Physicians often fail to counsel recovering heart attack patients on whether they are at risk of having another myocardial infarction triggered by sexual activity. In a letter to the Journal of the American College of Cardiology, Dietrich Rothenbacher, MD, MPH and colleagues have reassuring data.
Is sex after a heart attack safe? Researchers in Germany who conducted a prospective cohort study in coronary heart disease patients undergoing rehabilitation after a myocardial infarction came up with reassuring news.
"Patients need not be worried about sexual activity and should resume their usual sexual activity," Dietrich Rothenbacker, MD, MPH of the Institute of Epidemiology and Medical Biometry at Ulm University in Ulm, Germany, and colleagues wrote in a letter to the Journal of the American College of Cardiology."
They also assumed that sex isn't all that physically stressful for most people.
"Sexual activity generally inolves moderate physical activity for a relatively short time," they wrote, "comparable to climbing two staircases or taking a brisk walk."
The team queried patients 30 to 70 years old about their sex habits, including masturbation, during the 12 month period before their heart attack. The subjects had a mean age of 57 years.
They then followed these patients for 10 years.
After adjusting for age, sex, education, smoking status, comorbidities, and other factors, they found that there were 100 adverse cardiovascular events in these 536 patients during the 10 year study period.
The question was, were they related to sexual activity?
First they looked at the timing of the subject's initial heart attack to see whether it had been triggered by having sex. Only three of those patients said the event happened within an hour after having sex.
"It seems very unlikely that sexual ativity is a relevant trigger of MI in this population," they concluded.
Looking at the timing of the last sexual activity before a second MI in the study group, they found that only 0.7 % of patients had engaged in sex within an hour before the MI and 78.1% said it had happened more than 24 hours before the MI>
Further, they found, despite a presumed lack of consensus on physicians as to whether sexual activity after a heart attack is risky, there was only a modest decrease in sexual activity after MI. In men, the percentage of sexually active participants dropped from 74% to 68% post-MI. The women in the study were already far less likely to be sexually active. In female study participants, the percentage of those women who were sexually active dropped from 44% before their MI to 40% after.
They conclude that the benefits of sexual activity outweight the risks.
They also noted that erectile dysfunction can be a side effect of medications taken after an MI, and that when taken with other drugs, ED medications can cause blood pressure to drop Those hazards should be communicated, they wrote.