Just one in eight women and one in five men reported being counseled
on sexual activity within the month following a heart attack. And
those who did discuss the topic with their doctors were likely to
get overly restrictive instructions, researchers found.
“The guidelines say for an uncomplicated heart attack people should
be able to resume normal sexual activity after a week,” said lead
author Dr. Stacy Tessler Lindau, director of the Program in
Integrative Sexual Medicine at the University of Chicago Medical
Tessler Lindau added that patients often don’t know if they had an
uncomplicated heart attack, which is one that doesn’t result in
complications to other organs or body systems.
When patients are confused, “that’s when the patient and physician
need to speak,” she said.
About one in five heart attacks happen in adults under age 56, the
researchers note in the journal Circulation. Heart attacks can lead
to reduced sexual activity because people fear sex will trigger
another heart attack, they add.
The American College of Cardiology, American Heart Association and
European Society of Cardiology all support a relatively quick return
to sexual activity after an uncomplicated, or "minor," heart attack.
To see if doctors apply those guidelines in practice, the
researchers surveyed 3,501 heart attack patients from 127 hospitals
in Spain and the U.S. between 2008 and 2012. The average patient was
48 years old. Two thirds were women. Most participants were sexually
active in the year before their heart attack.
Most participants believed doctors should talk about sex and said
they felt comfortable discussing the subject with a physician. But
only 12 percent of women and 19 percent of men had such a
conversation in the month after their heart attack.
Of the minority who did discuss sex with their doctors, about a
third were told they could resume sexual activity without
restrictions. The others were told to limit sex, to be more passive
or to keep their heart rate down.
Spanish women were almost 40 percent more likely than Spanish men to
be given restrictive advice, while U.S women were less likely than
U.S. men to be told to restrict their activity. Overall, women in
Spain were 36 percent more likely than U.S. women to be told to
limit sexual activity.
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Further differences by country were evident. For example, most U.S.
patients who talked about sex with their doctors reported that they
had initiated the discussion, while most of the Spanish patients
said their doctor had brought it up.
The results might reflect an overly cautious attitude among doctors
who do bring up sex, said Tessler Lindau.
“It could be that the physicians who are motivated to raise the
issue are especially cautions throughout and thinking of all
potential risk to their patient after a heart attack,” she said.
Tessler Lindau said people who consider their sexual function
important should ask about sex after a heart attack if their doctors
don’t bring it up first.
“It’s fair game,” she said. “I think your physician will give you an
Tessler Lindau said sexual function tends to be important to most
people. When she's giving a presentation, she said, she often asks
people to decide whether they would rather lose their dominant hand
or their sexual function. They typically have to think, she said.
“Sexual function is a basic part of human physical function,” she
said. “If it’s not working - unlike a missing hand - the rest of the
world can’t see it, but it’s crucial.”
SOURCE: http://bit.ly/1xrwplT Circulation, online December 15, 2014.
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