Heart of Sex

heartThe American Heart Association and the European Society of Cardiology released a statement 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, and the role of intimacy without sex.

The Washington Post reported that, It’s billed as the first scientific statement with detailed guidance on resuming sex.

In Eduardo Chapunoff’s book, Heart Disease & Sex, he writes that 50% 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 to the value of 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, life longtwo hearts medication and even death)  I was not interested in ending my sex life.  I wanted sex until my life ended and thought humorously, what a way to go!   I wanted intimacy to continue to be 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 the potential risk to him if during sexual activity, my pacemaker/defibrillator provided a treatment, aka shocked me.  He was informed that he’d feel a bit of a jolt, but for it not to 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.

But wait, my 38 year old husband decided last month to have a near fatal heart attack, have surgery, and be placed in a hypo-thermic coma. Beyond a miracle is his survival.  Now it is he, who is dealing with the multiple effects of heart disease, medications and life adjustments.  Luckily, he’s married to a sex therapist, cardiac patient, and supportive partner ( I believe he’d agree)

When my husband asked the Dr about his sex life, specifically when he can have sex again, the Dr laughed noting it was the first question 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.

I am ready to return to the endless opportunities in the bedroom with my partner; it will take a bit of time and hopefully a lot of practice.

Listed are the AHA guidelines to resuming sex with heart disease and more:

General precautions listed in the statement include:  (I have added my two cents in red below)

—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 OK.

Only hugging and kissing??? Thats enjoyable but why exclude being masturbated 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.

Interesting, have a heart attack, end your affair?? You can read my articles on non-monogamy

—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 said having sex in a more “upright position” may be easier for some heart failure patients, whose symptoms may include shortness of breath.

spooningRecommended positions for male patients : partner on top in an arm less chair, missionary-  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 rear entryentry 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.

Cheers to the American Heart Association.

Myself as well as many others are interested in the endless possibilities to sex even with a cardiac condition.





About Anton Therapy

As a psychotherapist specializing in sexual concerns, I believe that communication and compromise, with a playful and open attitude are key components to a healthy intimate life. I infuse compassion, enthusiasm and a collaborative approach in treatment that puts clients at ease in discussing such personal topics. I hope this blog helps to open your mind, promote healthy sex, and encourages you to have a desire for intimacy and life! View all posts by Anton Therapy

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