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Sex After Heart Attack: What to Know

Kelly Brown MD, MBA

Reviewed by Kelly Brown MD, MBA

Written by Erica Garza

Published 05/31/2024

During sex, your heart rate and oxygen intake increase, making it a moderate form of exercise akin to jogging on a treadmill. If you’re recovering from a heart attack, you may wonder if this physical activity is too strenuous. Can you have sex after a heart attack? If so, when?

The good news is that most people can safely have sex after heart attacks as long as they ease back into it. Sex may even be beneficial for your heart.

Though studies show it’s rare to experience heart failure during sex, many men are scared it’ll happen — whether they have heart disease or no known risk factors for it. If you recently had a heart attack, you might be even more fearful of having another — and it’s not uncommon to experience sexual dysfunction as a result of this fear.

We’ll share some tips on how to maintain your sex life after a heart attack while keeping your heart healthy, especially if you’re taking heart medication.

The short answer is yes. You can safely have sex after a heart attack (aka myocardial infarction) as long as your cardiologist or other healthcare provider gives you the green light. The same goes for masturbation and oral sex, which affect your heart similarly.

Your provider will likely check for readiness through exercise stress testing as part of your cardiac rehabilitation program. Along with exercise, cardiac rehab often includes counseling and education on how to improve heart health and build endurance.

Health Perks of Having Sex

According to the American Heart Association (AHA), sexual activity is a crucial factor in the quality of life for men and women with cardiovascular disease (CVD). This includes elderly patients.

Yet, decreased sexual activity and sexual dysfunction are common in CVD patients and often connected to anxiety and depression. This is especially true if you experience heart failure.

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Who Might Be Medically Cleared for Sex After Heart Attack

If you had a heart attack in the past, the AHA says you’re at low risk for having another heart attack during sex if:

  • You have no CVD symptoms during routine activities

  • You don’t experience ischemia (low blood flow) with stress testing

  • You’ve undergone successful coronary revascularization (surgery to correct narrowed arteries)

  • You have no or mild angina (chest pain)

According to a 2018 review, those with “stable cardiac symptoms” and “good functional capacity” don’t have a high risk of adverse cardiovascular events. Other patients might need treatment or a heart stabilizer before having sex. 

If you have heart failure — meaning your heart has trouble pumping blood to the rest of your body — you may find sex even more challenging and have a higher risk of cardiac events. You should always talk to your doctor or cardiac rehabilitation team about any concerns before having sex.

You’re not the first person to Google “how soon sex after heart attack.”

Every case is different, which is why cardiac rehabilitation is so crucial — and why you should always consult your cardiologist to see if you’re stable enough to have sex.

If you’re stable after having an uncomplicated heart attack, you can resume sexual activity one week or more after the event, according to the AHA. But to be clear, this would mean you’ve had stable results in your cardiac rehabilitation program and show no cardiac symptoms during mild to moderate physical activity — like being able to go up two flights of stairs.

If you had open-heart surgery, the AHA recommends waiting six to eight weeks until you’re fully healed before having sex.

Having sex one week after a heart attack may seem extreme. But there are some good reasons your medical team is eager to get you back into bed.

Aside from supporting mental health and boosting quality of life, there’s evidence that sex (and other forms of physical activity) lowers the risk of a recurring heart attack the more often you do it.

In a 2011 review, researchers noted that heart attacks can be triggered by physical activity, including sex. However, the more regularly active patients were, the less likely they were to be triggered by sudden bursts of activity.

For every additional physical activity session patients did each week, their risk for heart attack dropped by about 45 percent, and the risk for sudden cardiac death decreased by 30 percent.

You can and should have sex after a heart attack if your provider says you’re good to go. But what if you can’t?

Some patients might have a lower sex drive than before they had a heart attack. Others may deal with new sexual obstacles, like erectile dysfunction (ED), as a result of their heart problems.

In one 2016 study, men were more likely than women to resume sexual activity by one month and by one year after a heart attack. That said, the most prevalent sexual problems men reported were erectile difficulties (22 percent) and lack of interest in sex (19 percent).

Some contributing factors to these issues included higher stress levels and comorbid health conditions (other medical problems they had besides a heart attack) like diabetes. And the longer patients waited to address sexual issues, the more likely they were to delay a return to sex.

