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Can I still have a love life?

It’s a question that heart attack survivors rarely articulate, even though it’s on their minds. After all, they wonder, if shoveling snow can trigger a heart attack, what about having sex? The fact is, sex isn’t all that strenuous. Men burn an average of five calories a minute during lovemaking—that’s about as demanding as walking a 20-minute mile or playing a game of table tennis.

Of course, what makes sex stand apart from a simple stroll are the emotions it stirs up. Could mental arousal coupled with physical exertion—both of which quicken the pulse, raise blood pressure and activate the blood’s tendency to clot—translate into high risk for men with heart disease? Researchers trying to answer that question interviewed 858 sexually active patients—most of them men—a week after their heart attacks. It turned out that only a tiny minority had had sex within two hours before their attacks. The researchers calculated that even for men with heart disease, the chance of having a heart attack during sex is only 20 in a million.

But sometimes statistics aren’t enough to reassure a heart attack survivor that it’s safe to make love again. Depression and anxiety—common in the wake of a heart attack—may put a damper on desire. Because both conditions affect a patient’s quality of life and contribute to cardiac risk themselves, it’s important to seek treatment for depression and anxiety.

Other times, the spirit is willing but the flesh is weak—a problem often traceable to blood pressure pills and other medications that may make it difficult to achieve and/or sustain an erection. That, too, is a subject that should be discussed with your doctor.

Is it time to resume your sex life? These points may be helpful:

  • Have sex as soon as you feel ready. It may take as little as two weeks to get to that point, but there’s no reason to rush.
  • Approach sex as you would any other physical activity such as brisk walking or stair climbing. Yes, you should be cautious, but there’s no need to be afraid.
  • Choose a time when you feel comfortable and relaxed.
  • Choose a peaceful place. There should be no ringing phones or other interruptions.
  • Don’t have sex right after a meal. Give the digestive process a three-hour head start.
  • Remember any medication your doctor may have instructed you to take before having sex.
  • Interrupt sexual activity if you feel cardiac symptoms coming on, and discuss the problem with your doctor.

When it comes to sexual activity and heart disease, perhaps the best advice is to keep the lines of communication open between you, your partner and your doctor.