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

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A question that commonly occurs to people who have survived heart attacks is “When can I resume sexual activity?”

This question is one that doctors should offer an answer to without you having to ask, but there’s so much to discuss after a heart attack and so little time to do it that sometimes it gets missed. Don't be afraid to bring up your questions and concerns with your doctor so he or she can address your specific needs. In the meantime, these guidelines should help.

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 doctor 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 the risk in some people with coronary artery disease (CAD).

But also like 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, doctors 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 doctor 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. Some of these problems may be due to medications you may be taking, 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 doctor, 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 doctor 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.

The Bottom Line

In general, normal sexual activity can be resumed within a few weeks of a heart attack. However, because there are important individual considerations to be made, you should discuss your specific case with your own doctor.

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Article Sources
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  • Steinke EE, Jaarsma T, Barnason SA, 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 Allied Professions (CCNAP). Circulation 2013; 128:2075.