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Sex and Coronary Artery Disease

If you have coronary artery disease (CAD), also known as ischemic heart disease or coronary artery disease, you may be wondering if certain physical activities are safe. Trek. Functioning. Golf. Sex?

Some people with coronary artery disease, as well as doctors, may be reluctant to bring up the latter topic. But sex is safe for many people with coronary artery disease and it’s important to your quality of life, says Jonathan H. Whiteson, MD, medical director of cardiac rehabilitation at NYU Langone Health.

“Having sex is defined in different ways. I prefer the term “privacy”. It is very important for people with heart disease to know that they can be intimate again, whether with a partner or alone, ”said Whiteson.

The first step is to make sure your heart disease is stable. This usually means that all symptoms, such as angina or chest pain, are manageable and do not get worse. CAD is not considered stable if you have recently had a heart attack, a heart procedure or if you have symptoms of worsening congestive heart failure.

Is your heart strong enough for sex?

If you’re bringing your spouse or partner to a cardiology appointment, don’t be surprised if they’re the first to talk about sex. “Often it’s the partners who bring up intimacy,” says Whiteson. “I get asked all the time, ‘Can having sex hurt my partner? “”

The answer: it depends on the person. As a general rule, however, “if you can walk for 5-10 minutes and climb a flight of stairs at the end, then sex and orgasm are probably safe,” says Whiteson.

What if you can’t? Cardiac rehabilitation can help.

It is a medically supervised program that emphasizes exercise, heart healthy habits and stress reduction. Since many people are new to their CAD for the first time after a heart attack, they make a seamless transition to a program. You can still participate even if you haven’t had an acute event, but you may need to ask your doctor for a prescription. Either way, most insurers will cover the cost if you have a CAD.

The American Heart Association’s Scientific Statement on Sexual Activity offers these guidelines:

  1. If you have frequent or very painful angina, a type of chest pain caused by poor blood flow to the heart, wait before having sex until your doctor tells you that your condition is stable.
  2. It may be safe to resume sexual activity as soon as a week after a mild heart attack, as long as you do not have heart symptoms such as chest pain.
  3. Sexual activity may be OK 6-8 weeks after a standard CABG if your incision is well healed.

Ways CAD Can Affect Your Sex Life

Even if you are physically ready, CAD can dampen your desire for sex or make it harder for you to arousal or orgasm. If you’re having trouble getting an erection, it may be related to the same thing that puts your heart at risk: clogged vessels that restrict blood flow, says Glenn N. Levine, MD, professor of medicine at Baylor College of Medicine. . But he points out that your erectile dysfunction (ED) could be due to other issues, such as:

  • Complications of diabetes, also common in coronary patients
  • Psychological factors, including fear of a heart attack
  • Medicines, including some antidepressants

Erectile dysfunction can often be reversed or improved, either with erectile dysfunction medications or by treating your underlying conditions better.

Meanwhile, depression is common in men and women with coronary artery disease, and this mood disorder can lead to problems with arousal, lack of interest in sex, and an inability to reach orgasm. If you think you are depressed, talk to your doctor. Some treatments for depression, such as regular exercise, can do double duty in strengthening your heart.

Anxiety is also common in people with coronary artery disease. You might worry, for example, that sex could trigger a heart attack. But as long as you are physically healthy enough to have sex, orgasm is unlikely to be dangerous.

As Whiteson points out, “the heart doesn’t know if you are having sex or if you are walking on a track. “

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