An implantable cardioverter defibrillator (ICD) is a device used to treat irregular heartbeats (arrhythmias) by monitoring the heart’s rhythm. If the heart starts beating too fast or too slow, the ICD sends a low-energy electric pulse to the heart to stabilize it. If this does not work, the ICD sends a high-energy pulse, or shock, to keep the heart beating correctly.

High-energy shocks can be painful and need medical attention. Some people describe them as being kicked in the chest.

While most people with ICDs can have sex like they did before, some experience sexual problems.

Some of these problems stem from anxiety over unexpected shocks. Some find it difficult to relax when they know a shock could occur. They may avoid sex out of fear or find that their sex drive isn’t what it used to be. Anxiety is also thought to be one of the biggest reasons men with ICDs experience erectile dysfunction.

Partners may worry that sexual activity is too strenuous for someone with an ICD and could cause a shock.

Medications used to treat heart conditions can also cause sexual problems, such as erectile dysfunction or low sexual desire.

Those who are concerned about sex and ICDs should talk to their doctor. A doctor can give individualized advice, reassure patients and partners, and make referrals for counseling when there are high levels of anxiety or depression. Patients are also encouraged to have regular follow-up visits with their cardiologist to make sure the ICD is working properly and to adjust it if necessary.

Partners should be assured that they cannot be harmed if a person’s ICD gives a shock during sexual activity.