By Guest Blogger Dr. Ramin Manshadi
People with coronary conditions naturally wonder if sex can put a strain on their heart.
It is possible. The general guideline is that walking up two flights of stairs equates to the strain on your heart while having a sexual encounter. If the patient can make that climb without any significant shortness of breath or chest pain, the likelihood of having difficulties from sex to be low. Not zero, but low.
So the healthier your heart, not only is the sex safer (we all want safe sex!), but also more enjoyable as you have increased stamina.
It should be pointed out that this concern doesn’t only apply to older persons, people in their thirties could be experiencing chest pains during sex, which could be a sign they have a very high-grade blockage in their heart.
Erectile Dysfunction
Issues with heart health can create other, seemingly non-related health issues. But a problem you might not expect to be connected is erectile dysfunction. While this exclusively affects men, it in turn has consequences for women as well.
Also called impotence, erectile dysfunction refers to an inability to sufficiently maintain an erection to have sex. Occasional impotence isn’t necessarily something to worry about, but a recurring problem can be another matter. It can negatively affect your sex life, your relationship, and even your self-esteem.
It may also be a sign of underlying medical problems.
While stress, tiredness, depression or relationship issues can also be the reason, there are a number of possible physical causes for impotence. Men with sexual problems of this nature are often smokers, people with high cholesterol or diabetes. All of these affect the inner lining of the arteries. This can cause erectile dysfunction. It is the blood flowing through the arteries that feed the male organ. If you have blockages there, it may be obvious, as that can interfere with its function. But it doesn’t take an actual blockage to affect the quality of your sex. High blood pressure can also impact the area. The sheer force of the pressure of the blood going to the vessels can damage the function of an artery. And if the artery isn’t functioning well, then the organ will run into problems.
Many men have never suspected there’s any correlation. In fact, many believe erectile dysfunction is simply something that often happens as they get older. But in truth, one of the main reasons this dysfunction occurs, is that as men get older, their cholesterol levels have risen, and plaque has built up in the arteries. Testosterone and other hormones also play a role. But the dysfunction for many relates directly to the condition of their vessels.
Men being men, they don’t say anything. They don’t know to ask or are simply too embarrassed. Usually it’s the wife who speaks up and asks, “Is there anything we can do?”
Fortunately…Yes
If you treat your underlying health issues by being active, eating right, not smoking and keeping your cholesterol down (and your sugar intake down if you have diabetes), you’re more likely to have better function. Sure, it will take some effort. But the results are undeniably satisfying.
L-Arginine
If improving your health behaviors doesn’t solve the problem, there are medications that doctors can prescribe. There is also an over-the-counter supplement that can assist. Called L-Arginine, it is an amino acid that has been shown in studies to improve function of the inner linings of arteries by helping the nitric oxide pathway. Not only can it potentially lower blood pressure, it has also been known to help correct erectile dysfunction. It should be noted that L-Arginine can interact with some other heart medications, including high blood pressure medicines known as ACE inhibitors, as well as nitroglycerin. So check with your doctor.
VIAGRA
Viagra is a medication commonly prescribed for erectile dysfunction (impotence) in men. While the best known, Viagra isn’t the only one in this class of drugs. There is also Levitra and Cialis, both of which function similarly. All have been “miracle” drugs for many with this ailment. However, they also pose some very real concerns for those with heart conditions.
These types of drugs (phosphodiesterase inhibitors) work by inhibiting a particular enzyme in blood, thereby causing dilation of the vessel. When you have dilation of the vessel, the penis engorges with blood. That is how an erection forms.
Drug Interaction: Passing out and Heart attacks
There is a problem with using Viagra while taking nitrates. Nitrates are used by people who have chest pains. They’re placed under the tongue to relieve the pain. But nitrates also cause vasal dilation, and the Viagra intensifies their effect. When you have too much vasal dilation, your blood pressure drops, you don’t get enough blood flow to the brain and you can pass out.
A different problem can occur as well. If you vasodilate the arteries too much, they open up and the heart muscle itself doesn’t get enough blood. If you already have some kind of blockage there, and suddenly have a supply/demand mismatch (more demand than supply), not enough blood flows to the heart muscle due to the lowered supply. It can precipitate a heart attack. In general, you should not take Viagra within 24 hours of any nitrates.
Other than Drug Interference… is Viagra Safe?
In general, there are two types of patient population: those with known heart disease and those without known heart disease. Of course, people without any known heart disease still might wonder if they can take the drug. To answer that, they can do a simple self-test. If you can go up one flight of stairs without significant chest pain or shortness of breath, you should be fine taking this drug.
On the other hand, if you do have heart disease, your cardiologist should make a recommendation whether you can take the drug, based on the status of your condition. For instance, if you have single vessel disease, meaning you have one blockage that’s been opened up by stenting, then you should be able to use Viagra. But if someone has multiple vessel blockages, or diffused disease in arteries that have not been corrected, then probably best not to use this drug. Once full blood flow has been restored to the heart and the patient has no more symptoms of chest pain or significant shortness of breath, then it should be safe.
Ask your doctor before using this drug, rather than simply rely recollection or understanding about the specifics of your condition. Plus, no two patients are exactly the same. The above are just guidelines. So final advice: consult your physician.
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Dr. Manshadi is a multi-boarded interventional Cardiologist treating patients from prevention to intervention. Because of his dedication to his work and patients he has been awarded Americas Top Doctors Award from U.S. News and World Report, and patient’s Choice Physician award. He complements his private practice with Academic Medicine and currently serves as Associate Clinical Professor at UC Davis Medical Center, Clinical Professor at University of the Pacific, and serves as the Chair of Media Relations for American College of Cardiology, California Chapter.
For more information visit: www.drmanshadi.com