Sex After a Heart Attack

Avoid the sex slip-ups that could land you back in the ER.

Sex After a Heart Attack

After your heart attack, you probably asked your doctor smart questions about eating right and working out. But there’s one topic that you may have brushed over: when it’s safe to hit the sack. And you’re not alone, less than 20 percent of people work up the nerve to ask about sex after a heart attack.

Don’t let shyness stand in the way of you feeling like yourself again. A satisfying sex life is key to both emotional and physical health and can be an important part of your recovery.

The case for speaking up
You can’t just Google, “when is it safe to start having sex again?” because every recovery is unique. The answer will depend on different factors like the medicines you’re taking and how much activity you can do. Many people get the green light from their doctor to have sex after about two weeks following their heart attack. But first, you may need to complete exercises that are just as stressful to your heart as sex to make sure you’re ready.

These exercises may include:

  • Climbing two flights of stairs at a brisk pace
  • Walking on the treadmill at about three-to-four miles per hour

Lots of couples are nervous in the bedroom after one of them has a heart attack. You or your partner might be afraid of making your condition worse. While it’s rare for sex to cause a heart attack—less than 1 percent of cases—taking the proper tests and getting cleared can help put your mind at ease.

Conquer your sex fears
Even with reassurance from your doctor, life after a heart attack can be complicated. It’s common to feel anxious, depressed or to go through changes in your relationship, all of which can spill over into sex. Working with a therapist who’s trained in sexual counseling can help you face those challenges together.

In one study, couples that worked with a counselor for three sessions reported more intimacy and better sex compared with those who didn’t get help after a heart attack. A counselor can:

  • Answer tough questions about both the physical and emotional sides of sex—for example, how does a person navigate being both a caregiver and a sexual partner for their spouse?
  • Encourage you to open up about sensitive topics.
  • Help you to finally communicate about problems you’ve been ignoring for years.

A counselor also can help you avoid health mistakes that people make when they skip “the talk” with their doctor.

Be careful with those little blue pills
Medication errors are one of those pitfalls. After a heart attack, many people take nitrates like nitroglycerin. Nitrates help with chest pain by opening up your blood vessels so blood can flow to your heart more easily. If you’re taking nitrates, don’t use erectile dysfunction meds without talking to your doctor first. The combination can cause a deadly drop in blood pressure.

Many heart medicines can cause erectile dysfunction or vaginal dryness as well. If a medication is putting a damper on your sex life, don’t stop it cold turkey—most likely, it’s keeping your blood pressure or heart rate under control. Instead, ask your doctor about trying a similar medicine with fewer side effects. There are usually other options in the same drug family and it’s just a matter of finding the best fit for you.

Start with stress-free sex
As you ease back into your bedroom routine, move at a pace that you’re comfortable with. Choose a familiar place like your own bed and ask your partner to take it nice and slow. When you’re ready for action, keep these pointers in mind:

  • Consider being the person on bottom during missionary position because it uses up less energy.
  • Place extra pillows under your chest when facing down to brace your scar if you had open-heart surgery.
  • Avoid anal sex because it puts pressure on the vagal nerve, which connects your gut and your heart. Straining that nerve can cause a drop in heart rate, fainting and chest pain.
  • Stop what you’re doing and call your doctor if you have chest pain, dizziness, nausea or trouble breathing.

Another word of advice: don’t cheat on your spouse or partner. Even though it’s rare for sex to cause a heart attack, one study found that almost 60 percent of sudden deaths that took place during sex happened when the person was having an affair. Some experts believe that cheating causes your blood pressure and heart rate to reach dangerous levels, increasing your risk of sudden death.

Be patient with yourself
Returning to a full and satisfying sex life may take time and require some honest conversations with your partner. But staying open with each other and being frank with your doctor about important sex questions can make the process go a little smoother.

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