Heart disease may contribute to changes in sexual function, such as reduced libido, vaginal dryness, or erectile dysfunction. However, sexual activity is safe and healthy for most people with heart disease.
People with heart disease may have firsthand knowledge of how the condition can affect their quality of life. Physical limitations and psychological stress can interfere with your ability to participate fully in daily activities. For some people, this includes their sexual health.
Sexual activity can be an important part of adult life. The World Health Organization (WHO) notes a link between positive sexual health indicators and good quality of life.
In a 2024 Swedish survey,
A 2024 review estimates that
When people talk about heart disease, they usually mean coronary artery disease (CAD), the most common type. However, several types exist, including:
How the condition affects your sexual health may depend on the type of heart disease you have. Some of the most common issues are:
Reduced libido or interest in sex
People with heart disease often report reduced interest in sex or reduced libido. Problems with blood circulation can reduce blood flow to the genitals, affecting arousal and lubrication.
People with heart disease may also be more likely to experience anxiety or depression, both of which can affect libido.
Reduced interest in sex may also be a result of changes in life due to heart disease or that occur around the age at which heart disease develops, according to a 2024 study.
Sexual anxiety
People with heart disease may experience anxiety relating to sexual activity. Causes of sexual anxiety in people with heart disease include:
- concerns about how their heart function may affect their sexual performance
- concerns about body image
- low self-esteem
- fear of experiencing symptoms during sex
In some people, this anxiety is sometimes rooted in fear of sexual activity causing death, especially if they’ve previously had a major heart event, like a heart attack. However, death during sex, even among people with heart disease, is rare.
Erectile dysfunction
Erectile dysfunction (ED) is difficulty getting or maintaining an erection. ED affects 42% to 57% of males with CAD, according to a 2018 research review. This is because CAD can reduce blood flow to the penis.
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Can I take ED medications if I have heart disease?
Doctors often recommend PDE5 inhibitors like sildenafil (Viagra) or tadalafil (Cialis) to treat ED. These medications are typically safe for most people with CAD.
Still, always consult a doctor, as these ED meds can interact with some heart medications.
For example, if you’re taking nitrates for angina, heart failure, or a recent heart attack, you may not be able to take these ED medications safely. The
» MORE: The Best ED Treatments When You Have a Heart Condition
Difficulties with orgasms
The combined issues of reduced blood flow and anxiety around sexual performance can lead to difficulties with orgasms. In females, this presents as orgasm dysfunction. Males may experience either delayed or premature ejaculation.
Difficulty having an orgasm may cause some people with heart disease to overexert themselves during sex when attempting to reach climax.
Vaginal dryness
Vaginal dryness is a common concern among females who have heart disease. This is likely due to reduced blood flow to the vagina. Lubrication of the vagina depends on blood vessels pushing out fluid, called a transudate.
However, declining estrogen levels may also play a role. Vaginal dryness is also a common symptom of menopause, when estrogen levels start to decline. It’s also around the time the risk of heart disease increases in females. Researchers are still exploring the link between estrogen and heart disease.
Local estrogen therapy may help alleviate vaginal dryness. A 2018 review notes that systemic hormone therapy may increase the risk of a cardiovascular event, while local therapy does not.
Painful intercourse
Vaginal dryness can often contribute to dyspareunia (painful sex) in females. The pain may occur during or after sex. Local estrogen therapy and vaginal lubricants may help relieve this symptom.
If you take medications to manage heart disease, these may also affect your sexual health. Several heart medications have sexual side effects, including:
| Medication | Sexual side effect(s) |
|---|---|
| angiotensin receptor blockers (ARBs) | ED |
| beta-blockers | • ED • vaginal dryness |
| calcium channel blockers | • ED • vaginal dryness |
| diuretics (especially thiazides) | • ED • vaginal dryness • reduced libido |
| statins | ED |
| amiodarone | testicular problems, like epididymitis |
| clonidine (Catapres) | ED |
| digoxin (Lanoxin) | ED |
| doxazosin (Cardura) | priapism (prolonged erection) |
| methyldopa | ED |
| metoprolol (Lopressor, Toprol XL) | reduced libido |
| warfarin (Coumadin) | priapism |
Talk with your doctor if you experience any side effects when using heart medications. They may be able to provide alternatives, adjust the dosage, or offer additional treatments to manage sexual side effects.
