Surviving a heart attack acts as a wake-up call for people to change their lives — either by quitting vices like smoking and alcohol, or eating healthier and exercising. It can also lead to questions like: What if it happens again? How soon can I have sex? What sexual problems can arise? Nearly two-thirds of men and over half of women resume sex by one month after a heart attack, but women are more likely to report sexual function problems a year after recovery, according to a recent study published in JAMA Cardiology.

“Those who had not communicated with a physician about sex in the first month after AMI [acute myocardial infarction;heart attack] were more likely to delay resuming sex” wrote the authors, in their paper.

Currently, the American Heart Association (AHA) guidelines suggest patients who do not have any complications, can resume sexual activity within one week to 10 days post-heart attack. In January 2012, the AHA published a report that supported the belief that those who can engage in moderate exercise, such as walking up a flight of stairs, are usually healthy enough to have sex. These are important recommendations that highlight the hesitancy couples experience to resume sex, although it’s usually harmless.

Dr. Stacy Tessler Lindau, author of the study from the University of Chicago, and her colleagues found among men and women 18 to 55 years of age, men were more likely than women (94 percent vs 91 percent) were more likely to have sex by one year after a heart attack. Women were less likely than men to report no sexual function problems in the year after the event (40 percent vs 55 percent). Moreover, more women than men (42 percent vs 31 percent) with no sexual problems prior to the heart attack, developed one or more incident problems the year after.

Common sexual function problems for women included a lack of interest (40 percent) and trouble lubricating (22 percent); men experience erectile difficulties (22 percent) and lack of interest (19 percent). Significant indicators that predict the loss of sexual activity in the year after a heart attack, also include higher stress levels and diabetes.

The researchers highlight the hesitancy to resume sex, and the lack of the “sex talk” with doctors and patients can influence the level of sexual function among patients.

A 2012 study in the American Journal of Caridology found heart patients do benefit from counseling when it comes to resuming sex. Patients who were sexually active before a heart attack were 1.5 times more likely to resume their previous level of sexual activity, if they received counseling before being discharged from the hospital. However, less than a half of men surveyed and about a third of women recalled receiving instructions about when they could safely resume sex.

The takeaway is doctors need to address sex post-heart attack, especially when there’s a reluctance to discuss. They need to understand the role they play in helping patients avoid needless fear about the risk of relapse or a sex-induced death. Receiving instructions about sex after a heart attack is an important predictor whether or not patients resume within the year.

"Patients want to know what level of sexual function to expect during recovery from AMI,” wrote the researchers.

These findings can be used to expand counseling and care guidelines to include recommendations for patients on what to expect in regards to sexual activity and unfcitob post-heart surgery.

Source: Lindau ST, Abramsohn E, Bueno H et al. Sexual Activity and Function in the Year After an Acute Myocardial Infarction Among Younger Women and Men in the United States and Spain. JAMA Cardiology. 2016.