TweetSex and Your Heart


To most people, "sexual activity" means sexual intercourse. But sex is much more than that. (In this article the word "sex" refers to sexual activity, not gender.) You can express your interests in sex in a lot of ways. You may just want your mate near you. Or you may like to touch and hold.
Several normal physical changes occur during sex. For example:


As you get aroused, your breathing rate slowly increases. Your skin also gets flushed. Your heart rate and blood pressure also become mildly elevated.


As you get more excited, sexual tension builds. Both heart rate and blood pressure rise even more.


During orgasm, you release pent-up tension. The heart rate increases to 90 to 145 beats per minute, with an average peak of 115 beats per minute. Blood pressure rises about 30-50 millimeters of mercury. After orgasm, your heart rate, blood pressure and breathing rate return to resting levels.

All these responses are normal during sex. In fact, you may not notice. People who've had a heart attack or heart surgery respond like others.


Sex After a Heart Attack or Heart Surgery

You can most likely resume sex as soon as you feel ready. But ask your doctor or nurse first.

A heart patient's interest in sex can be affected by such factors as:

age;


the length of a relationship; and


previous sex drive and pleasure.

Usually both men and women resume sex within a few weeks after a heart attack or heart surgery. More people resume sex after heart surgery than after a heart attack.

Most have sex as often as before. But some are less active. This may be due to anxiety, depression or lack of desire. Medical care and counseling may help.

When you recover from a heart attack, you may be more aware of your heartbeat, breathing, and muscle tightening or tension. This is normal, so don't worry.

You can touch, hold and caress without the goal of orgasm. You and your spouse can feel loved and secure without demands to perform. You don't need a lot of energy for these activities, and you can start soon after you leave the hospital. You can gradually return to your full sex life. As you get more confident, you will feel more at ease with yourself and your mate.

Intercourse takes slightly more energy than other sexual activities. So your doctor may tell you to wait until you feel stronger before you start back. Most are able to resume sex about four weeks after a heart attack. It usually takes two to three weeks after heart surgery.

If you're not sure you're ready for sex, a doctor can give you an exercise test to check your physical capacity. Your heart rate and blood pressure can help you and your doctor decide if you're ready. If symptoms occur during sex, your doctor may need to monitor your heart.


How Do Psychological Factors Affect Sex?

Psychological factors can reduce sex interest and capacity. After you recover, you may:

be depressed, sad or afraid;


have trouble sleeping or sleep too much, especially during the day;


eat more or less than usual;


gain or lose weight and be less interested in life; and


feel tired all the time (especially after activity).
These feelings are common. But in most cases they go away within three months after a heart attack or surgery. Problems with sex may increase if you remain depressed.

This loss of desire is often added to a false fear that sex will cause a heart problem. That's why a couple may stop having sex for months or even years. It doesn't have to be this way. Talk to your doctor about counseling. People depressed longer than three to six months after a heart attack or surgery have far less sex and enjoy it much less than those whose depression lifts earlier.


Does Age Affect Sex?

You tend to have sex less often as you age. But your interest can last as long as you stay healthy.

Aging can affect a man's ability to get erect. Because this may take longer to occur and require more stimulation than before, men often worry about their sexual ability.

A woman may fear she is less attractive as she ages. The vagina of an older women lubricates less and more slowly. Your worry about aging, added to heart disease, can affect your sexual desire and how you perform.


Will Medicines Affect Sex?

Many medicines for heart problems can affect sexual desire and how you perform. These include:

blood pressure medicines;


fluid pills;


tranquilizers;


antidepressants and some medications used for chest pain or irregular heartbeat.
Such medications may affect sex drive and normal sexual function. Male sex problems may include the inability to achieve or maintain an erection (impotence). Some men also may have premature ejaculations or none at all.

A woman may not have enough vaginal fluid, which can make intercourse more painful. Some women may not get sexually aroused (frigidity) or not be able to have an orgasm (orgasmic dysfunction).

But these changes may be due to something else. So don't stop taking your medicine. When you talk to your doctor, try not to feel shy or inhibited. Often a change in drug type or dosage may remedy it.


Preparing for Sex

You and your mate can prepare for sex in several ways:

Have a healthful daily routine of diet, exercise, rest and medicine.


