Sex when you have a heart or circulatory condition - your questions answered

Kate Blayney, Cardiac Rehabilitation Manager at John Radcliffe Hospital, Oxford, answers common questions.

Image of a heart and wrapped around a stethoscope

Should I worry about having a heart attack during sex?

Sex is no more likely to trigger a heart attack, or other heart problems, than any other form of activity. You can resume having sex when you feel ready – usually two to four weeks after a heart attack. If you’ve had surgery, it might be longer.

You should be fine if you can walk a mile on the flat in about 20 minutes, or climb two flights of stairs in 20 seconds. Even if you don’t feel ready for intercourse, other activities like foreplay and oral sex generally don’t place additional strain on your heart.

When can I have sex after heart surgery?

You may feel that sex will undo the work your surgery has done, or that the wound may open up, but you can have sex as soon as you feel comfortable. Find a position that does not put too much strain on your wound. It might help to place a small cushion between you and your partner.

I’m on new medication and can’t get an erection. What should I do?

Impotence (inability to achieve or maintain an erection) may be a side effect of your medication. Impotence is not just a male problem – women can suffer a loss of sexual desire. But you can talk to your nurse or GP, as it may be possible to change or reduce the dose of your medication.

I have a pacemaker or ICD – should I be worried about getting too excited?

There’s no reason why you can’t continue to have a good sex life after having a pacemaker or ICD fitted. But during your first four weeks of recovery, you should avoid sex positions that place pressure on your arms and chest. Sex aids such as vibrators are usually safe to use.

It is very rare to get a shock from an ICD during sex – the device will be programmed so a normal increase in heart rate, such as during sexual activity, doesn’t lead to a shock. The ICD won’t harm you or your partner even if it does go off.

Will having sex bring on an angina attack?

If you have a GTN spray, keep it handy on the bedside table in case you do experience chest pain. To reduce your chance of angina, try not to be too energetic at the start of your sexual activity.

Where to get more information

The Sexual Advice Association (SAA) has downloadable factsheets on a number of symptoms and sexual problems - you can show these to your GP and partner to help start a conversation.

The SMART SAA app, created by the Sexual Advice Association, gives you information and advice on what you can do if you have any type of sexual problem or concerns. You can use the app yourself or with your partner. Download it via the App Store, Google Play or via the Sexual Advice Association website.

If you want to speak to a specialist doctor or therapist you can try:

  • Institute of Psychosexual Medicine – provides both private and NHS doctors specialising in sexual health across the UK – although be aware that for a NHS consultation you will probably need to be referred by your GP.
  • College of Sexual and Relationship Therapists – provides private consultations across the UK. You can search by location for a therapist.
  • If you decide to have a private consultation, be aware that fees can vary. It’s worth ringing around to make sure you find someone you like, and that the timing of the appointment works for you (consultations over Skype and telephone are often available). The outcome is usually better if you go as a couple. 

More useful information