Most patients don't get counseling about sex after heart attack

Researchers interviewed 3,501 heart attack patients in 127 hospitals and one month later by telephone in August 2008-January 2012 in the United States and Spain. The patients' median age was 48 years and two-thirds were female.

One month after their heart attacks, only 12 percent of women and 19 percent of men reported they received sexual counseling from their healthcare provider -- though most reported they were sexually active within the year before their heart attack.

"Even with life-threatening illness, people value their sexual function and believe it is appropriate for healthcare providers to raise the issue of resuming sexual activity," said Stacy Tessler Lindau, M.D., M.A.P.P., study lead author, associate professor of obstetrics and gynecology and geriatric medicine and director of the Program in Integrative Sexual Medicine at the University of Chicago Medical Center.

In rare instances when healthcare providers counseled about sexual activity, they often recommended restrictions more conservative than medical guidelines. For example, those patients given restrictions more most often told to limit sex (35 percent), take a more passive role (26 percent), and/or keep their heart rate down (23 percent).

"Healthcare providers should let their patients know that for most it is OK to resume physical activity, including sexual activity, and to return to work," Lindau said. "They can tell their patients to stop the activity and notify them if they experience chest pain, shortness of breath or other concerning symptoms. If the healthcare provider doesn't raise the issues, I encourage patients to ask outright: 'Is it OK for me to resume sexual activity? When? Is there anything I should look out for?'"

In the United States and worldwide, heart disease is the leading cause of death. About 720,000 people have a heart attack in the United States each year and about 20 percent are 18-55 years old.

In 2013, the American Heart Association published a scientific statement about counseling patients with cardiovascular disease about sexual activity. The statement concluded that sexual counseling should be tailored to the individual needs and concerns of cardiovascular patients and their partners/spouses.

"When the topic of sexual function is left out of counseling, patients perceive that it's not relevant to their medical condition, or that they are alone in the problems they have resuming normal sexual activity," Lindau said.