Exercise is a great way to make you feel better and be more confident. Aerobic exercises include walking, jogging, swimming, bicycling or dancing. These activities can decrease your chance of rapid heart rate, lack of breath or chest pain during sex. Talk to your doctor first.


If you smoke, it's important that you stop.


Be patient with yourself. Try to understand your emotions. You or your mate may feel vulnerable after a heart attack or surgery. Your emotions may change quickly from tears to laughter or from happy to angry. These sudden mood swings are generally temporary. So try to be patient with each other. A good sense of humor helps.


Adjust what you expect from each other sexually. You may have had a good sex life before your heart problem. You may be afraid to resume sex, but don't let it stop you from enjoying each other again.


Avoid rushing into sex to prove things are "back to normal." If you and your spouse have sex before you're ready, your fears may not go away. In fact, they may cause even more problems. Don't expect too much at first. Most people must adjust to sex after a heart attack or heart surgery. There's no risk if you resume sex slowly and allow it to happen.
Resuming sex often gets you closer to your mate. It lets you rekindle tenderness and romance. Sex after a heart attack or surgery may ease stress. It can boost your self-esteem.


Coping as a Couple

Often heart patients aren't the only victims of heart disease, because their mates can also be anxious or depressed. Your feelings as well as those of your mate can add tension to your marriage. Both of you should recognize, respect and try to understand what the other is feeling.

Often a patient's mate fights to balance being over-protective and not helping enough. In most cases, spouses are over-protective. They don't like to make demands and upset their spouse. Or, they don't allow the person to be even normally active. They may feel guilty about their mate's heart disease; so they torment themselves by wondering if it's their fault. Other family members may be overly concerned, too.

If you and your family are depressed and anxious, serious conflicts may develop. A heart attack and heart surgery may change you and your mate's lifelong roles. For example, your spouse may have to be the major wage earner, or he or she may not like becoming a full-time homemaker if you used to hold or share that role. Either way, your mate will play a big part in how you cope and adjust.

Often a mate is concerned about the risk of sex and cardiac symptoms during sex. They may worry about sexual problems of the patient and other issues in your relationship. Your mate may feel angry and frustrated.

A couple may have already had problems with sex. These may get worse after a heart attack or surgery. Common complaints include:

mate chooses the wrong time for sex;


inability to relax;


lack of interest; and


not enough foreplay.
Generally, the more often a couple has complained about sex before the illness, the less often they have sex afterward.

Talk about the problems. Couples who discuss their sexual needs and concerns seem to cope better. Good communication may lead to earlier and better sex. A couple also should talk about their concerns and fears with a nurse or doctor. This can be done alone or jointly.


Guidelines For Resuming Sex

These guidelines can help you and your mate resume full sexual activity:

Choose a time when you're both rested and free from stress. The best time for sex may be early in the morning after a restful night's sleep or during the day after a nap.


It's best to wait one to three hours after eating a full meal before having sex. This delay allows your food to be digested. Like any other physical activity, digesting food requires more blood. When you use a lot of blood to digest food, your heart must work harder to have blood for other activities that need it.


Use a familiar, peaceful place where you won't be interrupted.


Take prescribed drugs before having sex.
After a heart attack or heart surgery, more than 75 percent of people don't change the way they engage in foreplay or sexual positions. For some, it's more comfortable for the heart patient to be on the bottom. But you may feel discomfort from an incision after heart surgery. If so, lie on your side facing your mate or with him or her in front or behind. These positions put less pressure on the chest wall and make it easier to breathe.

If you have a hard time breathing, you and your mate may want to sit in a chair facing each other. It's best to use a broad-based chair low enough to let you both rest your feet flat on the floor.

Your nurse or doctor can help you discuss your sexual preferences and alternatives. Masturbation helps some people regain self-confidence and may help ease the transition to intercourse. It causes less cardiac response and takes less of the body's metabolic energy. Oral-genital sex places no undue stress on the heart, but anal intercourse may lead to irregular heart rhythms.

Because couples fear cardiac symptoms or sexual problems, they may not be interested in sex. They can still build a good relationship if they cuddle and caress.


What If You Experience Symptoms During Sex?

Your heart beats faster and harder during sex and your skin can become flushed and moist. These changes are normal, not symptoms of heart strain.

