New Guidelines Say Sex Is Safe For Heart Patients
January 20, 2012

New Guidelines Say Sex Is Safe For Heart Patients

Survivors of heart attacks and people who have had heart surgery can safely resume sexual activity, as long as they are healthy enough to walk up two flights of stairs without chest pain or shortness of breath, according to new guidelines released on Thursday from the American Heart Association (AHA).

In a scientific statement, the AHA said that having sex only slightly raises the chance for a heart attack, meaning the new guidelines apply to people with and without heart disease.

However, certain patients, such as those with severe heart disease who experience symptoms while at rest, should delay sex until their condition has stabilized.

The statement, published online in Circulation: Journal of the American Heart Association, contains recommendations by experts from various fields, including heart disease, exercise physiology and sexual counseling.

"Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners," said Dr. Glenn Levine, lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston, Texas.

"Unfortunately, discussions about sexual activity rarely take place in the clinical context.”

The absolute rate of cardiovascular events during sexual activity, such as heart attacks or chest pain caused by heart disease, is miniscule because sexual activity is usually for a short time, the AHA said.

"Some patients will postpone sexual activity when it is actually relatively safe for them to engage in it," said Levine, who is also director of the Cardiac Care Unit at the Michael E. DeBakey Medical Center in Houston.

"On the other hand, there are some patients for whom it may be reasonable to defer sexual activity until they're assessed and stabilized,” he said, referring to people with severe symptoms of heart disease.

The new guidelines recommend that patients with sexual dysfunction be assessed to see if their sexual dysfunction is related to underlying vascular or cardiac disease, anxiety, depression or other factors.

Decreased sexual activity and function – common in men and women with cardiovascular diseases – is often related to anxiety and depression.

The AHA also advised that drugs that can improve cardiovascular symptoms or survival should not be withheld due to concerns that such drugs may impact sexual function.

The AHA´s additional recommendations include:

• After a diagnosis of cardiovascular disease, it is reasonable for patients to be evaluated by their physician or healthcare provider before resuming sexual activity.

• Cardiac rehabilitation and regular physical activity can reduce the risk of cardiovascular complications related to sexual activity in people who have had heart failure or a heart attack.

• Women with cardiovascular disease should be counseled on the safety and advisability of contraceptive methods and pregnancy based on their patient profile.

• Drugs to treat erectile dysfunction are generally safe for men who have stable cardiovascular disease. These drugs should not be used in patients receiving nitrate therapy for chest pains due to coronary artery disease, and nitrates should not be administered to patients within 24-48 hours of using an erectile dysfunction drug (depending on the drug used).

• It is reasonable for post-menopausal women with cardiovascular disease to use estrogen that's topically or vaginally inserted for the treatment of painful intercourse.


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