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What Doctors Don’t Tell Women About Sex After a Heart Attack

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If you suffer a heart attack, your doctor is likely to give you all sorts of guidelines about what is and is not safe when it comes to diet, exercise, work, travel and more.

And if you’re a man, there’s a good chance that your doctor also will tell you whether it’s safe to have sex again.

But if you’re a woman? Don’t count on your doctor to initiate that important discussion about physical intimacy—because with female heart attack patients, a new study shows, physicians are strangely mum on the topic of sex. That’s a crying shame, because their silence is leading to lots of unnecessary confusion and fear in the bedroom for women—and for their partners.

PHONE SEX INTERVIEW

For this study, researchers turned to a registry of heart attack survivors to investigate how women tended to fare sexually in the aftermath of their heart attacks. They sent letters to invite participation, and then they started dialing. The respondents were women between the ages of 43 and 75. Generally they rated their health as good to very good. All were in monogamous relationships, either marriage or a long-term same-sex partnership.

The women were asked a number of questions including, “Has your doctor ever talked to you about sex after having a heart attack?”—and the answer to that query raised red flags. Here’s why…

  • The majority of women surveyed did not recall any discussion with their doctors about resuming sex. That’s sad—because previous research showed that patients who are not counseled about sex are much less likely to be sexually active one year after their heart attacks than patients who are counseled.
  • The few women who did recall such a conversation said that they had initiated the discussion themselves—and that the instructions they got were befuddling. For instance, one woman said, “I asked the doctor point-blank when could I have sex again, and he said, ‘When you can climb two flights of stairs without getting out of breath.’ Well, I could…hardly climb two flights of stairs before I had a heart attack.” In other cases, the instructions given were so vague as to be meaningless. Another survey respondent recalled, “The day before I left the hospital I said, ‘You didn’t tell me when I could have relations.’ So then he says, ‘Well, that’s going to be up to you, how you feel.’ But that’s not giving me an answer.”
  • It was odd and frustrating to the patients that doctors did not discuss sex, particularly since they provided detailed guidelines for many other activities. As one woman said, “They tell you not to run the vacuum cleaner, not to do this or that for so many months after. Why not say, ‘As far as your sexual activity, hold off for four weeks’?”
  • Although hospital discharge instructions can be overwhelming, the women generally felt that the discussion about sex should start at the time of discharge and then be continued during follow-up care. One woman suggested that doctors should ask about sex at every follow-up appointment, especially at the one-month visit: “It sets a precedent. Just knowing that [sex]is an open topic would go a long way in encouraging women to discuss it.”
  • When those important conversations don’t take place, fear can take over. In fact, fear was the driving factor behind women’s loss of sexuality following a heart attack. For instance, one respondent reported, “My heart beat real fast and it scared me”…another said, “Fear is not conducive to a healthy romp.” The women’s partners were fearful, too. One woman recalled, “At first he was afraid because he thought I would have another heart attack. I told him I’d rather die with a smile on my face…I had to convince my husband that I wasn’t going to die in bed.”

GUIDELINES GO IGNORED

Both the American Heart Association (AHA) and the American College of Cardiology recommend that physicians counsel their patients—notice that’s “patients,” not “male patients”—about resuming sex after a heart attack. Yet based on the results of this survey, it seems that doctors just aren’t following the guidelines. And that’s really too bad, because such conversations would most likely put women (and their partners) at ease. Reason: The AHA says that sex is generally safe after a heart attack provided that a patient is in stable condition and has no complications…and that heart attacks rarely occur during sex because sexual activity is usually relatively short in duration.

One caveat, dear readers: Research shows that when a heart attack does occur during sex, it is usually during extramarital sex, not sex with one’s spouse. For more on that topic, click here.

What you can do: First, for more background info, read AHA’s article Sex and Heart Disease. Then, to find out whether sex is safe for you, prepare a list of questions for your doctor and insist on frank, detailed answers that take your individual situation into account—and don’t leave the doctor’s office until all your questions have been answered to your satisfaction.

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Source: Emily M. Abramsohn, MPH, public health researcher, University of Chicago. Her study was published in Journal of the American Heart Association. Date: November 12, 2013 Publication: Bottom Line Health
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