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Heart disease and intimacy

The Issue

If you have had angina, heart surgery, or a heart attack, you may:

  • Wonder if and when you can have sex again
  • Have different feelings about having sex or being intimate with your partner

Almost everyone with heart problems has these questions and concerns. The most helpful thing you can do is talk to your health care providers, spouse, partner, or friends.

When is it Safe?

Both you and your provider may be concerned that having sex will bring on a heart attack. Your provider can tell you when it is safe to have sex again.

After a heart attack or heart procedure:

  • You may have an exercise test, to see how your heart reacts to exercise.
  • Sometimes, at least the first 2 weeks or so after a heart attack, your provider may advise avoiding sex.

Make sure you know the symptoms that could mean your heart is working too hard. They include:

  • Chest pain or pressure
  • Feeling lightheaded, dizzy, or faint
  • Nausea
  • Trouble breathing
  • Uneven or fast pulse

If you have any of these symptoms during the day, avoid sex and talk to your doctor. If you notice these symptoms during (or soon after) having sex, stop the activity. Call your provider to discuss your symptoms.

Can you Be Intimate?

After heart surgery or a heart attack, your provider may say it is safe to have sex again.

But your health issues may change the way you feel about or experience sex and close contact with your partner. Besides being worried about having a heart attack during sex, you may feel:

  • Less interested in having sex or being close with your partner
  • Like sex is less enjoyable
  • Sad or depressed
  • Feel worried or stressed
  • Like you are a different person now

Women may have trouble feeling aroused. Men may have trouble getting or keeping an erection, or have other problems.

Your partner may have the same feelings you are having and may be afraid to have sex with you.

Talk to Your Doctor

If you have any questions or concerns about intimacy, talk to your health care provider. Your provider can help you find out what is causing the problem and suggest ways to deal with it.

  • It may not be easy to talk about such private things, but there may be a treatment that could help you.
  • If you find it hard to talk to your heart doctor about these topics, talk to your primary care provider.

If you are depressed, anxious, or afraid, medicine or talk therapy may help. Classes in lifestyle change, stress management, or therapy may help you, family members, and partners.

If the problem is caused by side effects of medicine you are taking, that medicine may be adjusted, changed, or another medicine may be added.

Men who have trouble getting or keeping an erection may be prescribed a medicine to treat this. These include medicines like sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis).

  • The above medicines may not be safe if you are taking other medicine. DO NOT take them if you are taking nitroglycerin or nitrates. Taking both kinds of these medicines can lead to a life-threatening drop in blood pressure.
  • DO NOT buy these medicines through the mail or another doctor who does not know your full health history. To get the right prescription, talk to the doctor who knows your health history and all the medicines you take.

When to Call the Doctor

If you have new symptoms of heart trouble during sexual activity, stop the activity. Call your health care provider for advice. If the symptoms do not go away within 5 to 10 minutes, call 911.

References

Morrow DA, Boden WE. Stable ischemic heart. In: Mann DL, Zipes DP, Libby P, Bonow RO, Braunwald E, eds. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 10th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 54.

Steinke EE, Jaarsma T, Barnason SA, Byrne M, et al. Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP).Sexual counselling for individuals with cardiovascular disease and their partners: a consensus document from the American Heart Association and the ESC Council on Cardiovascular Nursing and Allied Professions (CCNAP). Eur Heart J. 2013;34(41):3217-3235. PMID: 23900695 www.ncbi.nlm.nih.gov/pubmed/23900695.


Review Date: 2/24/2016
Reviewed By: Michael A. Chen, MD, PhD, Associate Professor of Medicine, Division of Cardiology, Harborview Medical Center, University of Washington Medical School, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
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