Another potential reason heart attacks and heart disease may affect erectile function has to do with blood flow. More on this below.

Choose your chew

According to the CDC (Centers for Disease Control and Prevention), a heart attack can permanently damage your heart, affecting its rhythm and ability to pump blood to the rest of your body — including to your penis.

Studies show heart disease and erectile dysfunction frequently coexist, to the point where ED is often one of the first warning signs. Cholesterol can build up and form plaques, whichcan then narrow your blood vessels and slow blood flow. Cholesterol also causes endothelial dysfunction which prevents blood vessels from dilating properly.

According to one study of 37 patients, 40 percent had ED in addition to having sex much less frequently after a coronary event — even though they reported no sexual dysfunction issues before the event.

Diabetes, high blood pressure, and smoking are all risk factors for both heart disease and ED. Beyond that, the above study concluded that virtually “all classes of drugs” used to treat cardiovascular diseases may affect sexual activity. Let’s dig in deeper.

Some medications prescribed for heart disease, such as beta-blockers or diuretics, can negatively impact sexual function. Why? It has to do with how they affect the nervous system and hormones.

Some reported side effects of heart medications include:

  • Erectile dysfunction

  • Loss of sexual desire

  • Anxiety (which triggers sexual dysfunction)

  • Ejaculatory dysfunction

This can lead patients to abandon their medications in an attempt to preserve their quality of life, which isn’t a safe option.

If you’re taking heart medication and think it’s affecting your ability to get or maintain an erection, let a health professional know. They may prescribe an ED medication.

But you should never take ED medication without checking in with your provider first. This can help you avoid harmful drug interactions.

You already know there’s a connection between erectile dysfunction and heart disease.

Increasing evidence shows that ED is a vascular disorder. That’s why high blood pressure and ED are often seen together — and why many of the most popular ED medications (including Viagra®) were originally intended to treat high blood pressure.

Viagra (sildenafil) belongs to a class of drugs known as PDE5 inhibitors. Others include:

These drugs help dilate blood vessels to increase blood flow to your penis and other parts of the body.

Although PDE5 inhibitors are sometimes prescribed for heart health, they’re typically not a first-line treatment. Still, these meds can sometimes be taken alongside other heart medications if your provider deems it safe.

Some medications prescribed for heart conditions, including nitrates, should never be taken with PDE5 inhibitors. Often prescribed for angina, nitrates work similarly to PDE5 inhibitors by dilating blood vessels. If you take nitrates with a drug like Viagra, your blood pressure can drop to dramatically low, dangerous levels.

If you’re taking nitrates or other heart medications you can’t mix with ED drugs, you can explore other options to address ED, like therapy, dietary changes, exercise, weight loss, or even using a penis pump or penis ring.

Most experts agree patients should ease back into having sexual intercourse when recovering from a heart attack.

Some ways to do this:

  • Start off with cuddling and foreplay to allow your blood pressure to increase gradually.

  • Lay off strenuous sex positions and stick with ones that exert less energy (like missionary).

  • Stop having sex if you have severe chest pain or shortness of breath.

  • Exercise regularly as part of your cardiac rehabilitation program.

  • Have sex before taking blood pressure medication to avoid negative side effects.

  • Avoid sex after a heavy meal or drinking alcohol.

Talk to your medical provider if you or your partner have any concerns about what is or isn’t safe.

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Feeling nervous about having sex after a heart attack is understandable. But there are steps you can take to ease back into your regular routine, starting with patience and rehabilitation.

Remember:

  • It’s rare to have a cardiac event during sex, but every case is different. Always ask your healthcare provider before restarting sexual activity if you’re unsure.

  • If your heart attack was uncomplicated, you may be able to have sex one week after the event. An exercise stress test and cardiac rehabilitation program will help get your heart health back on track. 

  • Be active. Though sex can trigger a heart attack, the risk is lower for those who get regular physical activity.

  • Heart disease and heart attacks can trigger ED. But you shouldn’t mix ED medications with certain heart medications (like nitrates).

