Sexual Health and Cardiovascular Disease (CVD)

Reviewed by: HU Medical Review Board | Last reviewed: March 2024

Understanding the relationship between sex and heart disease is key to ensuring a happy life and a healthy heart. One common concern for people with cardiovascular disease (CVD) is whether it is safe to engage in sexual activity. Many people may fear that having sex will increase their chance of a heart attack.1,2

How does heart disease affect sexual health?

Sexual health is an essential part of our lives. Yet more than half of people with heart failure (HF) report having less sex or none at all after their diagnosis. And about 3 in 10 people with HF have trouble having sex.1

The mental and emotional impact of living with a chronic condition like CVD can also contribute to changes in sexual desire and satisfaction. You may simply feel less interested in having sex. You may feel depressed after your diagnosis and worried about being intimate again. These are all very normal reactions.3

Is it safe to have sex with heart disease?

If you find it hard to exercise, it is understandable to be concerned about whether you can have sex safely. Sex is, after all, a form of physical activity. According to the American Heart Association (AHA), sex rarely causes heart attacks.1,2,4

The AHA states that it is safe to have sex if your heart condition has stabilized. The chances of sex causing a heart attack or other heart event are very low, experts say. Furthermore, the benefits of sex – lowered blood pressure, reduced stress, and a deeper bond with your partner – far outweigh the risks.1,2,4

However, you should get checked out by your doctor before having sex if you have:1,2,4

  • An unstable heart condition
  • Had surgery within the last 1 to 2 weeks
  • Symptoms such as chest pain, shortness of breath, or irregular heartbeat

Heart medicines and sex

Some medicines prescribed to treat CVD may affect sexual performance. For example, certain drugs may lower a person’s desire to have sex (libido) or make it hard to have an erection.1,2

Always take your medicines as prescribed by your doctor. Do not stop taking a prescribed medicine if you think it is causing sexual problems. Instead, talk with your doctor about these side effects. Together, you can come up with a plan that works for you.1,2

How is sexual health with CVD addressed?

In people with CVD, sexual health is typically addressed through a combination of:2,3

  • Cardiac rehabilitation
  • Heart medicines
  • Lifestyle changes like regular exercise and a healthy diet

If you have erectile dysfunction (ED), there may be medicines you can take to treat it, such as:2,3

  • Sildenafil (Viagra®)
  • Vardenafil (Levitra®)
  • Tadalafil (Cialis®)

However, people taking nitrates to treat chest pain with coronary artery disease (CAD) should avoid ED drugs like Viagra. Taking nitrates with ED drugs can lead to unsafe levels of low blood pressure.2,3

Also, do not take herbs or supplements to improve your sex drive. These may not be safe. Always talk with your doctor before taking any new medicine or supplement.2

If you are having sexual dysfunction, talk with your doctor to explore whether the underlying cause is related to your heart condition or something else. Sexual problems can stem from a number of conditions, including anxiety or depression.2

Special populations and considerations

Certain people with CVD may have special considerations when it comes to their sexual health.2

Postmenopausal people

People who have gone through menopause may experience changes in their sexual health due to hormonal shifts. Low libido and vaginal dryness are common complaints after menopause. Hormone replacement therapy or topical estrogen used during sex may help make sex more enjoyable.2

People with erectile dysfunction (ED)

Erectile dysfunction can be both a symptom and a consequence of CVD. The same underlying vascular issues that contribute to heart disease may also affect blood flow to the genitals. Managing heart disease risk factors, such as high blood pressure and diabetes, can help both heart health and erectile function.2

Talk with your doctor about how to address the root causes of ED. There may be suitable treatment options, such as ED medicines, that will not interfere with heart medicines.2

Health benefits of sex

Engaging in sexual activity, even for people with CVD, offers many health benefits. The release of endorphins during sexual activity contributes to an overall sense of well-being and may have positive effects on mood and mental health.1,4

The physical closeness and emotional connection gained through sexual intimacy can help reduce stress and anxiety as well. Stress and anxiety can impact heart health. Even if you are not able to have sexual intercourse, you can foster intimacy through touching and kissing.1,4

Beyond the emotional aspects, regular sexual activity has also been linked to:1,4

  • Improved heart health
  • Increased blood flow
  • Lower blood pressure

Talk to your doctor if you have any concerns about having sex with CVD. They can help you maintain a healthy balance between sexual activity and cardiovascular wellness.1,4

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Treatment results and side effects can vary from person to person. This treatment information is not meant to replace professional medical advice. Talk to your doctor about what to expect before starting and while taking any treatment.