Intimacy and Heart Disease: Resuming Sexual Intimacy

When you both feel ready for sex, start slowly. Once you have your doctor's OK, having sex with a partner you know well, in nearly all cases, will not cause a heart attack. On average, sex takes about as much energy as climbing two flights of stairs. Here are tips for resuming safe sexual intimacy.

Be patient. Give your partner and yourself time to rebuild intimacy.

• Start out slowly and give yourself time to feel ready. Try hugging, kissing, touching, or caressing at first. This will help you both feel close and wanted.
• Foreplay is activities that arouse but are short of intercourse. They help the body relax for the activities to come next.
• Choose a quiet, relaxed place to be intimate. Keep the temperature in the room comfortable.
• Choose a time when you both feel rested. Try when you wake up in the morning or after taking a nap.
• Wait at least 1 hour after eating, taking a bath or shower, or exercising before you have sex.
• If your doctor has prescribed medicine to be taken before sex, take it as directed.

• If you have chest pain (angina) during sex, stop and take nitroglycerin as prescribed. Call your doctor as directed. Keep in mind that it isn't safe to take nitroglycerin along with certain medicines for erectile dysfunction (ED). If you have chest pain after having taken a medicine that makes nitroglycerin unsafe, don't take nitroglycerin. Instead, wait and relax for a few minutes. If your chest pain doesn't get better and go away, call your doctor.
• If you have shortness of breath during sex, stop for a few minutes. If it doesn't go away, or if it comes back when you resume sex, call your doctor.
• If you have trouble sleeping after sex, or you're very tired the next day, talk to your doctor.
• If you can't become aroused, talk with your doctor. ED is fairly common, especially in people who have heart disease. It may also be caused by certain heart medicines, especially those for blood pressure control. Your doctor may be able to change the dose of your medicine. Or they may give you medicine to improve sexual function, unless you're taking nitrates.

If you've had heart surgery, ask your doctor when you can resume sex. Once your doctor says it's OK, sex should not cause any harm. Healing from surgery most often takes 4 to 6 weeks. To prevent pain until you've healed, stay with lower-level activities that don't put stress on your chest.