Sexual Activity is Safe for Most Heart Patients: American Heart Association
Severe heart disease patients with symptoms from minimal activity should not be sexually active until symptoms stabilize
Jan. 20, 2012 - If you have stable cardiovascular disease, it is more than likely that you can safely engage in sexual
activity, according to an American Heart Association scientific statement. It cautions, however, that medications for erectile dysfunction
aren’t safe for all men and women should be counseled on safety of contraceptives.
The statement, published online in Circulation: Journal of the American Heart Association, contains
recommendations by experts from various fields, including heart disease, exercise physiology and sexual counseling.
“Sexual activity is a major quality of life issue for men and women with cardiovascular disease and their partners,” said
Glenn N. Levine, M.D., lead author of the statement and a professor of medicine at Baylor College of Medicine in Houston, Texas.
“Unfortunately, discussions about sexual activity rarely take place in the clinical context.”
The recommendations include:
● 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 counseled 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 (blockages in the arteries that supply
the heart with blood), 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 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,” said Levine,
who is also director of the Cardiac Care Unit at the Michael E. DeBakey Medical Center in Houston.
“On the other hand, there are some patients for whom it may be reasonable to defer sexual activity until they’re assessed
Co-writers are Elaine E. Steinke, R.N., Ph.D.; Faisal G. Bakaeen, M.D.; Biykem Bozkurt, M.D., Ph.D.; Melvin D. Cheitlin,
M.D.; Jamie Beth Conti, M.D.; Elyse Foster, M.D.; Tiny Jaarsma, R.N., Ph.D.; Robert A. Kloner, M.D., Ph.D.; Richard A. Lange, M.D., M.B.A.;
Stacy Lindau, M.D.; Barry J. Maron, M.D.; Debra K. Moser, D.N.Sc., R.N.; E. Magnus Ohman, M.D.; Allen D. Seftel, M.D.; and William J. Stewart,
The American Heart Association/American Stroke Association receives funding mostly from individuals. Foundations and
corporations donate as well, and fund specific programs and events. Strict policies are enforced to prevent these relationships from
influencing the association’s science content. Financial information for the American Heart Association, including a list of contributions
from pharmaceutical companies and device manufacturers, is available at
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