Key Takeaways
- Most people with heart disease can safely engage in sexual activity.
- But sex can exacerbate some specific heart conditions, and anyone with heart disease should be mindful of warning signs like shortness of breath or chest pain during sex.
- It’s important to speak with a healthcare provider about the benefits and risks of sex after a heart disease diagnosis.
You should be mindful of how you feel during sex—or any other form of physical activity—if you have heart disease. However, having heart disease doesn’t necessarily mean you have to abstain from sex.
“Generally speaking, sexual activity is safe for patients with cardiovascular disease,” Lindsey Rosman, PhD, assistant professor of medicine in the division of cardiology at the University of North Carolina School of Medicine, told Verywell.1
>It may be helpful to think about the risks and benefits of sex the same way you would a workout, Jim Liu, MD, clinical assistant professor of internal medicine at The Ohio State University Wexner Medical Center, told Verywell. “I would think of sexual activity as any other physical activity—your blood pressure goes up, your heart rate goes up, and that’s how [sex] really impacts the heart,” he explained.
While sex is usually safe if you’re living with a heart condition, you should talk with your healthcare provider about any concerning symptoms to look out for during sex.
“Patients and their spouses are very reluctant to ever ask about sexual activity, and doctors are not very good at spontaneously bringing up the topic,” Glenn Levine, MD, professor of medicine in the cardiology department at Baylor College of Medicine, told Verywell. “Both patients and providers should be aware of this and not be afraid to bring this topic up on the part of the patient and their spouse.”
It’s important to know that living with a heart condition doesn’t mean that sex is “dangerous” for you. In fact, it can be good for your overall health and well-being. “Sexual activity is a form of exercise which can help strengthen your heart, reduce stress, and improve sleep,” Rosman said.
It may have benefits beyond the physical, Liu added. “Having sex has an impact on people’s quality of life, and this may have an indirect [positive] impact on heart health,” he said.
“There is a slightly elevated risk of experiencing a cardiac event whenever you’re physically active, whether it’s sexual activity or going for a walk,” Rosman said.
Is It Possible to Have a Heart Attack During Sex?
However, heart attacks during sex do not happen often. “Sex is a relatively rare trigger of heart attack or sudden death,” Rosman said. She added that less than one percent of all heart attacks occur during sexual activity.
Anyone with a heart condition should watch for the following warning signs during or after sexual activity, Rosman said:
- Chest pain
- Shortness of breath
- Rapid heart rate
- Irregular heart rate
- Dizziness
- Insomnia after sexual activity
- Fatigue the day after sexual activity
If you have heart disease and start to experience these symptoms, contact a healthcare provider.
Does Heart Disease Impact Sexual Function?
A heart disease diagnosis can impact your sex life in many different ways, experts said. The disease itself and the treatments prescribed can affect sexual function.2
“Heart disease and its treatment can change the way blood circulates throughout the body and may reduce the amount of blood supplied by the heart to distant areas of your body, including the genital region,” Rosman said. “Reduced blood flow can lead to erectile dysfunction in men and sexual arousal difficulties in women, [meaning] both men and women may experience difficulty reaching orgasm.”
The toll heart disease takes on your mental health can indirectly affect your sexual health.3 “Emotional stress, depression, and anxiety are common in patients with cardiovascular disease and are associated with increased risk for sexual problems,” Rosman said.
Following a heart disease diagnosis, you may become less physically active than you were before, which could affect your sexual desire and performance, she added.
Partners of people with heart disease may also be affected: “Heart disease can be stressful for patients’ spouses and partners, which can impact intimate relationships,” Rosman explained.
Lastly, the symptoms that come with heart disease—such as palpitations, chest pain, shortness of breath, and fatigue—may make people who experience them less likely to want to engage in sexual activity.
Can People With Heart Disease Take Medications That Affect Sexual Performance?
If you’ve been diagnosed with heart disease, it’s important to speak with a healthcare provider before taking any new medications, including those for sexual performance. In general, most drugs that enhance libido (sex drive) or otherwise impact sexual performance are safe. However, some people who take erectile dysfunction medications should be aware of possible side effects or complications.
“Medications to treat erectile dysfunction such as Viagra [sildenafil], Cialis [tadalafil], Stendra [avanafil], and Levitra [vardenafil] are generally safe for patients with heart disease,” Rosman said. “[But] men with cardiovascular disease should use these medications with caution because they can cause a temporary drop in blood pressure.”
Erectile dysfunction medications can be dangerous for people with heart problems who take nitrate therapy for chest pain, experts said.3 “You can never take nitrates with those kinds of medications,” Liu said. It’s important for people who do take nitrates for chest pain to know there are other treatments for erectile dysfunction, Rosman added.
If you have heart disease, you should talk to a healthcare provider before trying any new medication, including over-the-counter [OTC] therapies. “Patients should not use dietary supplements and other [OTC] pills for erectile dysfunction without discussing these medications with their doctor,” Rosman said.
Who Should Avoid Sex With Heart Disease?
Though sex is typically safe for people with heart disease, sex may exacerbate some specific conditions, Rosman said. For this reason, “patients with advanced [heart] disease, unstable angina, or uncontrolled hypertension should talk to their doctor before engaging in sexual activity,” she explained. Those with advanced disease include people with unstable coronary disease or severe heart failure, Liu said.
Talking to a Healthcare Provider About Sex and Heart Disease
It’s normal to want to resume sexual activity after a heart disease diagnosis. “Returning to sexual activity is a common concern for patients with heart disease,” Rosman said.3
When possible, you should discuss the risks and benefits of sexual activity with your healthcare provider and your partner, Rosman said.
Your cardiologist may suggest therapies outside of heart disease treatments that may help. “If emotional distress, depression, and anxiety are contributing to sexual difficulties, patients may benefit from individual counseling with a licensed psychologist or mental health provider,” Rosman said. “Couples therapy may also be beneficial.”
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