What About Sex?
by Wayne M. Sotile, Ph.D.

What about sex? This is a question on the minds of many recovering heart patients and
their mates. Here’s a list of commonsense strategies for managing this important part of
your rehab.
Let’s start with a few reminders:
· Anxiety about the ability to respond sexually is normal
· Accept that things might not go perfectly. Sex after heart illness is not dangerous; but
it’s also not simple.
· Remember that signs of sexual arousal are similar to signs of cardiovascular
problems. But sex is generally safe for heart patients; sexual activity causes very little
strain on the heart.
· Pace yourself.
· Remember your relationship. Anxiety about sex and your heart will lessen as you
both become comfortable discussing sex, being affectionate, and relaxing together.
· Guidelines for heart-safe sex:
¨ Don’t have sex (or do any form of exercise!) in excessive heat or cold,
or after a long evening of heavy eating or drinking.
¨ After a meal, wait at least ninety minutes before having sex.
¨ Make plans. If you' re thinking about making love, wait to initiate sex
until you and your partner are both relaxed, and choose positions that
do not strain your surgical wounds.
¨ The more comfortable you are with a lover, the more likely it is that
your body will cooperate with your sexual intentions.
¨ Rest for a while before you make love, and afterward as well.
¨ Don’t abruptly plunge into moderate-to-vigorous exercise of any sort,
including sex. Get in shape first!
¨ Do not attempt sexual relations when you are emotionally upset.
¨ Use positions that are comfortable for both you and your partner.
¨ If you' ve had surgery, you may find sex easier if your partner is on top
during the early stages of wound healing.
¨ To prevent shortness of breath, try lying side by side and facing each
other during sex.
¨ Select from a varied menu of sexual experiences;

This list is taken from my book, Thriving With Heart Disease:
¨ Never mix nitrates with Viagra or any arousal-enhancing
medication or formula.
¨ Never take ephedrine or any of its non-FDA-approved derivatives-
-ephedra sinica, sida cardifolia or epitonin--unless you have
discussed it with your doctor and are under medical supervision.
¨ If you have a history of heart rhythm disturbances or are concerned
about developing one, avoid anal intercourse.
¨ Do not stop taking any cardiac medication because of sexual side
effects. Instead, talk to your doctor.
¨ Discuss with your partner a plan for what to do if you begin to have
chest pain during sex: stop what you are doing; rest; if chest pain
continues, call your physician. (Even if chest pain passes, discuss what
happened with your physician.).

Remember: the better shape you are in – physically, emotionally, and in your relationship
– the more likely it will be that sex will continue to be a safe and fun part of your life.

to order Thriving with Heart Disease