Is sexual activity safe for heart failure patients?

People with heart failure may worry that sex could trigger a heart attack or worsen heart failure symptoms. The truth is that sex does pose some risk, but primarily for those with more severe heart failure.

Sexual activity requires about the same degree of exertion as walking at two to four miles per hour on a level surface. In other words, it has less of an impact on heart rate, blood pressure, and oxygen requirements than people tend to think.

Itís best to check with your doctor, but sex is generally considered safe if you have mild heart failure. On the other hand, if you have severe heart failure youíll likely need to work with your doctor to stabilize your condition before you can safely return to sexual activity. If you fall somewhere in between, your provider may suggest further testing to determine if sexual activity could pose a risk to your health.

Even if sexual activity is safe for you, heart failure may affect your interest in sex, sexual satisfaction, and sexual performance. Sexual counseling can provide practical advice and psychological support if you are experiencing sexual difficulties.

Heart failure and erectile dysfunction

Most men with heart failure have some degree of erectile dysfunction. The best way to treat erectile dysfunction is to optimize treatment of the underlying heart failure. As exercise capacity and symptoms of heart failure improve, so will sexual function.

Many men with heart failure can also take a PDE-5 inhibitor such as sildenafil (Viagra). PDE-5 inhibitors should not be used together with nitrates, with which they interact. PDE-5 inhibitors can also lower blood pressure, and may not be safe for men with moderate or severe heart failure.