Don't let a heart condition keep you from exploring endless sexual possibilities with your partner.
The American Heart Association and the European Society of Cardiology released a statement on Monday urging physicians to discuss sex with their cardiac patients post-heart attack, transplant, stroke, implanted heart device, or other heart conditions, as well as counseling their partners.
According to the AHA, counseling should address topics such as: when to resume sex, specific methods and recommended positions, as well as the role of intimacy without sex.
The Washington Post reported that this is viewed as the first scientific statement of its kind with detailed guidance on resuming sex after a heart condition.
In Eduardo Chapunoff's book, Heart Disease & Sex, he writes that 50 percent of post heart attack and implantable defibrillator patients don't return to having sexual intercourse. This news is sad and discouraging for a large portion of our population — which includes myself and my husband.
When people think of heart disease, they often associate it with the 70-year-old and older crowd. Even though the statistics are higher as we age, this stereotype excludes a significant portion of those with heart disease under the age of 50. Additionally, it limits the importance of sexual activity as we tend to de-sexualize those in their senior years. The recommendation by the AHA helps to end the view that elderly sex is not important, and adds an important voice to the opinion on remaining sexually active with cardiac and other health conditions.
At the age of 25, I was diagnosed with Cardiomyopathy (a weak heart muscle often leading to transplantation, lifelong medication and even death). I was not interested in ending my sex life. In fact, I wanted to have sex until my life ended and even thought humorously, "what a way to go!" I wanted intimacy to continue being a significant part of my relationship and sex expression.
At that time, doctors did not inquire about my sex life or provide suggestions. It was I who hounded them about expectations, effects and my abilities. My husband asked about the potential risk to him if my pacemaker/defibrillator provided a treatment, or shocked me, during sexual activity. He was informed that he'd feel a bit of a jolt, but that it shouldn't dissuade him. I reminded him that he always knew I was "electrifying."
The intensity of my cardiac symptoms and medication made sexual interest, arousal and response challenging for a handful of years. Now after 16 years post-diagnosis, two pacemakers and stabilization on my medications, my sexual expression and interest are pretty high. I am lucky to have no restrictions on my sex life. Oh, the endless possibilities!
When my husband asked the doctor about his sex life, specifically when he could have sex again, the doctor laughed, noting it was the first question most men ask post-heart attack. Now providers can be on the same track as their patients. We want to effectively treat our condition and get back to our lives our sex lives in particular.
Listed below are the AHA guidelines to resuming sex with heart disease and other heart conditions.
• Before resuming sex, make sure you can engage in moderate physical activity, such as walking briskly up two flights of stairs, without chest pain, breathlessness, or other symptoms.
(Make sure you are strong enough to walk slowly. When engaging in sex, remain a passive partner until your stamina increases. Enjoy lying flat during intercourse and receiving oral sex. If providing stimulation to your partner, lie relaxed on your side with a pillow supporting your head and back).
• If moderate activity is too strenuous, avoid intercourse but not intimacy. Hugging and kissing may be okay.
(Only hugging and kissing? That's enjoyable, but why exclude being touched by your partner, or receiving oral sex? Occasionally, deep kissing can lead to shortness of breath. Take breaks that allow you to breathe and gently kiss other parts of the body).
• Have sex in a comfortable, familiar place and avoid things that could add stress to the experience, including extramarital affairs.
• Tell your doctor about any symptoms during sex, including chest pain, dizziness, or insomnia afterward.
• Some positions may not be safe. Heart bypass surgery patients should avoid being on top in the missionary position and Steinke says having sex in a more "upright position" may be easier for some heart failure patients, whose symptoms may include shortness of breath.
(Recommended positions for male patients: partner on top in an armless chair, missionary with partner on top, lying side by side in a spoon position, standing on the side of the bed with partner on their back near edge of bed, or on their stomach with their rear lifted — lean your weight on the bed to reduce feeling dizzy or use your hands for support).
(Female patients: side by side spooning position, missionary with partner on top and weight on their knees to avoid pressure to your chest/abdomen, rear entry with pillows under chest and stomach for support, lying on your back with bottom to edge of bed with partner standing. If your head is too low, you may feel dizzy; support your head or elevate it slightly).