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Heart associations to doctors: it's time to talk about sex

Source: American Heart Association/European Society of Cardiology Consensus Statement; E. Steinke

On Monday, the American Heart Association and European Society of Cardiology released what was essentially an open letter to doctors everywhere:

Dear doctors everywhere,

Let's talk about sex.


The American Heart Association and European Society of Cardiology

Okay, not quite. But a new consensus statement from the two associations -- published in the journals Circulation and European Heart Journal -- carries essentially the same message: it's time for health care providers to talk openly about sex with their heart and stroke patients.

According to the press release, this is the first scientific statement to provide "detailed guidelines" and "how to" information for patients (and their partners) who have had a heart attack, heart transplant, stroke, heart device implanted or any other heart condition.

"Patients are anxious and often afraid sex will trigger another cardiac event -- but the topic sometimes gets passed over because of embarrassment or discomfort," lead author Elaine Steinke with Wichita State University said in the release.

The document provides evidence-based guidelines and recommendations that health care providers discuss everything from sexual positions to foreplay and the "role of intimacy without sex to gain confidence." 

There are specific recommendations on anal sex (potentially risky because it can stimulate the vagus nerve, thus slowing heart rate, rhythm and coronary blood flow) and even cheating (one study analyzing 68 deaths that occured during sex showed that 92.6% were men and the majority died while having extramarital intercourse). The document also includes helpful illustrations of people having sex in various positions -- and, in some cases, with oxygen tanks -- under decidedly unsexy headlines such as "Comfortable positions for intercourse with chronic illness or disability" and "Comfortable positions for intercourse after an implantable cardioverter defibrillator."

Okay, are you snickering? Well, stop. Heart attack and stroke survivors often carry a lot of anxiety -- and legitimate concerns -- about resuming their sex lives but past studies show that health care providers are failing to discuss the issue. For people with cardiovascular diseases, sexual activity and function is often decreased -- frequently because of anxiety or depression -- and both men and women with cardiovascular diseases are more likely to suffer from sexual dysfunction.

And embarrassment is a major factor preventing health care providers from talking about something that could have such a huge impact on their patients' health and quality of life.

As statement co-author Tiny Jaarsma says in the press release: “Time constraints or just plain embarrassment should not be an excuse for avoiding these topics that are essential to the cardiac patient’s mental and physical health."

Okay, docs, you heard the woman -- let's get sex talkin'.

Jennifer Yang is the Star’s global health reporter. She previously worked as a general assignment reporter and won a NNA in 2011 for her explanatory piece on the Chilean mining disaster. Follow her on Twitter: @jyangstar


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While I was under a cardiologist care I had experienced chest pains during and immediately after orgasm. When I told my specialist I got nothing more than a smile. When I asked what could be done I was basically told to decide before hand whether or not to engage in intimate behaviour and risk another episode.

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