Resuming physical activity, including sexual activity, following heart surgery takes time and patience. When this question comes up with my patients there are several considerations that I usually address.
First, patients must have adequate overall cardiopulmonary conditioning to participate in sexual activity. Generally speaking, if the patient can climb a flight of stairs or walk a half-mile at a steady pace, this is an adequate activity level for most people to resume sexual activity.
The second issue pertains to mechanical stress on the incision. If a standard mid-line sternal incision was used, it will be important not to put strain on the breast bone while it is healing during the first eight weeks. Many patients are able to use positions that avoid stress on the breast bone such as the patient remaining on his or her back. If the patient had robotic or other minimally invasive heart surgery, where the breastbone or ribs were not divided, the schedule of returning to activity may be faster.
Lastly, patience and awareness that some medications may interfere with sexual function are important. Common pain medications and a class of drugs known as beta blockers are used frequently after heart surgery and may have side effects affecting sexual performance and function. If this becomes a concern, ask your doctor to review your medications with you to determine if they may be contributing to any difficulties.
More Answers from Daniel O'Hair, MD