Angina symptoms that show the heart can't handle the work load include:

a feeling of pressure, pain or discomfort in the jaw, neck, arm, chest or stomach;


marked shortness of breath; and


very rapid or irregular heartbeats.
If you have any of these symptoms during sex, tell your mate, reduce your activity, rest and take medicine according to your doctor's prescription. Nitroglycerine tablets, taken three times over 12-15 minutes, may help. When the symptoms go away, you and your mate may resume sexual activity.

If the symptoms aren't relieved by medicine, or if they recur after resuming sex, get medical help. Tell your doctor if:

it's hard for you to sleep or rest after sex;


you notice a change in the place, number of times or severity of angina; or


you're very tired.


You may need to make a small change in your daily routine or medicine.




What If It's Not the Same?

Even couples who don't have heart disease can have problems with sex. Factors that can contribute to these problems include:

too much alcohol;


some kinds of drugs and uncontrolled medical problems; and


fatigue and the stress of recovery.
People can become insecure when changes occur in their sexual roles. Sex problems can be even worse when you add:

fear;


marital conflict;


previous sex problems;


family, legal or financial problems; or


depression or other stresses.
Talk about your feelings, the nature and possible causes of problems, and potential solutions. If you don't deal with them, they can lead to more complex physical, emotional and social problems.




When To Seek Sexual Counseling

If questions about sex become a major concern, you and your mate can ask your doctor or nurse. You may ask alone or as a couple.

Some couples don't like to discuss sexual desires and concerns with each other or with a counselor. But you and your partner can benefit when you do.


Myths and Misconceptions

There are a lot of myths about sex and heart disease that can create fear and slow recovery. Here are some common myths and truths:

Myth: Men and women are impotent by age 50. Impotence and lack of sex drive always occur when they have heart disease.

Truth: Older men may get an erection slowly, but they often have sex longer and control their ejaculation better than younger men. After menopause, a woman can still enjoy sex. In some cases, she enjoys it even more. This may be due in part to the fact that she doesn't have to worry about getting pregnant.

Myth: Sex after a heart attack often causes sudden death.

Truth: This rarely happens. When it does, it usually occurs when one has sex outside of marriage. Extramarital sex is probably more stressful than sex with a spouse. Often there's an unexpressed need to perform well with a new partner. Sometimes, there's been a high food and alcohol intake. Sex outside of marriage usually occurs in a new place.

Myth: Alcohol is a great stimulant for sex.

Truth: Small amounts of alcohol may help reduce tensions, fears and guilt. This may help how you perform and feel. But alcohol is a strong depressant. It may hurt how you perform even more. The long-term effects of alcohol are serious. Alcoholics who become impotent may not recover even after drinking stops.

Myth: Male hormones can increase the sex drive in men.

Truth: Men whose male hormone levels have dropped can have more sex drive and ability. This occurs after they take a hormone called testosterone. But this drug doesn't help men who have normal levels of this hormone in their blood.

Myth: Female hormones (estrogen therapy) for women after menopause, or who don't have enough of these hormones, will improve sex drive.

Truth: No studies have reported that estrogens improve women's sex drives. But these hormones (as well as creams) may lubricate the vagina and make it easier for the penis to enter. Women thus may find sexual intercourse more comfortable.

Myth: It's best for the heart patient to be on the bottom during sex.

Truth: Studies show that there's no advantage to being on top or bottom.

Myth: The heart rate response is a lot lower when one masturbates compared to when one has sex.

Truth: The heart rate response is lower when one masturbates, but not a lot lower.

Myth: The decline in sex drive and function after a heart attack is due to the heart not responding to the physical demands of sex.

Truth: Except for a few cases, the big impact of a heart attack on sex drive and function is psychological, not physical. The physical demands of sex are moderate. They're similar to walking up two flights of stairs at a brisk pace.

Myth: If angina occurs during sex, you should abstain from sex forever.

Truth: Chest pains during sex are rarely severe enough to cause someone with heart disease to stop having sex. A doctor may suggest that nitroglycerin (or an equivalent tablet) be placed under the tongue 15 to 20 minutes before sex. This will help the heart work and stop chest pain. Your doctor may also give an exercise test to help find any physical problems. Your doctor may have you take drugs on a regular basis to stop chest pains. He or she also may also tell you to work out more often.


Conclusion

When you and your mate feel better about sex, things may improve in other areas of your lives. Heart disease may alter your life in ways you don't like. But it also can allow you to reflect on what's important. Take advantage of it. How you relate to family and friends could get even better.

TweetNice read!