Sex and Intimacy

Sex and Intimacy

Sexual relations and intimacy are important to your well-being and relationships. You are not alone in thinking about sex and heart failure. In fact, about 2 out of every 3 people living with heart failure experience some issue with sex and intimacy. Some of the issues you may encounter are likely as a result of reduced desire and difficulty in engaging in different sexual activities. 

Sexual activity is not dangerous to your heart. But if you are living with heart failure, sexual activity – like all your activities – may need a bit of planning and careful consideration. 

If you can walk at a reasonable speed on level ground or climb a set of 20 stairs, then sexual activity is unlikely to affect your heart.  Do not have sex if you are unwell, have chest pain or are very short of breath.

Strategies for Safe and Positive Sexual Relations

As you feel better and want to enjoy sex and intimacy in your life, here are strategies you can use to address concerns and have a positive sexual experience. 

  • Have an open conversation with your partner about your concerns, needs and expectations. Talk together about how to approach sex.  
  • Start with building intimacy and recognize it may take time to return to your previous sexual activities. 
  • Keep an open mind, show affection, and build connections for more intimate activities. 
  • Use foreplay to help your heart get used to the increased activity level of intercourse. 
  • Choose less strenuous positions, such as lying on the bottom or lying side-by-side. 
  • Avoid positions that require you to support your weight with your arms. 
  • Talk to your health care providers about sex as part of your overall health – and don’t hesitate to ask for advice on managing any concerns.  

If you experience chest pain during sexual activity, stop. Rest and recover. If the chest pain persists more than 15 minutes, call 9-1-1. 

Common Sexual Problems Related to Heart Conditions

Your heart condition and your medications may affect sexual desire and relationships in a number of ways. 

  • Loss of interest or desire for sex.
  • Problems achieving or maintaining an erection.
  • Difficulty achieving orgasm. 
  • Pain or discomfort during intercourse. 
  • Medications such as beta blockers may cause sexual dysfunction. 

Remember that anxiety and stress about your condition and your health may also affect your physical health, relationships and hormones which can reduce sexual desire and function. Talk about your concerns and work with your partner on strategies for a positive sexual experience.

Talk to Your Health Care Providers

It can be difficult and sometimes uncomfortable to bring up your sexual health with your care team. Your health care providers may not ask directly about sex during your appointments. 

Here are some ways to start the discussion: 

  • “I read somewhere that my heart failure can get in the way of having sex.”  
  • “I want to be intimate with my partner but I’m scared about what will happen to my heart.”
  • “My partner is worried about us having sex and that it’s not safe for my heart.”
  • “Is it safe to use Viagra if I’m having trouble with getting or keeping an erection?”