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Sex After Heart Attack

Discussion on matters of sex has been considered and still continues to be taboo in India even though it profoundly affects the personal life of each one of us. Even today most patients are reluctant to ask questions on this crucial topic and most doctors are equally reluctant to offer advice. This results in much avoidable fear and suffering not only for the patients but also for their spouses.

Let me narrate an incident which occurred about ten years ago when such suffering was prevented by timely advice.

A fifty-year-old patient of mine, who had recently recovered uncle, who had come to see him, had told him that his sex life was now over and that it would be dangerous for him to indulge in sex any more. He had been a rather active ‘player’ in the game of sex all his life. He was naturally very upset and worried and had come to consult me on this very issue. It was more than three months since he had sustained myocardial infarction, and by this time he had recovered fully. His exercise tolerance was good and there was no disturbance of the heart rhythm nor any other complication. Accordingly I advised him to resume sex with his wife forthwith. More than ten years have passed. He has been happy and there have been no heart problems attributable to sex. This is a typical case and there are innumerable such cases who were encouraged to enjoy sex life after a heart attack, after they had been brought to a level of physical fitness where it would not only be safe but desirable to resume normal sex life.

Unfortunately, the fear psychosis among some of the patient and their spouses is so deep that sometimes a lot of persuasions is required to make patients resume this activity. It is very common for patients not to receive any advice from their doctors, or to receive a very guarded one which, in effect, is of little value.

Can every patient resume sexual activity after a heart attack?
Almost 80-90 per cent of patients should be able to do so sooner or later.

Who are the patients who can resume the activity earlier.
All those patients who have recovered without complications and have no abnormality of the rhythm of the heart and whose exercise tolerance is good.

What exercise tolerance do you rate as good?
A patient who can go up and down the Master’s stool 15-20 times each way at a good speed, or can generate 75 watt on a bicycle ergometer, without producing angina, arrhythmia or undue breathlessness or adverse changes in his electrocardiogram, is fit to resume normal sex life. As a rough indication, the ability to go up a flight of stairs at a good speed without producing any of the adverse symptoms enumerated above is good enough for normal sex.

How long does it take to reach such a state of fitness after the attack?
Anywhere from eight to twelve weeks after an uncomplicated heart attack. Of course, it would take longer if the infarction were more extensive and accompanied by complications.

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