By- Dr Kajal Singh, Associate Professor, Obstetrics and Gynaecology Department, NIIMS Medical College and Hospital
Yes, heart issues can affect sexual activity in both physical and emotional ways. It is vital to explore these impacts, and in particular, with women, because heart health and sexual health are closely related. Below are five scientific ways heart disease can affect sexual activity:
- Reduced Cardiovascular Endurance: It requires physical exertion. Conditions such as coronary artery disease or heart failure can affect cardiac output, leading to fatigue and also readings of dyspnoea (shortness of breath) during intercourse. Decreased sexual frequency and distance affect satisfaction with the sex act.
- Vascular Insufficiency: Adequate blood flow to the genitals is important for both arousal and lubrication. Atherosclerotic changes, common in patients with cardiac impairments, will lower circulation in the pelvic area that can lead to decreased lubrication and arousal. Women can also have dyspareunia (painful sex), typically seen in post-menopausal women.
- Medication Side Effects: Beta-blockers, diuretics, and certain antihypertensive medications can negatively affect libido and orgasmic ability. Most of these medications regulate sympathetic activity or cause vaginal drying that affects these sexual response cycles.
- Psychological Impact: After a cardiac event, anxiety and fear of an event or disruption are always considerations. This psychogenic inhibition results in HSDD and arousal dysfunction, all of which inhibit couples’ closeness.
- Hormonal and Autonomic Dysregulation: Chronic heart diseases impact the hypothalamic-pituitary-gonadal axis to change the physiological alterations in oestrogen and androgen that are needed for sexual desire and healthy tissues in the vagina. Autonomic dysfunction may also influence the clitoris and vaginal responses.
We must encourage open conversations about sexual health with cardiac patients. With coordinated care involving cardiologists, appropriate counselling, including pelvic physiotherapy and lubricants. Sexual well-being can be preserved or restored even in the presence of heart disease.