Sexuality and its problems in patients with heart disease should be understood from different points of view.

Psychosocial point of view:

The health professional must understand sexuality as an integral part of the life of the adult individual. When you go to the doctor’s office, you should feel that you have the space to talk freely about your sexual problems and concerns. An open medical consultation, without taboos regarding sexuality, can solve many problems related to this issue.

Having a heart disease does not mean that you cannot have a full sex life.

Sexual dysfunction:

We will define it as the inability to have satisfactory sexual relations and it is present in both men and women. Although in man it is more widespread, in this case, it is due to the inability to have sufficient and lasting erections to have sex.

Psychological factors:

There are psychological factors that can affect your sexuality. For example, the following problems often occur after a heart attack or other cardiological condition:

  • anxiety or depression
  • loss of libido or sexual desire
  • fear of making an excessive effort

If you have recently had a cardiovascular event, you may have doubts about whether or not you can make physical efforts. Many times there is a fear of death or of having a heart event again in the context of the sexual act. This generates anxiety, depression and can condition you to have a normal life. It is important to keep in mind that when suffering from a cardiovascular disease, you may have a greater or lesser degree of limitation to physical activity. A correct medical assessment will give you information about your ability to exert yourself and limitations.

As a rule, after a heart condition it is advisable to avoid physical efforts (including sexual activity) for a few days or weeks, depending on the type of condition and the severity of the condition. After this time your doctor will perform an assessment determining the stability of your condition, and if necessary, your ability to make an effort (through stress tests, for example).

It is difficult to establish exactly the level of effort of sexual activity since several factors intervene, including the level of arousal, just to cite an example. However, it is estimated that if you can perform two stages in an exercise test without developing clinical or electrocardiographic changes, you are in a position to have a normal sex life.

Erectile dysfunction (or male sexual impotence):

It has three main origins:

  • Psychological (already commented previously)
  • Organic: in patients with heart disease, blood vessel disease that irrigates the sexual organs may occur, as a result of the same atherosclerotic disease that affects the coronary arteries or other arteries of the body due to the accumulation of cardiovascular risk factors. In this regard, there are several treatment routes to improve erectile dysfunction, from the best known drugs (Viagra┬«, Cialis┬«, among others) to other techniques practiced by the specialist (Urologist). In our center we have professionals specialized in erectile dysfunction and treatments. In an upcoming blog post we will talk more specifically about the indications and contraindications for patients with heart disease of the drugs used in erectile dysfunction.
  • Pharmacological: side effects of medications. There are some drugs that in some cases can cause you, or loss of the livid, or erectile dysfunction or ejaculation disorders. Although these effects are rare, the presence of the causative drug can be assessed in the presence of another with a better tolerance for you.

Many times it is difficult to differentiate the cause of sexual dysfunction, whether psychological or organic, and a medical consultation can help to differentiate its origin.

Sources:

https://www.hopkinsmedicine.org/health/wellness-and-prevention/is-sex-dangerous-if-you-have-heart-disease

https://www.health.harvard.edu/heart-health/matters-of-the-heart-sex-and-cardiovascular-disease

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