relationships Expert, Matty Silver, looks at the benefits of intimacy after a cardiac event and why you need to talk to your doctor.
In my practice I have spoken to several clients who after having had a heart attack wonder when it will be safe again to resume sexual activity. When I ask them what their doctor said, they usually tell me they were too embarrassed to ask. I wasn’t surprised to hear that. A recent survey conducted by the Heart Foundation found that eight in 10 Australian health professionals believe it’s important to talk to heart attack survivors about sexual activity and intimacy, yet fewer than one in four do so regularly.
Heart Foundation Queensland Health Director Rachelle Foreman said that resuming sexual activity and just as importantly, emotional intimacy are important for quality of life for patients and their partners. “Heart attack survivors are worried about having another heart attack, performance, and over-exertion,” she said “Depression, fatigue, a lack of cardiac fitness, pain or discomfort, and sexual dysfunction, including low libido, can also play a role.
“Two out of three heart attack survivors tell us that having a heart attack had affected their sexual activity, yet only 1 in 4 had spoken with a health professional about it. That’s what prompted us to ask health professionals for their perspective, so that we could provide better information for both patients and health professionals.”
National Heart Foundation Chief Medical Advisor, Professor Garry Jennings, said the new survey results showed that while most health professionals recognise the importance of talking to patients about sex and intimacy, many lacked the time, confidence, protocols or resources to do so. The professionals surveyed felt that GPs and cardiac rehabilitation specialists were best placed to discuss sex and intimacy with patients, followed by cardiologists (re sexual activity) and counsellors (re intimacy).
So when is it safe again to resume sex? Professor Jennings believes it is reasonable to have sex as early as one week after a cardiac event such as a heart attack or angiogram/stent insertion, and six to eight weeks after coronary bypass surgery, when the wound has completely healed. He said “As with any physical activity, it’s important to feel comfortable and progressively increase your level of participation”.
There are some general guidelines:
Having sex takes about the same exertion as having a brisk walk or climbing up two flights of stairs. So, if you can do that level of exercise without getting chest pain or short breath, you probably will be fit enough to have sex. Why not walk together with your partner, which will give you both a chance to rebuild your intimacy and testing your fitness at the same time. Most doctors emphasise that participating in sexual activity in no way increases your chance for a repeat cardiac event.
It may take some time for a sexual relationship to get back to normal. Just having ‘outer-course’ is a great way to feel connected and get intimacy back. Kissing, cuddling, holding hands, mutual masturbation and just skin-to-skin contact will increase your feelings of intimacy. Besides the serotonin and oxytocin – the feel good hormones – the connection and bonding between partners is part of the healing process. Good communication is the key to a loving relationship, discuss with your partner how you feel. Improving your fitness through moderate physical activity will make you feel better and will help you regain confidence.
When you need to avoid stress on the breastbone after heart surgery, some positions may be more comfortable, starting with less strenuous positions such as the missionary position or sitting in a comfortable chair. Sometimes planning to have sex is a good idea, you can create a romantic atmosphere to get in the mood. Often sex in the morning is a good idea as you are usually well rested and not too tired yet.
Some issues may come up for men who had no or few sexual problems before their heart attack; about a quarter will experience some sort of erectile dysfunction after their operation. Erectile difficulties tend to go hand in hand with heart attacks, because the same factors that put you at risk for a heart attack, for example clogged arteries can make you go soft. Most heart attacks occur when a clot sticks in a clogged artery, blocking blood flow to the heart. Most men who have heart attacks also have a buildup in their other arteries – including those that supply blood to the penis. When blood can’t flow freely to your penis, you’ll have trouble getting or keeping an erection.
One on the world’s largest studies examined links between erectile dysfunction and heart disease, found even minor erection difficulties in healthy fit men can be an indicator of future heart risks. The authors of the study, undertaken in Australia and published in 2013 in the online journal PLOS Medicine, examined data of 95,038 men aged 45 years and older. The researchers concluded that erectile dysfunction does not cause heart disease but may be an early indicator of the problems that lead to it, such as a buildup of plaque in the arteries.
These results tell us that every man who is suffering from any degree of erectile dysfunction should be seeking medical assistance as early as possible, and also insist on a heart check by their GP at the same time.
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