Stroke Issues
Sexual Activity is Safe for Most Heart, Stroke Patients
By
Jan 19, 2012 - 5:29:38 PM

(HealthNewsDigest.com) - DALLAS, Jan. 19, 2012 -- If you have stable cardiovascular disease, it is more than likely that you can safely engage in sexual activity, according to an American Heart Association scientific statement.

The statement, published online in Circulation: Journal of the American
Heart Association, contains recommendations by experts from various
fields, including heart disease, exercise physiology and sexual
counseling.

"Sexual activity is a major quality of life issue for men and women
with cardiovascular disease and their partners," said Glenn N. Levine,
M.D., lead author of the statement and a professor of medicine at
Baylor College of Medicine in Houston, Texas. "Unfortunately,
discussions about sexual activity rarely take place in the clinical
context."

The recommendations include:


-- After a diagnosis of cardiovascular disease, it is reasonable for
patients to be evaluated by their physician or healthcare provider
before resuming sexual activity.
-- Cardiac rehabilitation and regular physical activity can reduce the risk
of cardiovascular complications related to sexual activity in people who
have had heart failure or a heart attack.
-- Women with cardiovascular disease should be counseled on the safety and
advisability of contraceptive methods and pregnancy based on their
patient profile.
-- Patients with severe heart disease who have symptoms with minimal
activity or while at rest should not be sexually active until their
cardiovascular disease symptoms are stabilized with appropriate
treatment.
-- Patients should be assessed to see if their sexual dysfunction is
related to underlying vascular or cardiac disease, anxiety, depression
or other factors.
-- Drugs that can improve cardiovascular symptoms or survival should not be
withheld due to concerns that such drugs may impact sexual function.
-- Drugs to treat erectile dysfunction are generally safe for men who have
stable cardiovascular disease. These drugs should not be used in
patients receiving nitrate therapy for chest pains due to coronary
artery disease (blockages in the arteries that supply the heart with
blood), and nitrates should not be administered to patients within 24-48
hours of using an erectile dysfunction drug (depending on the drug
used).
-- It is reasonable for post-menopausal women with cardiovascular disease
to use estrogen that's topically or vaginally inserted for the treatment
of painful intercourse.




Decreased sexual activity and function -- common in men and women with
cardiovascular diseases -- is often related to anxiety and depression.

The absolute rate of cardiovascular events during sexual activity, such
as heart attacks or chest pain caused by heart disease, is miniscule
because sexual activity is usually for a short time.

"Some patients will postpone sexual activity when it is actually
relatively safe for them to engage in it," said Levine, who is also
director of the Cardiac Care Unit at the Michael E. DeBakey Medical
Center in Houston. "On the other hand, there are some patients for whom
it may be reasonable to defer sexual activity until they're assessed
and stabilized."

Co-writers are Elaine E. Steinke, R.N., Ph.D.; Faisal G. Bakaeen, M.D.;
Biykem Bozkurt, M.D., Ph.D.; Melvin D. Cheitlin, M.D.; Jamie Beth
Conti, M.D.; Elyse Foster, M.D.; Tiny Jaarsma, R.N., Ph.D.; Robert A.
Kloner, M.D., Ph.D.; Richard A. Lange, M.D., M.B.A.; Stacy Lindau,
M.D.; Barry J. Maron, M.D.; Debra K. Moser, D.N.Sc., R.N.; E. Magnus
Ohman, M.D.; Allen D. Seftel, M.D.; and William J. Stewart, M.D.

The American Heart Association/American Stroke Association receives
funding mostly from individuals. Foundations and corporations donate as
well, and fund specific programs and events. Strict policies are
enforced to prevent these relationships from influencing the
association's science content. Financial information for the American
Heart Association, including a list of contributions from
pharmaceutical companies and device manufacturers, is available at
www.heart.org/corporatefunding.

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