Your sex life

Any serious health problem can impact on your sex life. Having a heart condition is no different. For anyone who was previously sexually active this is an important issue.

Is it safe to have sex?

Sex is a form of exercise, no more stressful to the heart than other forms of moderate exercise. If you think of sex as a physical activity then making love raises the heart rate about as much as climbing two flights of stairs. Sex, like any exercise, raises your blood pressure but only briefly. Your blood pressure falls immediately afterwards. This temporary increase in blood pressure is normal and safe.

  • After a heart attack, most people it should be possible to resume sexual activity four to six weeks afterwards. This applies to both sexes. If you experience any symptoms during activity it is likely this will happen during lovemaking as well. Once these symptoms are dealt with you should also be able to resume lovemaking without any difficulty.
  • Sexual activity should be resumed gradually and carefully in order to determine if it will bring on angina. You can take your GTN either before or during sexual activity in the same way you would use it for any other activity.

Sometimes high blood pressure, and blood pressure lowering drugs, can cause problems with sex:

  • Some men may have problems with impotence. Some of the physical causes of impotence include high blood pressure and heart disease. Sustained high blood pressure can affect the blood vessels in the penis, making it more difficult to have an erection.
  • Impotence can also occur as a side effect of blood pressure lowering drugs, in particular thiazide diuretics and beta blockers. Impotence that is caused by drugs is always reversible.
  • High blood pressure can reduce blood flow to the vagina. Women may occasionally find that sex is painful or that they are less likely to have an orgasm.
  • High blood pressure itself does not cause loss of libido (sexual desire). However, if you are worried about your health you may find that you do not want to have sex.
  • Very rarely heart attacks and strokes can occur during sexual activity. This is relatively rare in comparison with other activities which raise your blood pressure for similar lengths of time.

Even though you may find it embarrassing, talk to your doctor if you are having problems with sex. If you think that your problems started after you began your treatment your doctor can try you on a different drug.

Note: Do not buy or use drugs such as Viagra© unless your doctor has prescribed it for you.

Couple walking in the park

Talking to your partner can help

Losing interest in sex

Some people lose interest in making love. This can be for various reasons:

  • Some people are scared that sex might cause damage to their heart or that they might die during sex. This risk is actually very low.
  • Anxiety and depression are known to have an adverse effect on sexual desire. It's important to keep communicating, honestly, with each other as it is easy for a partner to feel rejected when sexual intimacy changes.
  • People tend to be more aware of their heart (e.g. after a heart attack) and this can draw attention to the natural increase in heart rate during activity.
  • Some drugs which are used to treat heart conditions can cause impotence in men. Speak to your doctor if this is happening to you.
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Change in relationships

Coming to terms with a heart condition can take time and both partners will have different ways of coping. Some people feel that their role within their relationship changes, especially if one partner takes on the caring role.

Talking to your partner about how you feel and any worries you may have will make it easier for you both to deal with the situation before it becomes a problem.

Retaining closeness and intimacy within your relationship will help to overcome difficulties. Remember that you can express your feelings in many different ways, through talking but also with body language and physical contact such as kissing and cuddling. Taking the first step may be the biggest hurdle to overcoming your anxiety about resuming sexual contact.

Practical advice to minimise stress on the heart during sex

  • Avoid sex within 2 hours of a bath or a heavy meal.
  • Keep the bedroom and the sheets warm. An electric blanket is helpful when it is cold.
  • Don't make love if you are tired at the end of the day. Wait until the morning or choose the time of day you feel at your most refreshed and relaxed.
  • Avoid caffeine, smoking or alcohol before and after sex. Alcohol may raise expectations you cannot fulfil.
  • Take your time.
  • Sometimes simple solutions can be found to make sex more comfortable and enjoyable, e.g. using different positions.
  • Avoid casual sex with an unfamiliar partner. There may be mismatches that you are not aware of that can make sex more stressful to your heart.

Although this seems limiting you will adapt quite quickly to find the best circumstances for you and your partner. Remember it's possible to maintain a healthy sex life.

If you or your partner have any questions or concerns regarding your sexual relationship try to talk to your doctor. If necessary he / she can refer you to a specialist for counselling. Your doctor will be used to talking about personal matters even if you aren't, so try not to feel embarrassed.

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