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Sex after a Heart Attack

Not every ailment is visible, and one of the most common problems that affect sexual functioning is a heart attack.

Overcoming fear

You may well have heard rumors of famous men who died because of a heart attack while in the throws of passion. For the average person who suffers a heart attack or undergoes heart surgery or even has angina, problems with sex almost always result. It's not that these people don't want to have sex; it's that they're afraid. They worry that, as a result of engaging in intercourse or having an orgasm, they will trigger another heart attack — this time, a fatal one.

This is not a groundless fear. Certainly, for a time after you had a heart attack, your doctor may not allow you to have sex. But just because you're given the green light, doesn't mean that you will feel ready. It doesn't take much to make a man lose his ability to have an erection, so you can imagine that the fear of provoking a heart attack would certainly be sufficient to cause impotence. For women, the usual problem is anorgasmia, the inability to have an orgasm, which is equally understandable.

The best treatment for fear of sex after a heart attack is reassurance by your physician or cardiologist. This should take place in the hospital while you are still recuperating. Sexual performance is almost always a concern of someone who has had heart problems; it helps speed recovery if your fears can be alleviated as quickly as possible. If you need further tests to determine what you can and cannot do, then, by all means, you should get them. No doctor should consider the loss of sex as no big deal, because it is a big deal — not only for the patient, but also for the patient's partner.

Some experts believe that one way to overcome the fears associated with sex is to make masturbation the first step and slowly work your way up to intercourse. Masturbation is also something that you can perform on your partner so that he or she doesn't have to be sexually frustrated during your recovery.

It may not all be in your head

Fear isn't the only factor that could be causing impotence. Heart problems are usually accompanied by vascular problems, and — because a man's erection is caused by blood flowing into the penis — sometimes the impotence a man experiences after a heart attack has physical rather than mental causes.

Angina, shortness of breath, and palpitations are problems associated with heart conditions, and, although they may not be deadly, they can certainly put a crimp in your sex life. Very often these symptoms show up after you've had an orgasm, during the period that your heartbeat is on its way down. Now, if every time you have an orgasm you get an angina attack, which is a sharp pain in the chest area, then that's not going to improve your desire for sex, is it? Here, again, you should consult with your physician or cardiologist. Don't be ashamed to ask specific questions. Your doctor may have suggestions that can help you have a relatively normal sex life, and you have every right to find out.

What can you do?

Here are some specific tips that may help you if you have heart trouble.

  • If you have a heart condition, don't engage in sexual activity when you're angry or under a lot of stress. At these times, the heart is already beating faster, and sex would only tax its abilities even more.

  • See if one of the new drugs like calcium channel blockers or beta-blockers can be prescribed for you. These drugs can make sex easier on your heart.

  • Some heart patients decide for themselves to take their medication, like propranolol (Inderal) or nitroglycerin, before having sex, thinking that they can prevent heart troubles. Do not attempt such techniques without first checking with your physician. (Propranolol is used on a schedule, so taking it out of schedule could be risky.)

The medications that are prescribed for heart conditions, such as beta-blockers, antihypertensives, and diuretics, can cause sexual functioning problems of their own. Sometimes your doctor can prescribe alternative medicines that will still be effective without getting in the way of your sexual functioning, so ask questions of your cardiologist.

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