Healthcare professionals are urged to counsel heart and stroke patients on how to resume a healthy sex life, according to a joint statement published by the American Heart Association and European Society of Cardiology.
“Patients are anxious and often afraid sex will trigger another cardiac event, but the topic sometimes gets passed over because of embarrassment or discomfort,” Elaine Steinke, APRN, PhD, the statements lead author representing the Council on Cardiovascular and Stroke Nursing of the American Heart Association, and a professor of nursing at Wichita State University in Kansas, said in a news release.
The statement is described as the first to provide “how-to” information about resuming sexual activities, and applies to patients and partners of patients who have had cardiac arrest, a heart transplant or stroke, or have received an implantable cardioverter defibrillator or had other cardiac conditions. Past recommendations have focused on when to resume sex, risks with sex and managing medications.
Among the new recommendations, as published July 29 on the websites of the journals Circulation and the European Heart Journal, healthcare providers should routinely assess all patients after a cardiac event and during follow-up visits to determine whether the patient is healthy enough to resume sexual activities; give individualized, structured counseling based on specific needs and medical conditions; discuss recommended positions, how to be intimate without having sexual intercourse and when to resume sexual activity; and counsel all patients regardless of gender, age and sexual orientation.
“There are many barriers or misconceptions that inhibit discussions about sex,” Tiny Jaarsma, RN, NFESC, co-chair of the task force on behalf of the European Society of Cardiologys Council on Cardiovascular Nursing and Allied Professions, said in the news release. “Some healthcare professionals may believe the patient does not want this information, but we have found it is easier for the healthcare provider to start the discussion than for the patient to bring up these issues.
“Time constraints or just plain embarrassment should not be an excuse for avoiding these topics that are essential to the cardiac patients mental and physical health,” added Jaarsma, a professor at the Linköping University in Sweden.
Exercise stress testing is recommended for some patients to determine whether the heart is strong enough to resume sexual activity. Physical activities such as brisk walking may be suggested for some heart patients before resuming sexual activity.
Patients may be advised that the stress of extramarital sexual activity could pose a health risk for people with heart disease, the authors noted.
In addition, while heart medications can affect sex drive and function in both men and women, patients should talk to their healthcare provider before stopping any medications, according to the statement. A healthcare provider can determine whether sexual problems are caused by the drug or an underlying condition such as depression.
The recommendations were developed from evidence-based research on sex counseling.
“Starting a conversation about sex can easily be included in patient discussions, particularly when discussing sex as part of recommendations for exercise,” Steinke said. “All healthcare providers should be ready and willing to address these areas.”
That group especially includes cardiologists, primary care practitioners, nurses, nurse practitioners and physical therapists. Providers may need additional training on sex counseling, she said.
Read a PDF of the statement: http://circ.ahajournals.org/content/early/2013/07/29/CIR.0b013e31829c2e53.full.pdf.