Sex and Heart Disease

Read about the author Samantha Evans

The first ever sex survey of 1,932 people aged between 55-74 with heart disease, heart attack and angina being the most common, was conducted by the British Heart Foundation in January 2014 and found that 3 out of 4 people said that their heart condition had affected their sex life.

Of those who had been affected, 32% said that they had sex less often and 19% said they had stopped having sex completely. The main problem cited was erectile dysfunction which affected 70% of men, of which 46% thought it was caused by the side effects of their medication. 36% thought it was a combination of medication and their condition and 18% just thought it was as a result of their heart condition.

Loss of libido was also a main reason for not having sex or less sex. This affected 55% of women and 44% of men respectively. Again, the most common reason given for this was medication.

According to Graham Jackson, Honorary Consultant Cardiologist at Guy’s and St Thomas’ Hospital, the main cause of sexual dysfunction for most people with heart disease is their condition and not their medication: although some drugs can impact upon sexual function. Medication can be changed or other drugs taken to combat the problem. Never stop taking your medication but discuss with your GP about your drug regime.

Erectile dysfunction is often a warning sign of heart disease. Difficulty in getting or maintaining an erection is commonly caused by stress, anxiety or excessive alcohol consumption.

It can also be an underlying symptom of atherosclerosis (narrowing of the arteries), diabetes or hypertension (high blood pressure). When a man becomes aroused, the blood vessels carrying blood to his penis dilate, enabling an increase in the flow and causing his penis to become erect. If these arteries are narrowed by disease, the blood flow is limited and therefore he is unable to get or maintain an erection.

There are several drugs which can alleviate some of the problems and you can discuss this with your GP. The use of a vacuum penis pump can be effective too but take a little practice to get used to.

Sex after a heart attack

Following a heart attack, many people feel frightened about having sex because they fear that they may have another one, especially women. Studies show that the increased risk to having another heart attack during sex is minimal. The amount of energy exerted by climbing two flights of stairs is similar to that when you have sex, so if you can climb two flights of stairs without getting too out of breath, sex should be OK.

It is important for healthcare professionals to reassure patients that they should not be worried about resuming their normal sex play.

Some people resign themselves to never having sex again and just feel that they are lucky to have each other and to have survived a heart attack. Many partners are worried about hurting their partner if they have sex and avoid making any attempt to do so, thus reinforcing the feeling that the person with the heart disease is being rejected. Some participants worry that their partner will look elsewhere for sex if they are not able to perform, thus increasing their feelings of anxiety.

Sadly, the survey found that a significant number of both men (26%) and women (44%) had never discussed their problems with anyone. The availability of drugs to combat erectile dysfunction made men more likely to seek help and discuss their problems with their GP whereas women felt that they just had to suffer in silence.

Many people who participated in the survey said that their problems were alleviated by talking to someone about them, which demonstrates that discussing sexual problems is really important after having had a heart attack or angina.

Resuming sexual intercourse should be part of cardiac rehabilitation but it is not always the case as some health care professionals feel uncomfortable discussing it or do not consider that the patient has a sex life due to their age. Many people feel too embarrassed to raise the subject and many healthcare professionals struggle to talk about sex too..

Sex is an important part of our lives and no one should have to stop because they have had a heart attack or angina. There are ways in which people can still enjoy having a sex life by making a few simple changes to the way in which they have sex.

Talk to your partner

It is important that people tell their partner how they feel after having a heart attack or when they have heart disease to help them understand their fears. Talking about how you feel and dsicuss what you would like to try or avoid can help you both overcome any anxiety.

Sex without Intercourse

A good sex life at any age isn’t just about the physical act of sex, it is also about intimacy and touch, both of which can benefit anyone. You may no longer be able to have full penetrative sex but being sexual is not just about sexual intercourse. Touching, kissing and other intimate sexual contact such as masturbation and oral sex can be just as rewarding and can bring you closer to each other.

Experiment

Introduce new elements to your sex life such as massage candles, a good lubricant and a well-made sex toy, both for him and her. Many sex toys are suitable for people who have aheart condtionn or who have had a heart attack.

Many men will enjoy either watching you use the vibrator on yourself or use it to stimulate you sexually. Even if your partner is unable to have sexual intercourse with you, he can still arouse you sexually using a sex toy.

Masturbating using a clitoral sex toy is no different to masturbating using your fingers and poses no risk to your heart.

The Pulse III Solo is ideal for men who do have erectile dysfunction as it can used with both an erect and flaccid penis.

Some doctors advocate that you should not use sex toys but there is no reason for this other than they are embarrassed about discussing their use and the subject of sex with you. Using a simple sex toy is often far less strenuous than intercourse, especially if you struggle to orgasm, have erectile function issues or cannot find a comfortable position.

Sex toys to avoid if you have a heart condition or pacemaker

Some sex toys should be avoided such as cock rings which can restrict blood flow to the penis and Stronic toys from Fun Factory which contain magnets that can affect pacemakers.

Change position

From the survey, 13% found that they were unable to have sex in certain positions. Experiment with different sexual positions you both find comfortable and pleasurable. Incoprporate cushions and pillows to find a comfortble position.

Vaginal Dryness

Some medication can cause vaginal dryness which makes sex feel less pleasurable or even painful. So try using a pH balanced sexual lubricant. Lubricants don’t just benefit women, they can help men last longer and make sex feel more pleasurable too. Always choose a skin safe lubricant or vaginal moisturiser that is free for glycerin, glycols and parabens.

Body Image

Body image can pose a problem due to scarring from surgical intervention, making you feel less attractive to your partner. However, many people don’t notice these changes – accepting you and loving you for who you are.

Exercise

All cardiac rehabilitation programmes involve taking regular exercise. Exercising together can help you encourage each other and reinforce your relationship by spending time together. This is a great time for you to discuss your worries with each other, both for the person with heart disease and their partner. People who exercise together are more likely to continue to do so and encourage each other than if they exercise alone.

Research published by Elsevier in the Canadian Journal of Cardiology ( October 2019) found that regular exercise is highly beneficial for all patients with cardiovascular disease regardless of age.Their results showed that the patients who benefited most from cardiac rehabilitation were those who started out with the greatest physical impairment.

Change of routine

Some participants (37%) said that they found themselves getting out of breath or tired very easily. Changing your routine can be both refreshing and enhance your sex life. Try having sex at a different time of day when you have more energy or when medication, such as heart drugs, have had time to work. Early morning sex can wake you up and create a sense of well being for the rest of the day rather than later evening when your energy levels begin to flag and sex becomes hard work.

The benefits of sex are numerous, including creating a sense of well being, improving your mood, reducing stress, increasing blood circulation to your sexual organs and reducing blood pressure, just to name a few. Your cardiologist will advise you when it is OK to resume sex but just because you have been given the go ahead it may not feel ready for you. Go at your own pace and slowly resume your sex life as and when you feel it is right for you.

Do not be scared to discuss your worries about your sex life with your GP. If they are not comfortable discussing it with you, ask to be referred you to a sex therapist or suitably qualified healthcare professional who can help you explore issues that may be blocking your path to leading a fulfilling sex life when you have heart disease.

At Jo Divine we believe that sexual health and sexual pleasure go hand in hand and have created a health brochure with suitable products to help people with sexual issues. We also have male sex toys in our main catalogue.

Working with medical professionals, we hope to encourage patients and HCPs alike in talking more freely about sexual problems. A health issue doesn’t mean your sex life will have to stop!

Useful Websites
British Heart Foundation : www.bhf.org.uk
British Cardiac Patients Association : www.bcpa.eu