Most younger patients don’t receive counseling about sex after acute myocardial infarction (AMI), according to a team of researchers from the United States and Spain.
It’s common for heart patients to have concerns about resuming sexual activity. Some worry that vigorous sex could lead to another heart attack. As a result, they avoid sex when they might not need to.
In this study, the authors sought to learn more about the experiences of younger patients – those between the ages of 18 and 55 – and the counseling they received from their physicians.
Almost 20% of AMIs happen to people in this age group, the study authors noted.
The study subjects were from the United States and Spain. They were all participants in the Variation in Recovery: Role of Gender on Outcomes of Young AMI (VIRGO) study. (This study was called IM-JOVEN in Spain) and were hospitalized at 127 centers in the two countries.
This analysis included data from 2,349 women and 1,152 men with a median age of 48 years. While they were hospitalized, the patients were interviewed about their sexual activity and attitudes in the twelve months before their AMI. They also completed health-related questionnaires.
One month after their AMI, they were asked further questions about physician counseling and recommendations on sexual activity.
Men and women from both countries had sex less frequently in the month after their AMI when compared to the twelve months beforehand. Among the patients who did have sex during the prior year, 54% of the women and 63% of the men had resumed sexual activity at the one-month mark.
Most of the patients felt that it was “appropriate” for clinicians to discuss sexual health issues. Most also said they would feel comfortable having such conversations.
But at the one-month follow-up, only 12% of the women and 19% of the men had had such a discussion.
Patients in the United States were more likely to bring up the topic. In Spain, clinicians tended to broach the subject first.
Women, older patients, and those who were not sexually active at baseline were less likely to receive counseling, the authors noted.
Women’s experiences differed based on their treatment location. In Spain, women were more often told to restrict their sexual activity than men were. In the United States, the opposite occurred – women were less likely to be advised to restrict sexual activity compared to men.
The researchers had concerns about the content of such restrictions, which usually involved limiting sex, taking a more passive role, and keeping the heart rate down. “Among the fewer than 15% of patients who received counseling about sexual activity, recommendations were inconsistent and only weakly related to patient characteristics,” they wrote.
They added, “Neither strong evidence nor clinical guidelines support the specific kinds of sexual activity restrictions patients received, nor do they support making different recommendations based on patient gender or age.”
Overall, they encouraged physicians to discuss the resumption of sexual activity with their AMI patients.
“This small modification in practice could help improve outcomes and quality of life for younger women and men with AMI,” they explained.
The study was first published online last month in Circulation, a journal of the American Heart Association.
Lindau, Stacy Tessler, MD, MAPP, et al.
“Sexual Activity and Counseling in the First Month After Acute Myocardial
Infarction (AMI) Among Younger Adults in the United States and Spain:
A Prospective, Observational Study”
(Full-text. Published online before print: December 15, 2014)
“Sex After MI: Few Are Counseled, Most Want to Learn”
(December 17, 2014)