Sexual activity 'safe for patients with stable cardiovascular disease'
The American Heart Association scientific statement contains recommendations by experts from various fields, including heart disease, exercise physiology and sexual counselling.
“Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners,” Glenn N. Levine, lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston, Texas, said.
“Unfortunately, discussions about sexual activity rarely take place in the clinical context,” he said.
The recommendations also include certain others pointers for individuals suffering from cardiovascular diseases.
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 counselled 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, 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 statement also added that 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,” Levine said.
“On the other hand, there are some patients for whom it may be reasonable to defer sexual activity until they’re assessed and stabilized,” he added.
The statement has been published online in Circulation: Journal of the American Heart Association.