Sexual Activity and Heart Disorders

Heart disorders—including coronary artery disease, heart failure, abnormal heart rhythms, and heart valve disorders such as aortic stenosis—are very common among older men. A man who has a heart disorder may worry that sexual activity could be dangerously stressful to his heart.

Generally, sexual activity is safe for older men with a heart disorder. Sexual activity is no more stressful on the heart than climbing one or two flights of stairs. The risk of having a heart attack is slightly higher during sexual activity than it is during rest, but the risk is still very low. The risk appears to be highest when having sex with a new partner.

Nevertheless, a sexually active man who has a heart disorder or high blood pressure needs to take reasonable precautions. Usually, sexual activity is safe if the disorder is mild, if it causes few symptoms, and if blood pressure is controlled to a normal or near normal level. If the disorder is moderately severe or if the man has other conditions that make a heart attack likely, tests may be necessary to determine how safe sexual activity is. If the disorder is severe or interferes with blood flow from the left ventricle (as can occur in heart failure or aortic stenosis), sexual activity should be postponed until after treatment reduces the severity of the symptoms. Sexual activity should also be postponed at least 2 to 6 weeks after a heart attack.

If a man takes a nitrate, such as nitroglycerin, to treat a heart disorder, taking sildenafil or vardenafil (for erectile dysfunction) is dangerous. Nitrates can cause dangerously low blood pressure if they are taken within several hours of sildenafil.

Most often, tests to determine the safety of sexual activity are done during exercise on a treadmill. The tests involve monitoring the heart to determine whether its blood supply is adequate. If the blood supply is adequate during exercise, a heart attack during sexual activity is very unlikely.