HEALTHCARE professionals are urged to counsel heart and stroke patients on how to resume a healthy sex life, according to a joint statement published in the American Heart Association journal Circulation and the European Heart Journal. It is the first scientific statement to offer detailed guidance for patients.
“Patients are anxious and often afraid sex will trigger another cardiac event – but the topic sometimes gets passed over because of embarrassment or discomfort,” said Dr Elaine Steinke, lead author of the statement and professor of nursing at Wichita State University in Kansas, US.
The statement is the first to provide “how to” information about resuming sexual activities, and applies to patients who have had a heart attack, heart transplant, stroke, received an implanted heart device, or have other heart conditions, as well as their partners.
Past recommendations focused on when to resume sex, risks with sex, and managing medications.
Among the recommendations, healthcare providers should:
·Routinely assess all patients after a cardiac event and during follow-up visits to determine if the patient is healthy enough to resume sexual activities.
·Give individualised, structured counselling based on specific needs and medical condition.
·Discuss recommended positions, how to be intimate without having sexual intercourse and when to resume sexual activity; and counsel all patients, regardless of gender, age and sexual orientation.
“There are many barriers or misconceptions that inhibit discussions about sex. Some healthcare professionals may believe the patient does not want this information, but we have found it is easier for the healthcare provider to start the discussion than for the patient to bring up these issues,”, said Tiny Jaarsma, co-chair of the task force on behalf of the European Society of Cardiology’s Council on Cardiovascular Nursing and Allied Professions and a professor at the Linköping University, Sweden.
Exercise stress testing is recommended for some patients to determine if the heart is strong enough to resume sexual activity. Physical activities such as brisk walking may be suggested for some heart patients before resuming sexual activity.
Patients may be advised that the stress of extramarital sexual activity could pose a health risk for people with heart disease, the authors note.
In addition, while heart medications can affect sex drive and function in both men and women, patients should talk to their healthcare provider before stopping any medications, according to the statement.
A healthcare provider can determine if sexual problems are caused by the drug or an underlying condition such as depression. – American Heart Association/European Society of Cardiology