How to have sex after a heart attack: Go slow, have therapy and DON’T go ‘on top’
Most people are too embarrassed to ask about when or how to have sex after a heart attack, but new guidance urging doctors to help their patients resume a healthy love life means they may no longer need to.
The recommendations are the first to provide specific details explaining exactly how to safely enjoy sex after a heart attack or stroke, and include guidance on sexual positions and activities patients can engage in if they aren’t ready for the physical exertion of intercourse.
After a heart attack or stroke, many patients are concerned that sex will trigger another heart problem.
The guidance recommends that all patients who have had a heart attack, heart transplant, stroke or other heart condition, or who received an implanted heart device, should undergo some type of sex counselling
While previous guidelines have discussed how long patients should wait to have sex after a heart attack, patients often have more specific questions about the types of sexual activities that are safe.
‘Patients are anxious and often afraid sex will trigger another cardiac event – but the topic sometimes gets passed over because of embarrassment or discomfort,’ said Elaine Steinke, lead author of the statement and professor of nursing at Wichita State University in Kansas.
The paper, jointly published in the American Heart Association journal Circulation and the European Heart Journal, also advises doctors to discuss the health risks of embarking on an affair, which has been shown to increase the risk of dying from heart problems.
It also recommends that all patients who have had a heart attack, heart transplant, stroke or other heart condition, or who received an implanted heart device, should undergo some type of sex counselling.
Although doctors and other health care providers may be a little embarrassed to discuss such details with their patients, this is not an excuse for withholding information.
Doctors may be embarrassed to discuss sex with heart patients, but this is not an excuse for withholding information, say experts
‘We deal with the intimate parts of the body in many ways as health care providers,’ Professor Professor Steinke told LiveScience.
‘Those who want information are very much relieved that the health care provider has brought up this topic.’
Heart attack patients who have no complications, and who don’t experience chest pain or other symptoms when they walk briskly, can typically engage in sexual activity after one week.
Those who have undergone heart bypass surgery can generally safely resume sexual activity after six to eight weeks if their incision is fully healed, the guidelines say.
If it’s unclear whether a patient is healthy enough for sexual activity, experts have suggested that they undergo an exercise stress test, which involves walking on a treadmill to test how much the heart can handle.
Patients should resume sexual activity gradually, and consider starting with activities such as hugging and kissing or sexual touching before engaging in intercourse, Professor Steinke said.
Those who experience chest pain or other symptoms during sex should report them to their doctor.
Although sexual intercourse raises the risk of a heart attack, the overall risk for patients is quite low.
Among those who’ve had heart attacks, less than one per cent happen during sex.
During sex, patients should be encouraged to assume their usual sexual positions, or one that is comfortable. Those who’ve had coronary artery bypass surgery are recommended to avoid being ‘on top’ as this may require more exertion, and to use pillows for support if needed.
Having an affair, or having sex in an unfamiliar environment, may be a cause of stress for the patient, Steinke said. She added that immediately post-heart attack was not the time to be having sex with a new partner in a hotel room.
Conversations about sexual activity should start before a patient leaves the hospital, and continue throughout the rehabilitation process.