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Sex talk with doctor a must

People who don't have a frank talk about sex with their doctor after they have had a heart attack are less likely to resume sexual activity, new research finds.

The study of 1,184 men and 576 women treated for heart attacks found that the men were 30% more likely and women 40% more likely to avoid sex in the following year if they didn't receive information on when to resume sexual activity.

The news from the study wasn't all bad, said Dr Stacy Tessler Lindau, an associate professor of obstetrics and gynecology and medicine-geriatrics at the University of Chicago.

Most have sex after heart attack

"What we found is that the majority of people who have heart attacks are sexually active after the heart attack," Lindau said. "This is something we haven't had great data about."

One year after the heart attack, more than two-thirds of the men and about 40% of the women reported some sexual activity. More of the men (38.8%) than of the women (17.5%) said they had discussed sex with a doctor during that year.

The men were more likely than the women to have been sexually active before the heart attack, 73.5% compared to 43.1%.

Age may have had something to do with the level of pre-heart attack activity. The average age of men in the study was 58, compared to 61 for the women.

Safe to resume sex

"Maybe there's something doctors can do to help maintain the previous level of activity," Lindau said. "Simply talk to them about when it is safe to resume sexual activity."

That talk should be a standard part of the hospital discharge routine, said Dr Dan J. Fintel, a professor of medicine at the Northwestern University Feinberg School of Medicine in Chicago, who often treats heart attack patients.

"The doctor should initiate discussions about return to normal life, about work, physical activity and eating habits," Fintel said. "Items of intimate nature, like sexual activity, should be on the list, but often are left off."

One purpose of the discussion should be to address fears about sex after a heart attack, both Lindau and Fintel said. "Many patients worry that having sex can trigger another heart attack," Lindau noted. "But the likelihood of dying because of sexual activity is very small."

Patient misconceptions

"Patients have all kinds of misconceptions about what is safe and what is not safe after a heart attack," Fintel said. "Often, the worried one is not the patient but a partner who is afraid that the patient will suffer an arrhythmia and die. Nothing could be further from the truth."

For most patients, the heart is not the source of possible trouble, Fintel said. It's the groin, through which a thin tube called a catheter is threaded to bring treatment to the heart. His advice is to wait until the area in the groin that might have been damaged in the treatment heals.

"When I say that to patients, they are very relieved," Fintel said.

If the physician doesn't bring up the subject at the time of hospital discharge, the patient should, Lindau said. "It is an appropriate topic for discussion with the physician," she said. "They want the physician to bring it up." - (Ed Edelson/HealthDay News, May 2010)

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