Sex is an important component in the lives of most healthy adults. As such, it is essential for providers working with post-coronary patients to advise them on returning to normal sexual function. To understand the sexual status of post-coronary patients enrolled in an exercise-centered rehabilitation program, researchers collected questionnaires on sexual activity from 161 patients. The wives of 100 of these patients were also administered questionnaires for the study.
The wives of these patients with reduced sexual activity reported their husbands being less willing to assume responsibility, having increased difficulty adjusting to life at home and in the workplace and being more neurotic and depressed than those with normal or increase sexual activity. This seems to suggest that a return to normal sexual activity is important for a recovering heart patient. Not only does it boost self-esteem but it also seems to reduce other poor psychological outcomes like depression. Additionally, those with lessened sexual activity had poor attendance in fitness classes during the study and therefore fewer exercise-related health improvements in final fitness testing.
Data collected from patients revealed that in nearly half of the group, sexual activity was unchanged or increased since the time before their cardiovascular incident. Of the remaining participants, 29 reported having adopted a more passive sexual role and 26 patients reported experiencing angina or premature ventricular beats during intercourse.
This chest pain caused concern in patients, some of whom reported feelings of fear associated with sexual activity triggering another cardiac event. Some patients even reported fears of coital death. A number of the wives who were questioned mirrored this concern, making it one of the more common reasons for reduced sexual activity after a heart attack.
It is important to note that reports of angina and premature ventricular beats are more frequent during bouts of standard laboratory exercise than during normal sexual relations. In laboratory testing, sexual activity was unlikely to raise heart rate above 120 beats per minute for more than a few seconds. Generally, the highest point of exertion is during climax which lasts only a few seconds before quickly returning to normal. For that reason, it has been concluded, that intercourse carries no increased risk for the average postcoronary patient and doctors need not recommend a more passive role or positioning.
Erectile dysfunction (ED) was also a factor for many of the patients for whom sexual activity had declined. Unfortunately, many of the drugs used to treat heart patients list sexual dysfunction as a side effect of their use. Additionally, medications for the treatment of ED are generally not recommended for those who have recently experienced a serious cardiac event.
In the above video Marie Young, a psychologist, gives us some advice about returning to sexual activity after a heart event. Dr. Young includes basic guidelines for helping patients decide when they may be ready. She also touches upon what to do if you are experiencing difficulty in doing so. If approached with science and sensitivity, many patients can rest assured that they can and will have a safe return to their significant other after a heart event.
Sources: European Heart Journal, Heart Foundation