Sexual activity declines in the year after a heart attack for patients who do not get instructions from their doctor about when it is safe to resume sex, the results of a new study indicate.
US researchers followed the progress of 1,184 male and 576 female heart attack patients. Of these, almost half of the men and about one-third of the women received instructions on resuming sexual activity when they were discharged from hospital.
Meanwhile less than 40% of the men and 20% of the women talked about sex with their doctors in the year following their heart attack.
One year after the heart attack, more than two-thirds of the men and about 40% of the women reported some sexual activity.
The researchers found that men were 1.3 times and women 1.4 times more likely to report a loss of sexual activity after one year if they did not receive information on when to resume sexual activity.
Overall, patients who had been given instructions about resuming sexual activity at the time of their hospital discharge were more likely to engage in such activity over the following year.
"Sexuality is an important part of life and most heart attack patients are sexually active. For the most part, physicians just aren't discussing this topic with their patients after a heart attack," said the study's lead author, Dr Stacy Tessler Lindau of the University of Chicago.
She noted that little is known about what happens to patients' sexuality and sexual function after a heart attack, particularly for women.
The consensus among doctors is that it is safe to resume sexual activity after a heart attack, once the patient feels better and is capable of performing moderate exercise.
"The likelihood of dying during sexual intercourse, even among people who have had a heart attack, is really small," Dr Lindau said.
She pointed out that some doctors may be reluctant to discuss sex with patients who are older, are not married or belong to a conservative religious group.
"But in the case of sexuality, stereotypes don't work. Older patients may not be married but still have an intimate romantic partner. Physicians need to bring up the subject, even if it's not part of a routine discharge check list, because not raising the question of sexuality leaves the door closed," she explained.
Dr Lindau said that further studies in this area are required to determine what patients need to know and how to tailor information so that they will feel free to ask questions and to seek help.
"Often physicians are focused on saving lives and sexual health may not be valued as much as medications and other treatments to prevent further progression of their coronary disease. Doctors need to be proactive and help patients recover their whole lives after a heart attack," she added.
Details of these findings were presented at the American Heart Association's 11th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.