Understanding the Effects of a Myocardial Infarction on Sexual Functioning: A Basis for Sexual Counseling

Abstract

Sexual counseling is an integral component of the rehabilitative process for clients who have experienced a myocardial infarction (MI). This article describes myths and fears concerning the dangers of resuming sexual intercourse after a heart attack, positions for intercourse, and the effects of intercourse on arrhythmias, angina, and blood pressure. The purpose is to provide the results of empirical research to dispel myths and fears and to consider the causes of sexual dysfunction, the changes MI brings about in sexual activity for men and women, and the effects of age, exercise, and antihypertensive drugs on the resumption of sexual activity. Guidelines are provided for conducting a sexual/cardiac history as part of the counseling model with specific information for the post-MI client.

Sexual Counseling for Individuals With Cardiovascular Disease and Their Partners

“…131 This is equivalent to walking a treadmill at 3 to 4 miles per hour. 139 This amount of energy expenditure has also been compared to climbing 2 flights of stairs at a brisk pace, although this may not be a useful indicator in those who are older or less physically fit or who have significant CVD. 2 For those with HF, the 6-minute walk test can easily be administered in the clinical setting to assess stability and ability for exertion.…”

“…127,139,143,144 If a patient tends to experience chest pain with sexual activity, nitroglycerine, if prescribed, can be taken just before or during sex. 143 The patient should be encouraged to seek medical assistance for any unrelieved chest pain and to report adverse symptoms to their healthcare provider.…”

Preoperative characteristucs of patients with improved quality of life one year fter coronary artery bypass surgery

“…It is a common finding that individuals with heart disease experience fear and anxiety regarding sexual performance, and many report sexual dysfunction or abstinence from sexual activity (Seidl et al, 1991). An interesting finding in the current study was that patients, with an improved quality of life, as assessed at one year post-operatively, had a significantly "normal" sex-life on admission compared to those who did not have an improved quality of life (p=0.04).…”

Progress in sexual counseling by cardiac nurses, 1994 to 2009

“…Likewise, some older adults continue to be sexually active into their 80s. Although an existing body of literature outlines the content of sexual counseling for those who have experienced a MI, [19][20][21][22] sexual counseling does not seem to be widely implemented in nursing practice.…”