What is  Sex and heart disease
Sexual activity is a normal human instinct, which protects men and women against feelings of isolation. It offers them an opportunity to be free of mental stress and tension by gestures such as touching, hugging, caressing and fantasy. Intercourse is the ultimate expression of sexuality.

Heart patients and their spouses frequently perceive sexual intimacy as stressful or even life threatening. Their fears and doubts are often not clarified by physicians and other health care providers, who may also feel inhibited while discussing sexual matters with their patients. Majority of the patients, therefore receive little or no instructions about resuming sex after a heart attack or heart surgery. Those who are instructed frequently don’t receive adequate information. Often the spouse is excluded from counselling. Without proper guidance, both patient and spouse rely on their own knowledge, myths and misconception to cope up with their unfounded fears of sexual inadequacy, impotence and death during intercourse.

Sexual problems in heart disease
Male heart patients frequently report a reduction in frequency and satisfaction of intercourse after heart attack or heart surgery. Sexual desire may decrease, leading to inhibition of feelings and failure of erection. Some men also experience premature ejaculation. Yet, such problems do occur in as many as 40% of happily married normal couples too. A strong emotional relationship between spouses lessens the occurrence of sexual dissatisfaction after a heart attack. Relatively few studies have been carried out regarding sexual activities of female patients with heart disease.

Causes of sexual problems in heart disease

• Anxiety

• Depression

• Preexisting sexual problem

• Concomitant stroke during acute heart ailment or heart surgery

•  Atherosclerosis of aorta or its branches supplying blood to penis

• Physical deconditioning

• Alcohol and tobacco abuse

• Some therapeutic drugs

Sometimes sexual problems encountered in heart disease are caused or aggravated by certain medicines. Some medicines known to cause sexual difficulties are spironolactone, beta blockers, thiazide diuretics, statins, anti-depressants and sedatives and anti-anxiety drugs. Personal physician is the best guide to assess whether particular medicine is responsible for sexual problems. If identifies with reasonable certainty, the offending medicine may be withdrawn. When a medicine is absolutely essential, sex may be scheduled when blood levels of the problem medication are low, that is, about 6-8 hours after dose of the medicine.