Published: September 02, 2008 11:26 pm         

Are you healthy enough for sex?

Six months after his heart attack, Dave did not want to even think about sex. Sam was ready to jump back into action before the stitches from his heart surgery had healed.

Sam is the target of the ads you hear on TV: “Some men are not healthy enough for sex.” In fact, the majority of men — and women — are healthy enough for sex even if they recently have undergone heart surgery or survived a heart attack or stroke.

Of course, your heart pounds a little faster at the mere thought of sex, and you may feel slightly breathless when it’s over. Sex is exercise, after all – the equivalent of a brisk 20-minute walk. An orgasm stresses the heart about the same as a climb up one flight of stairs.

Except during the first few weeks of recovery from a heart attack or surgery (when your doctor may warn you against certain activities), that’s ordinarily not too much stress for the heart.

Probably because it does challenge the heart in the same way that exercise does, sexual activity generally is considered good for the cardiovascular system. Data compiled by researchers at Massachusetts General Hospital concluded the risk of a fatal heart attack brought on by sexual activity was one in 50,000, even for a person with heart disease and one in 500,000 for a healthy person.

Other studies have found a wide range of health benefits for both men and women associated with sexual activity. Researchers have linked sex to better immune protection and to a lower risk of prostate cancer. One study found men with more frequent ejaculations (21 or more a month) had a lower risk of prostate cancer compared to men with four to seven ejaculations monthly.

After a heart attack, stroke or heart surgery, all of that may change. According to Dr. Miriam Stoppard in “The Magic of Sex,” fewer than 25 percent of heart attack patients return to the same level of sexual activity they enjoyed before the attack.

You may have heard stories of heart fatalities during love-making. They are tailor-made for office rumors and tabloid journalism. In reality, only about one half of one percent of fatal heart attacks occur after sexual activity, and 80 percent of these involve extramarital affairs or persons having sex with much younger partners.

Aside from the fear of death, there are many other reasons why heart patients may have a difficult time resuming sex. Sex drive may be reduced by the illness, and some heart medications such as beta blockers can also contribute to loss of libido in either men or women. This is a side effect that should be reported; in most cases, another medication can be substituted.

Erectile dysfunction is frequently associated with cardiovascular disease, and the ED drugs, Viagra, Cialis and Levitra are not indicated for men taking nitrates for heart-related chest pain. The combination can cause a life-threatening drop in blood pressure.

Depression, performance anxiety and other emotional after-effects are common following a heart attack or heart surgery. The patient may be preoccupied with his or her health during this period; in comparison, sex may be perceived as a trivial matter.

Emotional problems are to be expected with any major illness, but in the majority of cases they start to fade within about three months. Talk to your doctor if they persist for a longer period.

Although some individuals feel they can get by quite well without sex, that feeling is not necessarily mutual within a marriage. For good health as well as marital harmony, it’s important to make a special effort to resume sexual activity. In some cases, this may mean altering your routine and expectations.

If you develop chest pain, extreme shortness of breath or an irregular heart beat, stop what you’re doing and rest until the problem passes.

Sex is one of the most important issues to address after a heart attack, according to heart expert Dean Ornish, M.D., author of “Love and Survival: Eight Pathways to Intimacy and Health.” After surviving a major threat to your life, it’s time to start putting your life back together.



Rupp is information and assistance case manager with the Northern Oklahoma Development Authority Area Agency on Aging.