Sexual Intimacy

Being intimate (feeling and being close) with your loved one is important to living well.

Sexual intimacy is part of being close to your loved one. In a survey of cardiac patients, 75% of them told us that sexual activity was important in living well. Sex includes all the activities that allow a couple to feel pleasure in physical contact and emotional connection with each other.

Our patients told us they wanted to know more about the questions below.

1. How do I talk to my partner about sexual intimacy?
2. How do I deal with feelings of fear and anxiety around sexual intimacy?
3. When is it ok to get back to sexual intimacy?
4. How do medications affect sexual function?
5. What are other ways to be intimate with a partner?

How Do I Talk To My Partner About Sexual Intimacy?

Talking to your partner about your needs, desires, and fears about sex is important as you get back to sexual activity after your heart event. Remember, your partner will also have needs, desires, and fears. Try the methods below to help you support each other.

Hear and understand each other’s emotions

Ask what your partner is feeling and hear what your partner is saying. What are his/her fears? Listen and focus on his/her experience. Let him/her know you understand, and acknowledge that what s/he is feeling is real. You may be having the same feeling.

Once you have understood where your partner is coming from, share your thoughts and feelings. Sharing each other’s feelings and emotions helps to build intimacy. This will help make your sexual experience better.

Offer support

Let your partner know you support him/her.

Support each other by:

• listening.
• expressing that you hear each other.
• normalizing each other’s emotions (“I feel the same way”).
• problem-solving together. Try not to take over. Collaborate with your partner.
• not being judgmental of each other or yourself. Be compassionate.
• being open minded to new ideas, feeling and thoughts.
• working together to find solutions.

How Do I Deal With Feelings of Fear and Anxiety Around Sexual Intimacy?

Many people feel anxiety or fear around sexual intimacy after a heart event.

To decrease feelings of anxiety or fear:

1. talk to your cardiologist or family doctor
2. ask questions about risks and dangers, and what precautions to take

Any fears or anxieties you feel are your brain’s way of protecting you from danger. Fears are a normal part of your recovery. Recognize them and address them. This will help.

Before you get back to sexual activity with your partner, talk about your fears together.

Ask yourself:

• How realistic are these fears?
• What evidence do I have to support these worries?
• What does my doctor say about these risks?

When you get back to sexual activity with your partner:

• do what is comfortable for you.
• let go of any fears you may have. Be in the moment. This can help you enjoy the closeness with your partner.
• go slow. Getting back to your normal intimacy takes time.

It is normal for anyone who has had a heart event to have anxiety, fears, and even depression. Many people need a few months to recover from these fears.

• Learn the signs of anxiety and what to do if you have them »
• Learn the signs of depression and what to do if you have them »

If you struggle with anxiety, fears, or depression, you may find that your normal interests in intimacy and sexual activity are gone. Talk to your partner and to your healthcare professional about these concerns.

When Is It Okay to Return to Sexual Activity?

Returning to sexual activity with your partner may be an important part of living well for you. For some people, it is like returning to exercise, driving, work, or air travel.

If you have had a heart attack, the risk of having another heart attack while having sex is very low. Most people can get back to sexual activity within 2-3 weeks of going home from the hospital.

Remember this:

If you can easily walk up two flights of stairs or walk briskly, your heart should be safe during sex.

How to have sex safely

To keep your heart safe and comfortable during sex:

• slow down to reduce the work the heart has to do
• avoid holding positions where you have to support your own body weight
• use the spoon position. This involves lying down with the man snuggled up behind his partner.
• have your partner on top to lower your effort and reduce the work you have to do

Returning to sexual activity gradually can help you avoid symptoms of angina. If you do get angina, talk to your doctor.

Remember, if you are not ready for sex you can do other intimate things like:

• hugging
• snuggling
• kissing

How Do Medications Affect Sexual Function?

Medications can affect sexual function in both men and women. Common cardiac medications like beta blockers can affect how you perform during sex. Medications you take to help with depression can decrease your desire for sexual intimacy.

What Are Other Ways To Be Intimate With a Partner?

When returning to sexual activity, begin slowly. The goal is to return to activities that you were doing before your heart attack - getting back to your “normal”. A good way to begin is by doing together things that you both enjoy, like:

• massages
• eye contact
• holding hands

These activities can help you feel safe and enjoy your time together. Reaching orgasm may not be your goal right now. Instead, take the time to reconnect emotionally and do enjoyable activities. The physical intimacy and sexual activity will come back when it feels right.