Most heart and stroke patients whose conditions are stable can safely have sex, according to new U.S. guidelines.
The American Heart Association published the recommendations on sexual activity and cardiovascular disease on Thursday. The review by experts in heart disease, exercise physiology and sexual counselling concluded that people with stable symptoms generally have a low risk of heart problems with sexual activity.
Those who exhibit unstable symptoms while with minimal physical activity or at rest should first be treated and stabilized before engaging in sexual activity, the authors concluded in Circulation: Journal of the American Heart Association.
The recommendations include:
- It's reasonable for people diagnosed with cardiovascular disease to be evaluated by a physician or other health-care provider before resuming sexual activity.
- Cardiac rehabilitation and regular physical activity can reduce the risk of cardiovascular complications related to sexual activity in people who have had heart failure or a heart attack.
- Women with cardiovascular disease should be counselled on the safety and advisability of contraceptive methods and pregnancy based on their individual profile.
- Patients should be assessed to see if their sexual dysfunction is related to underlying heart disease, anxiety, depression or other factors.
- Drugs to treat erectile dysfunction are generally safe for men who have stable cardiovascular disease but should not be taken by those receiving nitrate treatment for chest pain due to blocked arteries.
The absolute risk of cardiovascular events is "miniscule" because sexual activity is short in duration and is estimated to cause less than one per cent of all heart attacks, the authors noted.
Last year, an analysis published in the Journal of the American Medical Association concluded that people who exercise regularly have a much smaller risk of having a heart attack immediately after sexual or physical activity.
The guidelines also include recommendations on sexual activity for other heart conditions such as heart failure, arrhythmias and pacemakers and heart conditions present at birth, as well as for estrogen replacement therapy after menopause and herbal medications.