Sex after a heart attack

By Madeleine Castellanos, M.D.

The health benefits of sex are many: it cuts your risk of heart attack or stroke, it burns calories, it boosts your immune system, it soothes nerves and not only is this activity good for your health but it feels fantastic too.

But what if you've already suffered from a heart attack? Do the benefits still exist? Will sex push you over the edge? When is it safe to have sex again, and how cautiously should you proceed?

It's no surprise that many heart attack survivors worry about rebooting their sex lives after a hospital stay. Aside from performance anxiety, the majority of survivors experience post-heart attack depression and anxiety, which is understandable considering how helpless a heart attack can make you feel. Despite your best intentions, and your most careful preventative measures, you've been betrayed by your body. Will it happen again? Can you even hope to stop it?

Still others worry that sex in particular will cause another heart attack and, quite possibly, death. We've all heard those bizarre stories of sex-induced death, courtesy of the tabloid rumor mill.

In reality, sex only raises the heart rate to about 130 beats per minute. Blood pressure also rises, but just a little. This rise in heart rate and blood pressure is actually comparable to the exertion you experience during many of the routine, physical activities you do throughout the day, such as carrying in the groceries or trudging up a set of stairs. If you can already do these activities without feeling tightness in your chest or shortness of breath, you're probably good to go. (If it makes you feel any better, sudden death during sex is extremely rare, less than one percent of heart attacks are attributable to sexual activity.)

Still, it's smart to show caution. Have a chat with your doctor before resuming your regular sex routine. Your doctor will most likely give you the green light within four to six weeks after your heart attack and stable heart attack patients may even be able to return to sexual activity within a couple of weeks.

But bypass patients, for example, may have to wait longer to resume regular sexual activity. They may also be advised to avoid positions that put added pressure or weight on the sternum for at least six to eight weeks. During this time period, a side-by-side position may be smarter.

And all patients should have sex only when they're feeling rested and relaxed.

A cardiovascular workout can be helpful for getting you back into shape (for activities both in and out of the bedroom). 

How? A good program can improve your heart's ability to function, lower your heart rate and reduce your risk of heart-related complications in the future.

"But before you run your next 5K, consider entering a structured cardiac rehabilitation program," says Logan Levkoff, a sex educator and author of How to Get Your Wife to Have Sex With You. "A health professional will be able to develop an exercise program just for you, based upon your fitness level and the severity of your heart disease, that includes both strength training and aerobic exercise. Later on, you'll gradually be able to increase the intensity your workouts (and the intensity of your sexual gymnastics)."

So don't let your heart condition ruin your sex life. Instead, let your sex life improve your heart condition.

Just remember to be smart about it.

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