Heart healthy enough for sex?

The TV ads for prescription medicines to treat erectile dysfunction (ED) tell viewers to “ask your doctor if your heart is healthy enough for sex.” So it begs the question … when would your heart NOT be healthy enough?

We asked a Marshfield Clinic cardiologist, Dr. Ralph Fitz, for his take. In general terms, he said if you can walk at a medium pace and go up two flights of stairs at a normal pace, you should be healthy enough to have sex.

A low-risk proposition

“Sex is actually pretty low on the exercise scale,” Fitz said. “The risk of anything catastrophic happening is very low.”

If you’ve recently had a heart procedure, you and your doctor likely discussed a timetable for resuming normal activities, including sex and the use of medications.

“Most bypass surgery patients are pretty happy with a six-week wait. But occasionally I’ll get someone who tries to have sex too early,” Fitz said. “It’s probably wiser to wait until the chest incision is better healed, even if your repaired heart is up to the event.”

If you’ve had a less invasive heart treatment, such as placing stents through narrowed arteries, you can resume most activities, including sex, at about 14 days. If you’ve had a portable device implanted, such as a defibrillator or pacemaker, you can enjoy sex at about four weeks after implant, as long as it isn’t vigorous enough to activate your device.

Heart patients beware

“Also, if you feel increasing chest pain with less activity than I just described, you shouldn’t have sex without talking to your family doctor or your cardiologist,” Fitz cautioned. If you had a heart attack, you should wait four weeks and discuss with your doctor.

For stable angina, valve disease and heart failure, if you have reasonable exercise tolerance, sex is generally safe.

The nitrates warning

As the ads suggest, you should not take Viagra, Cialis or other ED medications if you are on chronic nitrates or nitroglycerin to treat your angina.

“And even if you’ve been recently off nitrates and haven’t had sex for a while, if you are planning a weekend getaway and to use ED meds to have sex, I would not advise you to do that,” Fitz said. “Some nitrates are long-acting and can be dangerous, especially if you have not been sexually active.”

Talk to your doctor

The biggest takeaway message?

“Talk to your doctor if you have questions, and if you’re using nitrates regularly, you need to talk to us about refraining from the use of ED medicines. You must not use them without coordinating it with your doctor,” he said.