The majority of people diagnosed with heart disease after a heart attack or heart surgery have very real concerns about returning to sexual activity. This issue often gets buried in a long list of questions for the doctor or is difficult to bring up.
The good news is that fitness can improve your motivation and confidence to resume your sex life, and the cardiovascular risks surrounding sexual activity and heart disease are comparatively low.
According to a scientific statement by the American Heart Association, "sexual activity and function are common in patients with cardiovascular disease and are often interrelated with anxiety and depression."
There is also the underlying decrease in blood flow associated with cardiovascular disease that may have a negative effect on sexual performance. In fact, blood vessel problems are the leading cause of erectile dysfunction. According to Harvard's Dr. Michael P. O'Leary, the medical editor of "Erectile Dysfunction," in a special health report from Harvard Medical School, erections "serve as a barometer for overall health." Erectile dysfunction can be an early warning sign of trouble in the heart or elsewhere. Because of this, it's important to bring sex up with your doctor in order to assess and understand your situation.
The good news is that fitness can improve your motivation and confidence to resume your sex life, and the cardiovascular risks surrounding sexual activity and heart disease are comparatively low. The American Heart Association's statement outlines specific cardiac conditions and how to evaluate if sexual activity is recommended. It points to studies of young married men that found that sexual activity with a person's usual partner is comparable to "mild to moderate physical activity in the range of 3 to 4 metabolic equivalents (METS; ie, the equivalent of climbing 2 flights of stairs or walking briskly) for a short duration," noting that "heart rate rarely exceeds 130 bpm and systolic blood pressure rarely exceeds 170 mm Hg in adults with otherwise normal blood pressure."
If you are older, less conditioned, or have a more complicated history of heart disease, the intensity may be slightly higher. Therefore, it is probably more reasonable to equate sexual activity to mild to moderate physical activity in the range of 3 to 5 METS.
With increasing research, the message is becoming clear: For most people with uncomplicated heart disease, the risk of angina, arrhythmia or death is relatively low during sexual activity and comparable to the risk associated with mild to moderate physical exertion. We know that fitness plays a key role in reducing our day-to-day risk of cardiovascular complications, and the more fit we are, the lower our risk of heart attack or sudden death during sexual activities. Being fit will also make sex more enjoyable, because it will allow for more subtle changes in heart rate and blood pressure.
As always, for the most accurate information relevant to your situation, please ask your personal physician for his or her advice about when to resume sexual activity.
If you or your partner has heart disease, what have you experienced in trying to resume your sexuality activity?
Originally publishing in Ornish Living.