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Sex after a heart attack

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C. A. V. Nogueira, M.D. |
Sex after a heart attack
Heart disease and intimacy   Resuming sexual activity following a heart attack

Sex can be a taboo subject among healthy people so it's not surprising that one of the least-heard questions is who, and when, can have sex after a heart attack.

The story about heart attacks has two sides: bad thing is that more and more people get them, but the good side is that the survival rate is greatly improved thanks to new researches in medicine and better healthcare.

There is another good news: After the uncomplicated heart attack, the patient can live a perfectly normal life, and live it for decades. So, why some patients are afraid to have sexual intercourse after the heart attack while otherwise are perfectly capable to work, walk, even run, climb the mountain? There are several reasons for that.

When a patient survives a heart attack and begins to recover, he will get advice from their doctors on what to do to stay healthy and get back to normal. That includes a lot of things, from the proper diet to when to return to work - but usually there's no word about sex. There are two reasons for that: patients don't ask and there is no definition of "normal".

A study in 127 hospitals in the United States and Spain shows that doctors are not very good at starting the topic of sexual activity after a heart attack. Researchers studied 2,349 women and 1,152 men who had suffered from a myocardial infarction. In the month following the heart attack, only 12% of women and 19% of men had some discussion with a doctor about sex.

Some patients think they should be grateful for being alive and asking about sex would be asking too much, some of them are simply ashamed, and some think that sex is too physically demanding and there's no point in asking.

Now, the point is sex is a form of exercise and must be assessed as that, nothing less, nothing more. There is no evidence that having sex increases the risk of having another heart attack. Once the patient is recovered, he has the same chance to get another heart attack while having sex as someone who has never had a heart attack.

So, let's see the recommendations are. The Scientific Statement of the American Heart Association (AHA) states that it is reasonable to resume sexual activity as early as one week after an uncomplicated heart attack. However, the majority of doctors will recommend a much longer period of abstinence because "sex is exercising". British health authorities recommend "For most people, this is usually around 4-6 weeks".

So, those recommendations differ which tells us that before any sexual activity - and before any other exercise - the patient should consult with his doctor. But, as a rule of thumb, if you can climb the stairs, you can have sex. It maybe sounds funny, but it's true: walking up two flights of stairs places the same amount stress on the heart as an intercourse. Walking one kilometer places the same amount of stress. So, if the patient can do those usual tasks with no pain or breathless, then sexual activities shouldn't be a health problem.

And now an interesting statistics: of those who die or have a heart attack during sex, 80% are having extramarital sex. The problem isn't in the act itself but in the environment: a new sexual relationship brings a great deal of tensions and excitement, and for the heart that just recovered that can be too much.


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