When most people hear the term disabled or physically challenged, they immediately think of someone with an affliction that you can easily see, such as a person who is in a wheelchair, who uses a cane, or who signs instead of speaks. Not every ailment is visible, however, and one of the most common problems that affects sexual functioning is a heart attack.Overcoming fear
You may have heard rumors of famous men who died because of a heart attack while in the throes of passion. I can’t attest to the truth of any of these stories. But I can tell you that, for the average person who suffers a heart attack or undergoes heart surgery or even has angina, problems with sex almost always result. Not that these people don’t want to have sex, but they’re afraid. They worry that, as a result of engaging in intercourse or having an orgasm, they will trigger another heart attack — this time, a fatal one.
This isn’t an absolutely foundless fear, but studies show that the increased risk is really minimal. For healthy people, the risk of having a heart attack after sex is about 2 in a million. For people with heart conditions, that figure rises to 20 in a million. Even though the number increases by tenfold, you can see that the risks remain very small.
Certainly, for a time after you’ve had a heart attack, your doctor will forbid you from having sex. And just because the doctor gives you the green light doesn’t mean that you will feel ready. It doesn’t take much to make a man lose his ability to have an erection, so you can imagine that the fear of provoking a heart attack can certainly cause impotence. For women, the usual problem is anorgasmia, the inability to have an orgasm, and it is equally understandable that a woman who normally gets little enjoyment from sex may be reluctant to participate in the act.
The best treatment for fear of sex after a heart attack is reassurance from your physician or cardiologist. I believe that this reassurance should take place in the hospital while you are still recuperating. Sexual performance is almost always a concern of someone who has had heart problems, and having your fears alleviated as quickly as possible can help speed up your recovery. If you need further tests to determine what you can and can’t do, then, by all means, you should get them. No doctor should consider the loss of sex as no big deal because it is a big deal — not only for the patient, but also for the patient’s partner.
By the way, the patient may not be the only one who suffers from impotence or anorgasmia. The partner, who is just as afraid of causing a crisis with his or her lover’s heart, can also suffer. The partner may need just as much reassurance as the patient.
One way to overcome the fears associated with sex is to make masturbation the first step and slowly work your way up to intercourse. You can also perform masturbation on your partner so he or she doesn’t have to be sexually frustrated during your recovery.
It may not all be in your head
Fear isn’t the only factor that can cause impotence. Vascular problems usually accompany heart problems, so — because a man’s erection results from blood flowing into the penis — sometimes the impotence a man experiences after a heart attack has physical rather than mental causes.
Angina, shortness of breath, and palpitations are problems associated with heart conditions, and, although they may not be deadly, they can certainly put a crimp in your sex life. Very often these symptoms show up after you’ve had an orgasm, when your heartbeat is on its way down. Now, if you get an angina attack (a sharp pain in the chest area) every time you orgasm, these attacks won’t improve your desire for sex. Here, again, you should consult with your physician or cardiologist. Don’t be ashamed to ask specific questions. Your doctor may have suggestions that will help you have a relatively normal sex life, and you have every right to find out.
What can you do?
Here are some specific tips that may help you if you have heart trouble.
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If you have a heart condition, don’t engage in sexual activity when you’re angry or under a lot of stress. At these times, the heart already beats faster, and sex would only tax its abilities even more.
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See if your doctor can prescribe drugs such as calcium channel blockers or beta blockers for you. These drugs can make sex easier on your heart.
Some heart patients decide for themselves to take their heart medication, such as Inderal (propranolol) or nitroglycerin, before having sex, thinking that they can prevent heart troubles.
Do not attempt such techniques without first checking with your physician. (Propranolol is used on a schedule, so taking it out of schedule can be risky.) Men suffering from impotence may consider taking Viagra or another drug used to treat erectile dysfunction. This can be deadly, however, so don’t ask for a prescription from another doctor without first checking with your heart specialist.
The medications that are prescribed for heart conditions, such as beta blockers, antihypertensives, and diuretics, can cause sexual functioning problems of their own. Sometimes your doctor can prescribe alternative medicines that will still be effective without getting in the way of your sexual functioning, so ask questions of your cardiologist.
Both the medical profession and the patients share the responsibility for the lack of communication between them. Some cardiologists gloss over the sexual aspects, but many times the patients are simply too shy to discuss their sexual problems with their cardiologist. This embarrassment especially holds true for older people, who form the biggest proportion of heart patients. They may believe that, at their age, sex isn’t important. But sex is important,and it can play an important role in your recovery. Don’t ignore sexual problems; speak out.
I believe that consulting with a sex therapist who is trained in working with people with heart ailments is also a good idea. Sex therapists aren’t shy about speaking to you about your sexual functioning, and, if necessary, they can act as an intermediary and speak to your doctor to find out exactly what sexual activities you can perform safely.
