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Sex and Coronary Arterial Disease

If you have coronary heart disease (CAD), also known as ischemic heart disease or coronary heart disease, you may wonder if certain physical activities are safe. Step. Run. Golf. Sex?

Some people with CAD, as well as doctors, may hesitate to discuss the last topic. But sex is safe for many people with CAD, and it’s important to your quality of life, says Jonathan H. Whiteson, MD, medical director of cardiac rehabilitation at NYU Langone Health.

“Having sex is defined in many different ways. I prefer the term ‘intimacy’. It is very important for people with heart disease to know that they can be intimate again, whether it is with a partner or on their own, ‚ÄĚsays Whiteson.

The first step is to check if your heart disease is stable. This usually means that any symptoms, such as angina or chest pain, are manageable and do not get worse. CAD is not considered stable if you have recently had a heart attack, a heart procedure or symptoms of aggravation congestive heart failure.

Is your heart strong enough for sex?

If you are bringing your spouse or partner to a cardiology appointment, do not be surprised if they are the first to talk about sex. “Often it’s the partners who bring intimacy to the fore,” Whiteson says. “I’m constantly asked, ‘Can sex hurt my partner?'”

The answer: It depends on the person. As a general rule, however, “if you can walk for 5 to 10 minutes and climb a flight of stairs at the end of it, then intercourse and orgasm are probably safe,” Whiteson says.

And if you can not? Cardiac rehabilitation can help.

It is a medical supervision program that focuses on exercise, heart healthy habits and stress reduction. Since many people first learn about their CAD after a heart attack, they effortlessly switch to a program. You can still participate even if you have not had an acute event, but you may need to ask your doctor for a prescription. Either way, most insurers will cover the cost if you have CAD.

The American Heart Association’s scientific statement on sexual activity provides these guidelines:

  1. If you have frequent or very painful angina, a type of chest pain caused by poor blood flow to the heart, wait to have sex until your doctor says your condition is stable.
  2. It may be safe to resume sexual activity as soon as a week after a mild heart attack, as long as you do not have heart symptoms such as chest pain.
  3. Sexual activity can be 6-8 weeks after standard coronary artery bypass surgery if your incision has healed well.

Ways CAD Can Affect Your Sex Life

Even if you are physically ready, CAD can dampen your sexual desire or make it harder to get aroused or have an orgasm. If you are having trouble getting an erection, it could be related to the same thing that is endangering your heart: clogged vessels that restrict blood flow, says Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine. But he points out that your erectile dysfunction (ED) may be due to other problems, such as:

  • Complications of diabetes, which are also common in CAD patients
  • Psychological factors, including fear of a heart attack
  • Medications, including certain antidepressants

Erectile dysfunction can often be reversed or improved, either with ED medication or by treating your underlying conditions better.

Meanwhile, depression is common among both men and women with CAD, and this mood disorder can lead to problems with arousal, lack of interest in sex, and inability to reach orgasm. If you think you may be depressed, talk to your doctor. Some treatments for depression, such as regular exercise, can do double work by strengthening your heart.

Anxiety is also common in people with CAD. For example, you may be worried that sexual intercourse may cause a heart attack. But as long as you are physically healthy enough to have sex, climax is unlikely to be dangerous.

As Whiteson points out, “the heart does not know if you have intercourse or if you are walking around a track.”

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