Is it safe to have sex if I have heart failure?

Answer From Rekha Mankad, M.D.

If you're living with heart failure, you know that physical activity may leave you feeling fatigued or short of breath. If exercise makes you feel winded you might wonder — is it safe to have sex?

Sex is typically a moderate form of exercise — it generally falls into the same activity level as climbing two or three flights of stairs. So, it's not uncommon for those with heart failure to worry that having sex might further harm the heart, especially after surgery or a procedure. Also, heart failure medications may dampen the sex drive or cause unpleasant sexual side effects. An estimated 60 to 87 percent of those living with heart failure say they have sexual problems.

However, remaining sexually active is important for maintaining a healthy quality of life and to stay connected to your partner. How do you do that with heart failure? Stick with your cardiac rehabilitation plan. The American Heart Association says cardiac rehab and exercise can cut the risk of sex-related complications in those with heart failure. Research suggests that participating in an exercise program helps boost oxygen levels and reduces your heart rate during sexual activity, making it safer and more pleasant.

Keep in mind that sexual intercourse may not be safe for your stage and type of heart failure, but kissing and touching is okay. For example, you're considered high-risk for complications during sexual activity if you have New York Heart Association class IV heart failure or if you had heart surgery within the last one to two weeks.

So skip sex until your doctor says you are stable. Start with kissing and touching. Take all your medications as directed, and don't skip meds for fear of sexual side effects. Don't try over-the-counter herbs or supplements to boost your sex drive, either. If you have any sexual difficulties, don't be shy about talking to your cardiologist or other doctor. The American Heart Association and the European Society of Cardiology want everyone with the disease to be screened for sexual problems and offered counseling as part of their rehabilitation. Some evidence suggests that five hours of sex therapy can help you return to sexual activity more quickly after a cardiac event.

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Rekha Mankad, M.D.

July 27, 2018 See more Expert Answers