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Safe sex - after a heart attack.

Even in our so-called "age of enlightenment," seems that both doctors and patients are often reluctant to address the question of sex after a heart attack. Among both males and females who have had a heart attack, studies show a marked decline in the frequency of intercourse after the attack, probably due to a number of factors. Impotence-the ability to have or to maintain an erection-and lack of desire are both often cited as post-heart attack problems. Either or both may be the result of emotional factors, cardiac drugs, or both. Fear of another heart attack may deter both the patient and his or her spouse.

Impotence is such a widespread and embarrassing problem in otherwise normal males that it is little wonder that it should become more of a problem after a heart attack, if one perceives sexual activity as hazardous to one's health. Heart attack during sex, whether marital or extramarital, is a highly overrated phenomenon. Documented cases of death due to heart attack during sex are distinctly uncommon. Widowers or others with new partners need not fear that they are any more at risk of a heart attack than with their former partner-epecially if they are engaged in a monogamous relationship.

Obviously, the stress upon the heart during intercourse varies greatly, both in intensity and duration, from one person to another. On the average, however, the demand on the heart is probably no more than that for the many forms of exercise acceptable for the post-heart attack patient. Because anxiety about intercourse can be a major factor in impotence, patient and doctor should discuss the matter just as they would discuss other methods of exercise.

Similarly, they should discuss whether medication, cardiac or otherwise, is another factor. Among the possible offenders are beta-blockers, antihypertensives, tranquilizers, and antidepressants. Likewise, the depression that often accompanies heart attacks can readily affect sexual desire and performance.

A recent report in the Journal of Cardiovascular Nursing offers other guidelines as well. If the heart attack was uncomplicated by heart failure or recurrent anginal pain, the patient can safely resume sexual activity by the time he is able to walk up two flights of stairs or walk a block without discomfort. This usually occurs 3-6 weeks after leaving the hospital.

One should avoid putting extra strain on the heart by not eating large meals or drinking too much alcohol. Very hot or cold baths or showers before or during lovemaking are also inadvisable, as is intercourse in an overheated room. If you do have chest pain or palpitations for more than 15 minutes after intercourse, see your doctor. He may just recommend that you take a nitroglycerin tablet before or during loveplay.

Finally, remember that recovery from a heart attack can be enhanced by the satisfaction that comes from a loving physical relationship with one's partner. Although sexual intercourse is a desirable aspect of physical intimacy, it is not an essential part of it-and one can achieve orgasm by other means if impotence remains a problem. Sex after a heart attack can be safe and satisfying!
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Copyright 1992 Gale, Cengage Learning. All rights reserved.

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Publication:Medical Update
Date:Mar 1, 1992
Previous Article:Spotlight center stage.
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