Sex and the heart

Having heart disease does not mean the end of an enjoyable, satisfying sex life.

For anyone who was previously sexually active, failing to resume sexual enjoyment may cause unnecessary frustration, irritability and marital discord. This applies to men and women in heterosexual relationships and the gay community. It is a long-standing stable sexual relationship that is important and, if it existed before the heart problem was detected, it should continue afterwards. Casual sex may be more stressful to your heart and this is discussed in a question below.

A new relationship developing after heart disease that has been diagnosed in one or both partners should not present problems providing it has none of the dangers of a casual encounter. Relationships based on trust, understanding and love are not casual, and as they develop, no undue stress is placed on the heart. Above all else, if you are involved in a loving new relationship, do not let your anatomical heart interfere with your emotional and happy heart!

QUESTIONS YOU MAY FIND DIFFICULT TO ASK YOUR DOCTOR

What happens to my heart when I am making love?

If you become aroused, your heart rate begins to increase and you breathe a little faster; as the excitement increases, both the heart rate and the blood pressure increase, reaching their peak at orgasm and settling back to resting levels after about three minutes' rest. The average duration of sex is 15 minutes and the heart is really only stressed for 3 minutes.

If the heart rate is increasing, is sex stressful to the heart?

Sex is just another form of exercise as far as the heart is concerned. We have already said (in Chapter 3) that angina pain can be brought on by exercise, so pain could occur during sex, but the important point is that sexual activity is no more stressful to the heart than other normal daily activities. In one study using tape recordings of the heart beats during sex, the heart rate averaged 120 beats per minute and was less than that often seen during other daily activities. In another study, the blood pressure rise was not found to be dangerous or exaggerated.

The stress to the heart during sex is the same as 4 minutes on a treadmill exercise ECG. If you can do more than 4 minutes on that, making love should be OK. If your partner needs to be reassured, ask the doctor to arrange for the exercise ECG test to be performed in the presence of your partner.

Is casual sex more stressful to the heart than with a partner in a long-term relationship?

Yes, casual sex can be more stressful. Long-standing relationships, where people are comfortable with each other, should present no problem, but a casual encounter can lead to a greater heart rate rise. This is not harmful to a normal heart, but if coronary disease is present, problems may occur. There may be an age mismatch (older man, younger woman) and the environment unfamiliar (a hotel room), following too much food and drink (casual sex at an office party). 'Playing away' can therefore be risky.

You sometimes hear horror stories of people dying while they are making love. Are these stories true?

You can die at any time and this includes during sex! The risk during sex is very low indeed and no higher than during other normal daily activities. However, it may be significant that, of those who die or have a heart attack during sex, 75% are having extramarital sex, and 95% are men: so the advice is, beware!

I had a heart attack recently. How soon can I start making love again?

After a heart attack, providing there were no complications, sexual activity can be resumed in 2-3 weeks. Ask your doctor and use a stairs, walking or treadmill test (see below) as your guide. The advice is the same whether the patient is male or female.

Sex is normal and not unduly stressful for couples with a longstanding relationship and should be enjoyed as much by those with heart disease as those without. As you recover from a heart attack and return to normal activities, you should be able to return to the normal activity of sex.

 
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