A long-term health condition like a heart attack or heart surgery can be hard on relationships with partners, family and friends. You may find it difficult to talk with people about your condition, even if they are close to you.
The way you feel about yourself will change. Coping with any physical and emotional changes can affect how you feel and interact with others.
Ways to help your relationship
It’s very likely that some of the roles you played in a relationship will change. Recognising this and accepting this can be a way to move forward.
Be open about how you feel and let your family and friends know what they can do to help.
Don’t feel shy about telling them what you need, such as time for yourself. Think about things from your partner’s perspective as well. Your heart attack or heart surgery has affected them too so try to be understanding about what they are going through.
Don’t rush or expect things to be the same straight away. Adjustments take time for everyone.
When is it safe to have sex again?
Having sex takes about the same exertion as brisk walking or climbing up two flights of stairs. So as a general guide, if you can do that level of exercise without getting chest pain or short of breath, you’re probably fit enough to have sex. The risk of triggering a cardiac event during sex are very low if you can do that level of exercise.
If you have had heart surgery, wait until your breastbone has healed (about six to eight weeks after the operation). Don’t put any pressure or stress on your chest. Some positions may be more comfortable than others.
Stop having sex if you experience the warning signs of a heart attack. If you have breathlessness or chest discomfort during or after sex, you should consult your doctor.
Take things slowly - it can take time for a sexual relationship to get back to normal. Building on intimacy is a good start. Intimacy is an important part of sexuality.
It’s about feeling connected and close to someone, and feeling loved for who you are. You’ve been through some big physical and emotional changes.
You may feel very differently about your body and your sexuality. You and your partner may have unspoken fears that make you avoid being intimate. But delaying intimacy will only increase the anxiety around sexual intercourse.
Ways to build intimacy
- Kissing, cuddling, kind words, hand holding, and togetherness are all important ways to be close to each other. This will increase your feelings of intimacy.
- Communication is the key to every loving relationship. Discuss with your partner how you feel about yourself and the way your body and body image may have changed.
- Stay open-minded and explore what you both like sexually. Simply touching, being touched and being close to someone helps a person feel loved and special.
- Taking care of yourself and improving your fitness through moderate physical activity will make you feel better about yourself and help you regain confidence.
- Make an effort to look attractive and take care of yourself. This will enhance the way you feel about yourself and help you regain confidence.
Getting back to sex
Sexuality is not just the act of sexual intercourse. You can find new ways of doing things and new positions that still bring you and your partner pleasure. Take things slowly. At first it is best to be the less active partner. The good news is that the lifestyle changes that help your heart can also help your sex life.
Sexual activities that take less energy can be a bridge to resuming intercourse. They could include masturbation, oral sex, sex toys or reading erotic material. These can all be normal and healthy ways to fulfil sexual needs of you and your partner.
Some sexual positions may be more comfortable, especially if you need to avoid stress on the breastbone after heart surgery. Start with less strenuous positions (e.g. missionary position, sitting).
Use a comfortable, familiar setting so you feel less stressed. You could create a romantic atmosphere, using soft music and candles.
Think about timing. Plan to have sex when you are both least fatigued and well rested (e.g. in the morning). This will enhance sexual performance. And don’t rush - plan to have plenty of time to enjoy each other.
Problems and worries about sex
Talk with your partner or doctor about your feelings and worries about having sex.
Research shows that people want to talk about these issues with their doctors, but that it often doesn’t happen. You can also talk to your cardiac rehabilitation coordinator, sex counsellor or the Heart Foundation Helpline.
You may notice changes in your sexual interest or ability. This is common and is usually short-term. It can be because of things like tiredness, depression, anxiety, concerns about physical ability and the effect of your medicines.
Erectile dysfunction can be related to your medicines, or other causes. It can also be connected with other things, like acute stress, anxiety or depression, your age and your erectile function before your heart attack.
Talk with your doctor about possible causes and what might help. Erectile dysfunction can be improved with medicines or other aids. Your doctor may be able to prescribe medicines, as long as you aren’t taking nitrate therapy, and don’t have low blood pressure, abnormal heart rhythms or chest pain.
Fear and anxiety
Both men and women often fear a failure to perform. For men it might about getting a good erection, and for or women it might be about difficulty getting aroused. You may feel that your partner is no longer sexually attracted to you. They might be afraid that sex will cause you to have another heart attack.
You and your partner will need time to adjust to the physical and emotional changes after your heart attack or heart surgery. Encourage your partner to talk openly about their fears and feelings. For some couples, professional relationships counselling can be a good option to give you the opportunity to talk about your feelings and any changes in your relationship since the heart attack or heart surgery.
Sexual relationships are most satisfying when you can discuss your thoughts, feelings and concerns openly with each other without fear of rejection of embarrassment.
Medicines and sex
Some medicines can affect your sex life. Some heart medicines can reduce your desire for sex, or affect vaginal lubrication or your ability to get an erection. Some antidepressant medicines can reduce your sexual desire and feelings of connection with your partner. They can also affect your ability to have an erection or an orgasm.
There are simple things you can do to reduce some effects of medicines. For example, lubricants are readily available from your pharmacy. If you are on blood pressure medicine, you can plan to have sex just before taking it to help overcome impotence.
If you think your medicines are affecting your sexual desire or ability, talk to your doctor. Don’t stop taking your medicines without checking with your doctor. Nitrate medicines can interact badly with erectile dysfunction medications.
Speak to your doctor about your medicines. Learn more about taking medicines and their side effects.