Is sex after a heart attack dangerous?

Less than 20 percent of heart attack survivors get advice from their physician on whether or not they can resume sexual activity, and what information they do get is often incorrect, according to a newly published study.

About 90 percent of the patients included in the study said they thought it would be appropriate to talk about sexual health and activity with their doctor, but only 12 percent of women and 19 percent of men reported having this discussion with their physician within a month of their heart attack.

Among the patients that did get counseling on sexual activity, they indicated that health care providers recommended restrictions on sexual activity in about 70 percent of cases, including limiting sexual activity, taking a passive role and maintaining a lower heart rate.

The researchers noted that these recommendations “were inconsistent and only weakly related to patient characteristics.” They also noted that “neither strong evidence nor clinical guidelines support the specific kinds of sexual activity restrictions patients received.”

Dr. Faheem Ahmad, a cardiologist at Advocate South Suburban Hospital in Hazel Crest, Ill. says that these findings should spur a new level of communication between patient and physician.

“After a heart attack, there are many issues to contend with,” says Dr. Ahmad. “And, sexual activity needs to be one of the subjects addressed, as it is a major quality of life issue for many people.”

He says physicians need to make time for the subject, and patients and their partners need to put aside any embarrassment.

“Physicians need to pay attention to this study and realize that they may not be meeting all of their patients’ needs,” he says. “I believe that this research should prompt physicians to directly ask every heart attack patient if they have any questions about resuming sexual activity.

Dr. Ahmad points out that recently the American Heart Association (AHA) has published a scientific statement on sexual activity and cardiovascular disease that lays out many recommendations that can assist physicians and patients decide on a sensible plan of action and timeline.

He echoes the AHA’s general advice on sexual activity after a heart attack or for those living with heart disease:

• If you’ve had heart failure or a heart attack, cardiac rehabilitation and regular physical activity can reduce the risk of complications related to sexual activity.
• Ask your doctor to evaluate you before resuming sexual activity.
• If you’re experiencing sexual dysfunction, check with your doctor to see if it could be related to cardiovascular disease or to anxiety, depression or other factors.
• Don’t skip the medications that could improve cardiovascular symptoms because you’re concerned they could impact your sex drive or function. Your heart health should come first.