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Why This Doctor Prescribes Sex After Heart Disease

You don't have to give up on intimacy out of fear

By Barb DePree, M.D.

Heart disease is a sobering reminder of mortality. After a heart attack or surgery, you live with a new reality: dietary restrictions, lifestyle changes, a new pharmaceutical regimen. You’re likely more conscious of your breathing and your heart rate.

With all the preoccupations and adjustments that accompany heart disease, sex can become a low priority. Maybe you’re afraid intercourse will damage your newly fragile heart — or actually trigger a heart attack. It’s hardly surprising if it’s difficult even to be interested in sex.

And yet, after a heart attack, we know it’s important to resume normal activities and to feel connected to people and life. What better way to feel vital and connected than to make love with your most intimate companion?

What Gets in Our Way

Generally, the issues that stifle your sex life after a heart attack or surgery have to do with fear, depression, medication and lack of communication with the doctor.

First, let’s address the persistent myth that sex can cause a heart attack. Studies repeatedly show that, if you can walk up a flight of stairs or carry a 20-pound bag of groceries into the house, you’re fit enough for sex. If you’ve passed the stress tests and are cleared to resume normal activity, what better activity than sex? Sure beats doing the laundry.

Talk With Your Provider

If you continue to worry, air your concerns with your doctor. A study at the University of Chicago showed that doctors frequently neglect to talk with patients about their sex lives after a myocardial infarction and that this tendency was particularly pronounced with female patients. (Fewer than half the men and a third of women received instructions about sex when they were discharged from the hospital.)

Patients who didn’t receive guidance from their doctors about sex were less likely to be sexually active in the year following their heart attack. If the doctor doesn’t advise you about sex, please initiate the conversation yourself.

Tackling Depression

Depression commonly follows on the heels of heart disease, and women are more likely to become depressed than men. And both depression and many antidepressant drugs are likely to suppress sexual interest, leaving you between a rock and a hard place, sexually speaking. The good news is that depression after heart surgery or a heart attack usually resolves itself in about three months.

Other medications, like beta­ blockers that lower blood pressure and regulate heart rate, have also been linked with depression and sexual dysfunction. Again, your doctor may be able to adjust dosages or switch medication if necessary.

A Fun Workout


Finally, the good news is that sex is good for you emotionally and physically. It’s like a gentle, pleasurable workout. And anything you can do to improve your overall health — exercising, losing weight, stopping smoking — will improve your heart health and, incidentally, the quality of your sexual life.

So! You have a new exercise routine and a new diet plan — or at least foods you’ve resolved to avoid. It’s time for a sexual health regimen! Here’s my Rx:

  • When did you last buy yourself — or did your partner buy you — a sexy negligee? It’s time. It’s part of your heart health prescription. A doctor said so.
  • If you’ve fallen off your date­-night routine through the health emergency, get back in the groove now. Our relationships help us heal and maintain good health, and our most intimate relationships help us most. I know it’s not “sexy” to plan sex, but it’s easy enough to lose track of time in day­-to­day life without the added stress of recovery. Mark your calendar!
  • Investigate products that can help you be comfortable and enjoy intimacy. Massage oils can be a leisurely luxury. If you’re not already using a lubricant (or a warming lubricant), this may be the time to add that tactile element. A vibrator can give both you and your partner some fresh spark for exploration.
  • Factor sex (which is low-­ to moderate-­intensity aerobic exercise) into your workout routine at least once or twice a week. Your mood and relationship will benefit just as much as your body. (Strength and flexibility can be part of your “workout,” too, with some imagination.)
  • If you have any concerns about sex or your health, talk to your medical team. While they may not bring it up, your sexual health is a critical part of your overall health. If you’re in the midst of hormonal changes, you may find that some symptoms of menopause — more dryness, vaginal atrophy— have progressed while you were attending to other things. Your medical team — your cardiac surgeon, your primary care doc, or a menopause care provider — can help you recover.
  • Love yourself. You’ve survived and will thrive. You deserve attention, pampering, care. Start by giving it to yourself.


Barb DePree, M.D. Dr. Barb DePree is a gynecologist who has been providing health care to women for more than 25 years, and has devoted her practice to midlife women since 2006. She is the founder of Read More
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