When It's Safe to Resume Sexual Activity After a Heart Attack

After a heart attack, once things have stabilized a bit, it is natural to begin wondering about when it is safe to resume sexual activity.

This question is one your healthcare provider should answer for you as a matter of course, without waiting for you to ask. But there’s so much for healthcare providers to discuss with you after a heart attack, and so little time to do it, that sometimes this vital question gets missed. Don't be afraid to bring up your questions about sexual activity (and any other concerns you may have) with your healthcare provider, because it’s important for him or her to give you individualized answers. In the meantime, these guidelines should help.

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When It's Safe to Have Sex Post-Heart Attack

The timing of sex after a heart attack depends on your individual situation. Cardiovascular health varies considerably among people who have had heart attacks, so you'll need to talk to your healthcare provider for specific recommendations. But here are some general observations you should be aware of.

The effect of sexual intercourse on the cardiovascular system is very similar to the effect of moderate exercise. In particular, it is roughly equivalent to walking 2 to 4 miles per hour on a level surface. So it should not be surprising that, like exercise, sexual activity can transiently increase cardiac risk in some people with coronary artery disease (CAD).

But just as with exercise, with appropriate precautions sexual activity after a heart attack is something that is usually quite safe, and (because it contributes to well-being, solidifies the bond between you and your partner, and helps to prevent depression), ought to be encouraged.

General Guidelines

In general, healthcare providers ask people to avoid sexual intercourse for 4 to 6 weeks after a heart attack — the period of time that most of the healing occurs in the damaged heart muscle.

During this healing time, you should be receiving medications to help your heart heal, to prevent the progression of atherosclerosis, and to prevent another heart attack or other form of acute coronary syndrome.

In addition, you should be participating in a cardiac rehabilitation program, which helps your cardiovascular system to tolerate the moderate levels of physical exertion you will experience during everyday life — and during sex.

If you do all of these things, by the time you are ready to resume sexual activity, your cardiovascular system will be prepared for it — and you will be practicing “heart-safe sex."

Special Considerations

Certain individuals after a heart attack — those who have developed heart failure, who have blood pressure problems, who are having continued angina, or who have other complications — may need to avoid sexual activity for longer periods of time, while their medical problems are being fully stabilized. If you are one of these people, you will need to work with your healthcare provider to determine when you are stable enough to resume sexual activity.

Sexual Dysfunction After a Heart Attack

It is common for men to suffer some degree of erectile dysfunction after a heart attack, and for both men and women to experience a decrease in the desire for sex. In fact, studies suggest that women experience a greater loss of sexual desire after a heart attack than men. Some of these problems may be due to medications you may be taking, to smoking, or to poorly controlled hypertension — but more often they are due to anxiety, depression, or fears about having another heart attack during sex.

These kinds of psychological issues most commonly resolve on their own after a month or two, as you regain confidence in your abilities to function normally in all the other aspects of your life. (Once again, a cardiac rehab program can be very important in rebuilding your confidence.) But if these issues persist, it will be useful to discuss them with your healthcare provider, as they can almost always be treated effectively.

In men, medications for erectile dysfunction — such as Viagra (sildenafil), Cialis (tadalafil) and Levitra (vardenafil) — are usually very effective. These medications can be used safely in most men with CAD, with one important exception: If you are taking nitrates for angina, then taking any of these medications for erectile dysfunction can produce a dangerous drop in blood pressure, and they simply cannot be used. However, if your CAD is considered to be stable and you are not taking nitrates, your healthcare provider will probably be happy to allow you to take one of these drugs for erectile dysfunction.

Here’s an additional warning: If you are taking Viagra, Cialis or Levitra, you should not take nitrates even if you have an episode of angina. Instead, you should stop all activity, rest, and wait 10 minutes. If the chest pain is not gone after 10 minutes, call 911.

A Word From Verywell

Normally, sexual activity can be resumed within a few weeks after a heart attack, once you are on a good medical regimen and have participated in cardiac rehabilitation. However, because there are important individual considerations to be made, you should discuss your specific case with your own healthcare provider.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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By Richard N. Fogoros, MD
Richard N. Fogoros, MD, is a retired professor of medicine and board-certified in internal medicine, clinical cardiology, and clinical electrophysiology.