Most people with heart disease, particularly CAD, can safely engage in sexual activity. However, people with the following conditions may need to exercise caution:
- cyanotic heart disease
- pulmonary hypertension
- hypertrophic cardiomyopathy
- heart failure
- angina
- uncontrolled arrhythmia
Experts recommend consulting a doctor to ensure your risk of complications is low. Depending on your situation, a doctor may ask you to perform a stress test as part of their evaluation.
Can you die from sex if you have heart disease?
Death during sexual activity is extremely rare. When it does happen, it’s usually due to cardiac arrest. It’s more likely to occur if you have an uncontrolled arrhythmia, but it’s still rare among that population.
Sexual activity is comparable to mild to moderate physical activity, like a brisk walk or walking up a few flights of stairs. In some people, it can raise the heart rate to 180 beats per minute and significantly increase blood pressure. This level of physical exertion may be life threatening for some people.
If you have a condition that increases your risk of cardiac arrest during physical exertion, talk with a doctor about how you can safely engage in sexual activity.
A 2024 study found that having sex at least 12 times a year decreased the risk of developing heart disease or dying from any cause.
A 2022 study found that those who had weekly sex reduced the risk of dying from heart disease by 22% compared with those who had sex once a year or not at all.
Several studies have found similar heart-protective benefits of sex, including a 2020 study that noted weekly sex reduced the risk of dying after a heart attack.
- lower blood pressure
- reduce stress
- promote better sleep
- stimulate the release of the hormone oxytocin
All of the above can improve heart health in people with heart disease.
While you can manage ED with medication and vaginal dryness with estrogen or lubricants, other issues may be more complicated.
If you’re interested in maintaining a good sex life while managing heart disease, consider the following expert tips:
- Talk with a healthcare professional: It’s essential to talk with a clinician about your risk of a cardiac event with sexual activity. It can be uncomfortable for some people to discuss sexual health matters with anyone, including a doctor. Finding a doctor with whom you feel comfortable talking openly is important.
- Talk with your partner: Open communication with your partner may alleviate some of the anxieties around sexual performance.
- Have sex when your energy levels are high: Low energy levels can make issues of arousal and stamina more significant. You may have more success engaging in sexual activity safely when your energy levels are high, such as in the morning.
- Avoid positions that put pressure on your chest: Choose sexual positions that don’t place extra pressure on your chest or make it more challenging to breathe.
- Consider alternative sexual activities: There’s no one way to “do sex.” If intercourse is a challenge for you, consider other activities that require less energy or experiment with toys or aids. You can also discuss masturbation as a tool for your sexual health.
- Talk with a therapist: Therapy can help with body image or self-confidence issues. Couples therapy can also help address communication issues, behaviors, and emotions that may contribute to sexual challenges.
Can a pacemaker affect my sexual performance?
If you have a problem with your heart rhythm, you may need a pacemaker or implantable cardioverter defibrillator (ICD).
Sexual activity is typically safe for people with a pacemaker. People with pacemakers or ICDs experience the same sexual issues as other people with heart disease. However, a small
How long do you have to wait to have sex after a heart attack?
In a 2012 scientific statement, the American Heart Association (AHA) recommends waiting
The Canadian Heart and Stroke Foundation notes that it may be at least 2 weeks for most people.
How long do you have to wait to have sex after heart surgery?
The 2012 AHA scientific statement notes that most people can return to sexual activity within
Can a heart patient masturbate?
Masturbation can have the same effect on your heart as sexual intercourse. If you’re concerned about how a heart condition may affect your ability to have sex, it should also apply to when you masturbate. Talk with a healthcare professional about your risk of a serious cardiac event due to sex or masturbation.
Your heart health and sexual health are intertwined in surprising ways. People with heart disease may experience changes in their sexual desire or function due to altered blood flow and psychological effects.
These factors may lead some people with heart disease to feel anxious about sexual activity. However, research suggests that sex is safe for most people with heart disease and can actually provide numerous benefits.
Still, talk with a healthcare professional about your specific risk, especially if you’ve had a significant cardiac event.
Medications are often available to manage some of the physiological effects of heart disease that influence sexual health. Talking with your partner and making other adjustments can also contribute to a fulfilling sex life.