Can your heart handle sex?

What exactly is heart disease?

Imagine the heart as a pump. It receives incoming blood from the whole body through the veins, then pumps it back out to the body through the arteries. It regulates its pumping action with a complex arrangement of electrical controllers called pacemakers. The term "heart disease" can encompass any condition that affects the vessels, the pacemakers, or the heart muscle itself.

A significant component of heart disease is "atherosclerosis," or narrowing of the arteries of the heart muscle itself. When arteries become clogged with a material called plaque, caused by deposition of fatty materials, blood flows less freely and the tissues supplied by those arteries die. When that tissue is the heart, the resulting condition is known as a myocardial infarction, or heart attack.

The survival and well-being of the patient depends on how much of the heart muscle dies. The prognosis for people who have had a heart attack is drastically improved over previous decades, due primarily to newer medications and advances in surgical procedures, of which the most invasive is bypass surgery.

Physician advice for people with heart disease

Although people can safely resume sexual activity at some point after a heart attack or bypass surgery, only one in four men return to previous levels of sexual activity, according to Dr. Miriam Stoppard in The Magic of Sex. This has more to do with anxiety of the patient and his partner than with physical limitations, according to Dr. Jack Gillis in the The Heart Attack Prevention and Recovery Handbook. Gillis writes that most patients can safely resume sexual activity three to eight weeks after heart attack or bypass surgery. Sexual activity is no more dangerous to the heart than climbing up three flights of stairs. Of course, the patient should consult his or her cardiologist prior to resuming sexual activity.

So many of his patients had questions about sex that Miami cardiologist Dr. Eduardo Chapunoff has written an entire book on this subject, Sex and the Cardiac Patient, in which he outlines ten considerations for resuming sex after a heart attack.

10 rules for resuming sex after a heart attack

1. Obtain clearance from your doctor.

2. Watch for cardiac symptoms (fatigue, nausea, shortness of breath).

3. Prevent psychologically stressful situations.

4. Avoid excessive physical demands.

5. The room should be temperature-controlled and well-ventilated.

6. Avoid sexual intercourse for at least two to three hours after eating or after consuming alcohol.

7. Take all medications correctly.

8. Seek medical advice when necessary.

9. Pay attention to your partner.

10. Maintain a sense of humor.

In The Heart Attack Handbook, Dr. Joseph Alpert has additional recommendations for making sex after your heart attack just as enjoyable as it was before. The recommendations apply to both men and women.

• Allow ample time for foreplay.
• Consider just being intimate without intercourse at first, until both partners are comfortable.
• Start with positions that require less energy, such as with your partner on top or the "side" (lateral) position.
• Reduce sexual activity if you develop rapid heart rate or rapid breathing lasting longer than 30 minutes after sex, or severe fatigue or insomnia the day after sex.
• For those heart patients without partners, the return to masturbation (the current medical term is "solitary sexual behavior") is the same as for sex with partners. Dr. Chapunoff recommends masturbation as very practical, because "it is always at hand!"

Heart disease is not the end of sex

Most of the post-heart attack anxiety is the fear of having a heart attack during sex. Only six of 1,000 heart attack sufferers die of heart attacks during sex, and 80% of those are cheating when they die! Sounds like illicit sex can be particularly hazardous to heart patients!

Having a heart attack and/or bypass surgery is a very traumatic experience. But with time, patience, and an understanding and sympathetic partner, there is no reason why people with heart conditions can't enjoy satisfying love lives.