Want more advice on how to protect your cardiovascular health and sexual health? Learn which blood medications cause ED and whether statins cause erectile dysfunction. You can also check out our complete guide to vasodilators.

9 Sources

  1. Bispo GI, et al. (2013). Cardiovascular changes resulting from sexual activity and sexual dysfunction after myocardial infarction: integrative review. https://www.researchgate.net/publication/240308076_Cardiovascular_changes_resulting_from_sexual_activity_and_sexual_dysfunction_after_myocardial_infarction_Integrative_review
  2. Centers for Disease Control and Prevention (CDC). (2024). Heart Attack Symptoms, Risk, and Recovery. https://www.cdc.gov/heartdisease/heart_attack.htm
  3. Dahabreh IS, et al. (2011). Association of Episodic Physical and Sexual Activity With Triggering of Acute Cardiac Events.https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5479331/
  4. Dye CI, et al. (2022). Sex, Rhythm & Death: The effect of sexual activity on cardiac arrhythmias and sudden cardiac death.https://www.frontiersin.org/articles/10.3389/fcvm.2022.987247/full
  5. Ibrahim AB, et al. (2018). Erectile Dysfunction and Ischaemic Heart Disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6331774/
  6. Jackson GR. (2013). Erectile dysfunction and cardiovascular disease. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4442980/
  7. Levine GL, et al. (2012). Sexual Activity and Cardiovascular Disease - A Scientific Statement From the American Heart Association.https://www.ahajournals.org/doi/full/10.1161/cir.0b013e3182447787#
  8. Lindau ST, et al. (2016). Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. https://jamanetwork.com/journals/jamacardiology/article-abstract/2546890
  9. Palmeri SE, et al. (2007). Heart Rate and Blood Pressure Response in Adult Men and Women During Exercise and Sexual Activity. https://www.ajconline.org/article/S0002-9149(07)01744-4/fulltext
Editorial Standards

Hims & Hers has strict sourcing guidelines to ensure our content is accurate and current. We rely on peer-reviewed studies, academic research institutions, and medical associations. We strive to use primary sources and refrain from using tertiary references. See a mistake? Let us know at [email protected]!

This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for and should never be relied upon for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment. Learn more about our editorial standards here.

Kelly Brown MD, MBA
Kelly Brown MD, MBA

Dr. Kelly Brown is a board certified Urologist and fellowship trained in Andrology. She is an accomplished men’s health expert with a robust background in healthcare innovation, clinical medicine, and academic research. Dr. Brown is a founding member of Posterity Health where she is Medical Director and leads strategy and design of their Digital Health Platform, an innovative education and telehealth model for delivering expert male fertility care.

She completed her undergraduate studies at University of North Carolina at Chapel Hill (go Heels!) with a Bachelor of Science in Radiologic Science and a Minor in Chemistry. She took a position at University of California Los Angeles as a radiologic technologist in the department of Interventional Cardiology, further solidifying her passion for medicine. She also pursued the unique opportunity to lead departmental design and operational development at the Ronald Reagan UCLA Medical Center, sparking her passion for the business of healthcare.

Dr. Brown then went on to obtain her doctorate in medicine from the prestigious Northwestern University - Feinberg School of Medicine and Masters in Business Administration from Northwestern University - Kellogg School of Management, with a concentration in Healthcare Management. During her surgical residency in Urology at University of California San Francisco, she utilized her research year to focus on innovations in telemedicine and then served as chief resident with significant contributions to clinical quality improvement. Dr. Brown then completed her Andrology Fellowship at Medical College of Wisconsin, furthering her expertise in male fertility, microsurgery, and sexual function.

Her dedication to caring for patients with compassion, understanding, as well as a unique ability to make guys instantly comfortable discussing anything from sex to sperm makes her a renowned clinician. In addition, her passion for innovation in healthcare combined with her business acumen makes her a formidable leader in the field of men’s health.

Dr. Brown is an avid adventurer; summiting Mount Kilimanjaro in Tanzania (twice!) and hiking the incredible Torres del Paine Trek in Patagonia, Chile. She deeply appreciates new challenges and diverse cultures on her travels. She lives in Denver with her husband, two children, and beloved Bernese Mountain Dog. You can find Dr. Brown on LinkedIn for more information.

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