When is it safe to have sex after a heart attack?

Having and surviving a heart attack will be a life-changing event.  The fear, worry, and anxiety-driven thoughts and feelings can consume both the person who had the heart attack and their partner. 

After surviving a heart attack, there will be many questions a person will want to discuss with their doctor.  One question that should be asked and discussed but often isn’t, is when can I resume sexual activity after a heart attack?

The avoidance of bringing up the topic of sex after a heart attack with a physician usually stems from embarrassment.  Without this communication, some patients may develop sexual problems like low libido or erectile dysfunction for men that can delay returning to their normal sex lives. A study published online by JAMA Cardiology found that among 2,800 participants, those who did not have a discussion about sex in the first month after a heart attack, were significantly more likely to delay resumption due to higher levels of stress or diabetes.

Besides, some patients feel if the physician doesn’t bring it up then it must not be an issue.  But this should not deter anyone, man or woman, who has had a heart attack from having a frank discussion on this important part of their life. You will want and need to know the timeline for moving forward with sex since it is an individualized situation for any heart attack survivor. You will also want to know if there are any symptoms or warning signs to look for during sex that may require medical attention.

When we engage in sex, it is comparable to the effect of moderate exercise of walking 2-4 miles per hour on a level surface or climbing two staircases.  But according to a study in the issue of the Journal of the American College of Cardiology, sex does not appear to trigger a heart attack.  Researchers looked at 536 heart attack survivors, ages 30 to 70 and evaluated their sexual activity 12 months prior to their heart attack. After a 10-year follow up the study found an average of about 3% heart-related events occurred making it unlikely that sexual activity is a relevant trigger of heart attacks. 

But just like exercise, there needs to be appropriate precautions on sexual activity after a heart attack to avoid the unlikelihood but always a possibility of any kind of a heart-related event during sex.  It is important to remember that each heart attack survivor has their own unique special considerations that need to be taken into account on regarding when is it ok to return to having sex.

Guidelines for sex after a heart attack

·      Generally, most doctors advise to refrain from sexual intercourse for at least 2weeks after a heart attack, if there are no serious complications.  This allows time for the damaged heart muscle to heal.

·      During this time is when most heart attack survivors will be participating in a cardiac rehabilitation program.  This is to help the heart and cardiovascular system to return to tolerating physical exertion in everyday life including sex.

·      Some patients with heart failure, hypertension, angina or other complications may need to avoid sexual activity for a longer period of time until they are more stable.  Let your doctor determine when it is safe for you to return to sexual activity.

·      It is common for men to have some erectile dysfunction after a heart attack and for both men and women to have a lack of interest in sex.  These issues could be due to medications, anxiety, depression or fears of having another heart attack during sex.

·      Men with erectile dysfunction can usually use Viagra or Cialis unless taking nitrates for angina which can cause a dangerous drop in blood pressure.  Discuss with your doctor on whether these medications would be appropriate. 

When heart attack survivors follow their doctor’s guidelines and recommendations on recovering from a heart attack, they are more likely to be able to return to sexual activity within a few weeks once their heart can handle it.