By Henrylito D. Tacio
Yes, a person can have sex again – even after a heart attack. Such assurance comes from a doctor who is a recipient of the Outstanding Filipino Physician Award from the Department of Health.
“A person who survives a heart attack can sex again provided he follows some precautions,” says Dr. Willie T. Ong, an internist-cardiologist, who is an active consultant in cardiology at the Manila Doctors Hospital and Makati Medical Center.
A heart attack happens when some of the heart’s blood supply is suddenly and severely reduced or cut off, causing the heart muscle to die because it is deprived of its oxygen supply.
Generally, the most recognizable symptom of a heart attack is pain in the middle of the chest that may spread to the back, jaw, or left arm. Less often, the pain spreads to the right arm.
“During a heart attack, a person may become restless, sweaty, and anxious and may experience a sense of impending doom,” says The Merck Manual of Medical Information. “The lips, hands, or feet may turn slightly blue.”
A heart attack is a medical emergency. “Half of deaths due to a heart attack occur in the first 3 to 4 hours after symptoms begin,” the Merck manual points out. “The sooner treatment begins, the better the chances of survival.”
Those who survive a heart attack are usually wary of having sex with his partner. But the chance of another heart attack during sex is a myth. In fact, the chance “is so low that it’s not worth worrying about,” says Dr. James E. Muller, a researcher who published a 2000 study, ‘Triggering of Cardiac Events by Sexual Activity,’ in the American Journal of Cardiology. “The absolute risk is very low and should not be a consideration for those with stable coronary disease,” he points out.
Of course, it’s normal for patients to have sex less frequently in the weeks and months after a heart attack. A patient has “no choice but to abstain (from any sexual activity), by virtue of the fact that he or she is still recovering from the illness,” says Dr. Helen Ong-Garcia, a cardiologist at the St. Luke’s Medical Center.
Generally, patients can resume sex after a heart attack if they are “able to walk a couple of flights of stairs, if they’re able to walk on a treadmill, or do moderate-intensity activity without any chest discomfort or without any severe shortness of breath,” says Dr. Randal Thomas, a preventive cardiologist and director of the Cardiovascular Health Clinic at the Mayo Clinic.
The American Heart Association says a doctor may prohibit sex among those who survived heart attacks in the following instances: a few days after a heart attack, bothersome chest pains, and shortness of breath.
Dr. Ong advises patients with heart disease or those who survived heart attacks to follow these five tips before engaging in sexual acts:
Get a medical clearance first from your doctor. After a heart attack, a cardiologist would usually request a treadmill test (jogging while being monitored by electrocardiogram). This test would determine how much physical activity, measured in metabolic equivalents (METS), a patient is allowed before the oxygen supply to the heart is hampered.
“During an orgasm, the heart rate dramatically increases from 80 beats to 114-145 beats per minute,” Dr. Ong says. “The blood pressure also jumps by 40 millimeters of mercury, so a systolic blood pressure of 130 can reach 170 during climax.”
A person will expend 5 METS while having sex with his wife, Dr. Ong informs. However, he discourages those who survived a heart attack from engaging in sexual activities other than their wives. Doing so would bring the energy level to 10 METS.
“The stress and excitement of having an unfamiliar partner in unfamiliar territory is equivalent to an hour of heavy cycling or rowing,” Dr. Ong says. “This explains why some people unceremoniously die in motels while ‘in action.’”
Ask the healthy partner to do the work. “For more serious cases, the heart patient may preferably lie on his or her back and let the healthier spouse stay on top,” suggests Dr. Ong. “It’s hard to imagine a post-heart attack patient performing acrobatic maneuvers in bed.”
If both partners have heart problems, Dr. Ong suggests that they practice “intimacy without sex.”
Do it in the morning. Here’s the reason why, according to Dr. Ong: “Patients usually feel stronger and healthier in the morning as compared to the wearisome hours of the evening. Older patients usually feel weaker and more tired as the day goes by. So, a ‘morning special’ may be a good idea.”
Take a light meal only before sex. Some motels advertise three-hour use of their special mirrored rooms, including a free steak and soda for only P1,000. You better take note.
“Gorging on food immediately before making love is not advisable because digesting food would make the blood supply preferentially go to the stomach and deprive the heart of much-needed oxygen,” warns Dr. Ong. His friendly advice: “Take your free meal after sex and not before.”
But for those who have already eaten, they must wait from one to three hours after eating a meal before engaging in sexual activities. The waiting time allows the digestion of food to be taken.
Don’t forget to take your medications. This is very important. Usually, heart patients take several pills like nitroglycerine to dilate the arteries of the heart, and other pills for high blood pressure, diabetes, or cholesterol problems.
“Just continue taking your medications a few hours before lovemaking as we want you to be strong and protected,” Dr. Ong reminds. “Those with chest pains should have their pills handy just in case they feel something is wrong. Be prepared. Have all your pills, patches, gadgets, and a glass of water ready to go.”
What about those having problems with erectile dysfunction or impotence? Can they take those erection-enhancing medications? Although they are not highly recommended, its intake remains safe, as long as it is not taken at the same time with nitroglycerin, physicians caution.
The US Food and Drug Authority warns that the combination can send blood pressure plummeting to unsafe levels and cause dizziness, fainting, heart attack or stroke. “There have been some reports of death,” says Dr. Thomas. “Anybody who’s had a heart attack or heart surgery should definitely be cleared through their doctor before they think of using any of the medications for sexual dysfunction.”
Dr. Edgardo E. Eba, consultant of the Cardiac Rehabilitation at the Philippine Heart Center, assures, “No one dies (by engaging in sexual activity). Just don’t go into any sexual activity without preparing yourself.” – ###
