“Having a heart condition, including atrial fibrillation, does have an impact on your intimacy,” says Peter Kowey, MD, a cardiologist who specializes in heart rhythms and professor of medicine and clinical pharmacology at the Sidney Kimmel Medical College at Thomas Jefferson University in Philadelphia. But fears of negative consequences from having sex when you’re living with atrial fibrillation are largely unfounded. “I can assure you that the risk of an episode of atrial fibrillation is not increased by any particular activity," says Dr. Kowey. “It would be very unusual to have that reliable a relationship between a physical activity, including sex, and atrial fibrillation.”
Are You Heart-Healthy for Sex?
As long as you’re not having any heart symptoms, you’re under the care of a doctor, you’re physically active, and any heart conditions are under control, then having sex is safe, says John Day, MD, an electrophysiologist and director the Intermountain Heart Institute Heart Rhythm Specialists at Intermountain Medical Center in Murray, Utah. In fact, Dr. Day says that not only is sex safe for atrial fibrillation patients, but he would also encourage it within a monogamous relationship because sex is actually very healthy for the heart. Sex does cause your heart rate and blood pressure to rise. But as Day explains, sex is really a mild or moderate physical activity. “If you are able to walk briskly or climb two flights of stairs with no problems, your heart should hold up just fine during sex.” Because sex is exercise, it’s good for the heart. Exercise can help you maintain a positive outlook and upbeat mood. It also helps you maintain a healthy weight and regulate your biological rhythms so you sleep better at night. Kowey says that getting the all-clear from your doctor that you can have sex and that it won’t affect your atrial fibrillation puts the mind at ease. “Just the reassurance for many of these patients is enough therapy for them,” he says. The misconception about sex and the heart may come from Hollywood. It’s really only in the movies where men drop dead of heart attacks during or immediately after sex, says Day, adding that in real life, a sex-induced heart attack is an incredibly rare event.
Your Heart Is Unique
Gene Kim, MD, a cardiologist and electrophysiologist at Torrance Memorial Medical Center in Torrance, California, says that although sex is unlikely to trigger atrial fibrillation — also called afib — everyone is different. “I would monitor and ask that patients to let me know if they have afib episodes that are triggered by sex,” says Dr. Kim. Kim recommends that his patients keep a diary of any afib episodes, including when they occur, how long each lasts, and what the patient was doing at the time. These diaries help him and his patients monitor progress and track potential triggers. In the unlikely case it was sex that triggered the event, they would be able to see that, he says.
Sexual Side Effects of Afib Heart Medication
Ironically, it could be your medication, rather than the atrial fibrillation itself, that’s interfering with intimacy. Your doctor may prescribe beta-blockers to lower your blood pressure, and some men experience erectile dysfunction (ED) as a side effect. “Sexual dysfunction is the most frequent complaint I get from patients who are on beta-blockers,” Kowey said. The solution is simple. “You may have to switch therapy,” he said, adding that your doctor can also tinker with the dosage. Generally, side effects are dose-related, and you may do fine on a lower dose. It’s also possible that you have an underlying condition unrelated to atrial fibrillation that’s causing your sexual dysfunction. You may be referred to a urologist or other specialist who deals with ED to investigate and to treat any condition, and medication may help.
Increasing Your Comfort Factor
Doctors recognize that living with atrial fibrillation can be scary and make you afraid to have sex. Kowey tries to put his patients at ease and will bring up the topic if he senses they’re too intimidated to take the initiative. “If you wait for patients to bring it up, they may not,” he says. “It’s important as their doctor to anticipate their concerns and address them.” Kim says he asks many open-ended questions to give his patients the opportunity to express any worries about sex and atrial fibrillation. “At the end of the visit I give them another opportunity to ask questions or discuss any concerns,” he says. Day does the same. Leaving it until the end, he says, seems to create the best opportunity for patients to ask the questions that are most important to them. The takeaway? Knowing that your doctor is ready and willing to reassure you and answer your questions should be the impetus you need to voice your concerns. If you’re living with atrial fibrillation, you don’t have to wait for the doctor to bring up the subject of sex.
