Is sexual intercourse before 18 really dangerous?
Nine sex tips for people with heart disease
Sex increases blood pressure and heart rate, slightly during foreplay and most strongly in the 10 to 15 seconds during orgasm.
However, a systolic blood pressure of 170 mmHg or a pulse of 130 per minute are rarely exceeded - at least not in otherwise normotensive men who have sex with their partner.
In general, the exposure to sexual activity is in the range of three to five metabolic equivalents (MET), depending on age, fitness and state of health.
Less than one percent of all heart attacks during sexual intercourse
As expected, there is an increased risk of cardiovascular complications during coitus. The absolute event rate, however, is "tiny", according to the American Heart Association (AHA), mainly because the exposure is usually rather short.
Less than one percent of all heart attacks and all cases of sudden cardiac death occur during sexual intercourse.
The "angina d'amour" - during coitus or in the following hours - accounts for less than five percent of all angina pectoris attacks.
But what about the individual cardiovascular disease patient: is sex allowed or not? The current AHA publication (Circulation 2012; online, January 19) helps answer this question.
Experts have compiled the published study data and the guidelines of large professional societies and derived recommendations from them:
Important: medical history and physical examination
Before patients with newly diagnosed cardiovascular disease become sexually active again, careful attention should be given Medication history and physical exam occur. If this results in a low risk of cardiovascular complications, then nothing speaks against sex.
If the cardiovascular risk is not low or unknown, a Stress test recommended. Sexual activity is not a problem if patients can manage at least 3-5 METs on the stress test without experiencing angina, excessive dyspnea, ischemic ST changes, cyanosis, hypotension, or arrhythmias.
The risk of cardiovascular complications during sex can be due to cardiac Rehabilitation and sports be lowered.
Patients with unstable, decompensated, and / or severe symptomatic cardiovascular disease should abstain from sexual activity for so longuntil they are stabilized and optimally treated. The same applies to patients in whom cardiovascular complaints were triggered by the sexual act.
Any concerns about possible adverse effects on sexuality must not be a reason to prescribe symptomatic and / or prognostic more effective cardiovascular drugs to renounce.
Drugs used to treat erectile dysfunction, i.e. PDE-5 inhibitors, are considered safe in the case of stable cardiovascular disease. However, PDE-5 inhibitors are prohibited when patients are taking nitrates. Conversely, patients taking a PDE-5 inhibitor should not use nitrate for 24 to 48 hours (depending on the substance).
Premenopausal women with cardiovascular disease should consider contraceptive safety and pregnancy to advise become.
Postmenopausal women with cardiovascular disease should seek treatment for dyspareunia no systemic estrogen receive.
After a cardiac event, newly diagnosed cardiovascular disease and after implantation of a defibrillator as part of the medical consultation also the topic of "sex" be addressed.
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