How Long Should You Wait?

A heart attack, whether it’s your partner’s or your own, is a devastating challenge for any couple. Recovery may be slow. Anxiety and fear are inescapable. Depression is common. The partner who is suddenly thrust into the role of caregiver may, at times, feel overwhelmed. Amid so many physical and emotional challenges, sex may feel like a low priority.

But it shouldn’t. What both of you need most of all is comforting, and nothing comforts like the touch of the one you love.

Both partners may be afraid of risking a recurrence. Not knowing what to do, they wait. Sadly, most are not getting appropriate advice from their doctors. In a recent study of patients aged 55 or younger, only 12 percent of the women and 19 percent of the men talked to their doctors about sex, and patients were more likely than doctors to bring it up (and I'd wager the numbers grow smaller with older patients). As one man said, “The subject was never mentioned in ten weeks of after-care sessions for life style and food advice and recuperative gym exercises.”

When sex did get talked about, two-thirds of the doctors gave advice that was more restrictive than the American Heart Association guidelines. Jalees Rehman writes, “The kind of restrictions recommended by doctors in the study—and presumably by medical practitioners who weren’t polled—are not backed up by science and place an unnecessary burden on a patient’s personal life.”

Blanket restrictions are unreasonable because every patient and every heart attack is different. It’s vital to discuss with your doctor your case in particular. After an uncomplicated heart attack, one week may be long enough to wait. Or you may need longer. The important thing is to be guided by where you are in your recovery.

Having sex is like doing mild to moderate exercise. If your doctor gives you the okay—and ask if he or she doesn’t give you the answers you need!—and if you can handle such activities as climbing stairs and carrying groceries without chest pain or feeling out of breath, sex should be fine as well.

You will be adjusting to new medications. Antidepressants may lower libido, and beta-blockers may interfere with erections. If you’re in open communication with your doctor about sexual issues, dosages may be adjusted or medications switched.

Various stressors are unavoidable, but sex can relieve stress and soothe both patients and their partners. The years of cultivating awareness of your own and your partner’s body will pay off. Care in tending to your relationship in the years before a crisis is like money in the bank. You never know when you might need it.

Sex is exercise, and exercise strengthens heart muscle. Sex also strengthens relationships. It’s a medicine no couple should be without for long.

Sex after Her Heart Attack: New Research; New Guidelines

Life is scary after a heart attack. You’re not sure what to expect. You may be depressed. You’re probably on several medications. You may be confused about what you’re allowed to do and when.

Like sex. When is it safe to have sex again?

Chances are, your cardiologist hasn’t discussed that topic. For one thing, your doctor is probably more concerned with saving your life at first, and then with the details of your recovery, like rehab and medications. When to resume your sex life just isn’t high on the radar of topics to discuss post-surgery.

And for another, most physicians don’t bring up the S-word at any time, as we’ve discussed before. But a new study of women who have had a heart attack confirms that “most women don't have discussions with their doctors about resuming sex after a heart attack, even though many experience fear or other sexual problems,” says Emily Abramsohn, one of the study’s researchers, in this article from Medical News Today.

Patients are often uncomfortable broaching the topic, and their caregivers also hesitate to bring it up. Their partners may also be afraid to do anything that might cause pain or induce another attack. “I had to convince my husband that I wasn’t going to die in bed,” said one woman in the study.

Now, new guidance for doctors from the American Heart Association (AHA) encourages doctors to discuss sex with their post-surgical patients and to advise them about when it’s safe to resume their sex life and how to do it.

The guidance, which is based on a review of scientific literature and is the first statement of its kind from the AHA, acknowledges the importance of resuming an active sex life. Sex is a return to normalcy and re-establishment of intimacy, and as such is an important element in the healing process.

Along with the position statement from the AHA, a new study from a group of researchers at the University of Chicago surveyed 17 women who had survived a heart attack within the past two years. The average age was 60. The study found that:

  • Most women were fearful about resuming their sex life
  • The doctors discussed sex with about one-third of their female patients
  • Frequently the conversation was initiated by the patient, who generally found the information to be unhelpful
  • Most women began having sex about a month after their heart attack; all but one had resumed sex within six months

The AHA guidelines could clear up some hesitation and confusion among physicians as to what, exactly, to tell their patients. The guidance states that sex is safe for most patients who are stable and without complications. If you can climb two flights of stairs, you can probably have sex, which is considered only moderate exercise.

But if you’re scared or unsure, then ask. “Know that you’re not alone in having fears surrounding sexual activity,” Abramsohn said. “And if you are concerned, bring it up with your doctor.”

“Dr. Ruth” Westheimer even weighed in on the topic in this article, “What I suggest is that people write down their questions and send it to the doctor in advance of their appointment. That way they'll be sure the question gets asked, and the doctor will have had time to get prepared to answer it."

From the Heart Docs: Sex is Safe after Heart Attack

It’s official. The American Heart Association (AHA) has just released its most comprehensive guidelines ever regarding sex for patients with heart disease.

The bottom line: Sex is safe after a heart attack. In fact, it’s good for you to get back into the swing of things as quickly as possible.

So, if you’ve been waiting… and waiting… to have sex after your partner’s heart attack. If you’ve been haunted by images of your partner dying in the middle of “doing it.” Or, if you’ve stopped having sex altogether, you might want to dig out that sexy negligee at the back of your drawer.

In its latest recommendations, the AHA makes official what the unofficial guidelines have been for years: Sex won’t cause a heart attack. It’s simply a mild exercise that’s a lot more fun than a treadmill. If your partner can carry a 20-pound bag of groceries from the car to the house or climb a flight of stairs without becoming short of breath, then you should schedule a make-out session.

(He or she should probably pass the stress tests at the rehab center or get a doctor’s approval, but then resuming a normal life, including sex, is the goal.)

If you, as the healthy partner, are terrified of hurting your mate, rest assured that the chances are miniscule. In the normal course of daily life, your partner’s risk of having a second heart attack is 10 in 1 million per hour. During sex, that rises to 20 to 30 in 1 million per hour.

And just so you know, the AHA report also noted that those most at risk for a heart attack during sex are married men who are having an affair in an unfamiliar place, usually with a younger woman.

Don’t fit that profile? Then you have nothing to worry about.

The only red flag in the new recommendations is that a man who is taking nitroglycerin shouldn’t use medication for erectile dysfunction (such as Viagra). This can cause dangerously low blood pressure. Also, if your partner’s condition isn’t stable, if he or she is experiencing chest pains, shortness of breath, dizziness, or other symptoms, then even mild exercise, such as sex, should be avoided, and you should contact your doctor.

Basically, as one doctor said, “What’s good for the heart is good for the penis.” This includes moderate exercise, not smoking, maintaining a good weight. And sex. That’s good stuff for all of us.

Often, other issues that have nothing to do sex might nonetheless put a damper on bedroom frolics. Depression, for example, is common following a heart attack. Depression can persist for several months, but usually resolves itself without intervention. Medication (including some medications for depression) can cause loss of libido. And beta-blockers for hypertension can interfere with maintaining an erection. So if your partner is experiencing these symptoms, his or her doctor might be able to adjust the medications.

The AHA released its report to encourage doctors to talk to their patients about sex, because it’s an important quality-of-life issue. Also because, in the absence of specific guidance from their doctors, people are confused and afraid, and they tend to avoid sex. So, if your doctor doesn’t bring up the issue of sex, you should.

Recovery is difficult enough without giving up important pleasures like sex, and it’s that reconnection with normal life that helps to speed recovery