THURSDAY, Jan. 19 (HealthDay News) -- Sexual activity generally
isn't hazardous for people with cardiovascular disease, the
American Heart Association says in a new statement.
But patients should get checked by a doctor beforehand and be
aware that heart problems could spell trouble in some cases of
cardiovascular disease, especially if they're not controlled.
The heart association also cautions that there needs to be more
research into how sexual activity affects the cardiovascular system
of women and older people who have specific conditions.
"The reality is that in most patients, the risk is low," said Dr. Glenn Levine, a professor of medicine at Baylor College of Medicine and lead author of the statement. "In most patients with stable heart disease, it is reasonably safe to participate in sexual activity, which is probably comparable to mild to moderate physical activity, like walking or going up several flights of stairs."
Heart patients frequently don't mention the risk of sexual
activity but it may still be on their minds, Levine said. "We want
to encourage health-care professionals to discuss this and
encourage patients and partners to bring it up."
The statement authors report that fewer than 1 percent of acute
heart attacks are linked to sexual activity. For people who have
had a heart attack, engaging in sexual activity increases the risk
of another heart attack or death "from 10 chances in 1 million per
hour to 20 to 30 chances in 1 million per hour," according to the
Research has found that sudden death is extremely rare during
sexual activity. But when it does occur, it's almost always in men
and mostly in those who are having extramarital sex, "in most cases
with a younger partner in an unfamiliar setting and/or after
excessive food and alcohol consumption," the statement said.
The statement suggests that certain heart patients avoid sexual
activity just like other potentially risky exercise. "Certainly
there are some patients who have unstable or severe symptoms,"
Levine said, "and it's more important for them to be stabilized and
treated before they engage in any significant physical
The statement authors also write that sexual activity is
"reasonable" for people who suffer from mild angina (chest pains)
and those with mild or moderate valvular heart disease and no or
mild symptoms. It's also "reasonable" for people whose atrial
fibrillation (an irregular heartbeat) is controlled and for those
Some research has linked heart medications to erectile
dysfunction. But the statement says recent research hasn't directly
connected modern heart drugs to the condition. "Cardiovascular
drugs that can improve symptoms or survival should not be withheld
because of concerns about their adverse impact on sexual function,"
the statement said.
The statement also cautions male heart patients who take
nitrates for chest pain to avoid erectile dysfunction drugs. But
it's "reasonable" for post-menopausal female heart patients to use
topical or vaginally inserted estrogen to treat painful
Dr. Reena Pande, a cardiologist at Brigham and Women's Hospital
in Boston, said the statement includes plenty of common sense.
"If you're active and asymptomatic [no symptoms], you're OK. If you have frequent chest pain, shortness of breath and palpitations, you should probably not have sex," Pande said. "And if you're in between, your doctor may want to do some tests to help figure out if sex is safe for you."
For doctors specifically, the statement offers helpful guidance
about exactly when sexual activity is a good idea, such as six to
eight weeks after open heart surgery, she said.
Pande also agrees with the overall message about communication
between doctors and patients.
"Talk to your doctor about sex. Your doctor can help you figure out if it's safe or not safe," she said. "We understand it may be an uncomfortable subject, but it's better to bring it up with your doctor now than to put yourself at risk. Communication is critical. We will not know you are having a problem unless you tell us."
The statement was published online Jan. 19 in the journal
For more on sexual heath, visit the
U.S. National Library of Medicine.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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