Making love when you have heart disease – is it safe?

Are palpitations, tightness or chest pain during sex dangerous?

“Just as dangerous as palpitations, tightness and chest pain while cycling, gardening or climbing the stairs,” said Peter Leusink, senior lecturer in sexual health. “When people make love to each other, they get aroused, they feel lust and they come. It may seem as if you are losing control of your body, but that is not the case. Having sex together is just as much of an effort as cycling together. It is normal for your heart to beat faster and for your breathing to speed up. If you can walk around the block without pain, and most heart patients can, you don’t have to be afraid to make love. If you are, start with self-gratification first to experience what arousal and cumming do to your body. Incidentally, the risk of a heart attack or stroke during sex is negligible. The research that has been done shows that the chance is one in a million to have a heart attack up to an hour after the start of the lovemaking. If people have previously had a heart attack or stroke, the chance is one in half a million. Still very very small.”

Is it safe to use erection pills if you have heart disease?

“You should not use an erection pill containing a drug such as sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra) if you have had a heart attack less than six months ago. Erection pills are very safe, also for heart patients. They can be combined with many other medicines, except with the ‘tablet’ or ‘spray under the tongue’. People who want such a pill, I ask: ‘Do you still get excited?’ Because that’s where sex starts. If not, you will first have to investigate with your partner how you can feel that again. Compare it to a rollator, which is also an aid, it will not make you walk. For example, you have to look for sexual stimuli yourself and provide arousal. If that succeeds, an erection pill can make an erection last longer. Women should see if they can still get moist enough. If that doesn’t work, use a lubricant, otherwise penetration will hurt too much. With chronic diseases, including heart disease, it can take longer before you get aroused again. Even after menopause it takes longer to get excited. Take the time for that and discuss what you like and enjoy together. You have to explore. That is very different from seeing if penetration is successful again.”

Can heart medicines make you less interested?

“In particular, blood pressure lowering drugs can cause problems to get excited. For this, good blood flow to the erectile tissue is important, which applies to both the penis and the clitoris. The clitoris is larger than just the tip, there is an entire organ behind it that consists of the same tissue as the erectile tissues of the penis. In a heart disease those cavernous bodies already have less blood circulation because the vessels are narrowed. It can sometimes make a difference which blood pressure lowering medicines you are taking. If you want to try out whether another remedy is less of a problem, do so in consultation with your treating doctor. There are many types of heart drugs, and the sexual side effects are not always predictable. Definitely discuss this with the doctor, but remember that lack of excitement is never just due to the medication. Heart medicines have no effect on orgasm and dry ejaculation, where the semen ends up in the bladder, so not outside the body. That does apply to drugs for prostate complaints that older men sometimes use, and to antidepressants.”

Read more? The rest of this article will be in the new ‘Heart’ guide to be released in June 2021. Order the guide here for only €9.95. With free shipping!