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Every tenth man in Poland has a problem with satisfactory sexual intercourse. Unfortunately, most people look for help on the Internet or do not try to solve their problems at all. Meanwhile, sometimes a cardiologist can help.
From the research of prof. Zbigniew Izdebski shows that every tenth man has problems with erection or satisfactory sexual intercourse. Few of them realize that their problems could be solved by a cardiologist. According to Dr. Beata Kłosiewicz-Wąsek, director of the Allenort Cardiology Center in Warsaw, sexual activity is a rare topic raised by patients in cardiovascular diseases. – Of course, the problem also concerns women, but practice shows that it is never defined by them. During cardiological visits, the doctor usually does not have enough time to create an atmosphere of trust that allows him to talk to the patient about his sex life. It is often accompanied on both sides by discomfort related to the discussion about this aspect of life or simply a lack of knowledge that should be passed on to the patient. Meanwhile, cardiological scientific societies around the world emphasize that such a procedure should be the standard. The problem is so important and obvious that in January this year the American Heart Association standards were published on the relationship between cardiovascular diseases and sexual life – says Dr. Kłosiewicz-Wąsek.
Exercise capacity is measured in cardiology in the metabolic units MET. It is measured during an exercise test in which the patient runs on a treadmill or pedals on a stationary bicycle. A moderately fit, young 30-40-year-old should be able to make an effort of 10-11 METs. Sexual intercourse is an effort of 4 METs, which is roughly the amount needed to climb the stairs to the first floor. – People with heart disease may have limitations in making such an effort – says Dr. Kłosiewicz-Wąsek. Some patients will experience shortness of breath, chest pain or heart rhythm disturbances during intercourse.
The solution is to inform the cardiologist about your problems. If in doubt as to whether a patient may be allowed to be sexually active, an exercise test will be prescribed. It will allow to assess both the patient’s ability to perform adequate physical effort, as well as to assess the probability of additional cardiological problems, such as cardiac arrhythmias. A patient who knows that it is safe to perform certain physical exertion under monitoring conditions will never fear it in everyday life. On the other hand, any form of heart disease that is not stabilized (e.g., unstable coronary artery disease or compensated heart failure) will be threatening and will require treatment before resuming sexual activity.
Heart disease and sex
Since sexual activity is associated with taking extra effort, many cardiac patients feel anxious about intercourse. Previous cardiovascular events, such as attacks of arrhythmias, coronary episodes, including, of course, myocardial infarction, exacerbation of heart failure, tend to cause depressive reactions in patients who live in fear that something will happen to them. This, in turn, can make you anxious to engage in sexual activity. – This psychological aspect is often underestimated by patients and carefully ignored – says Dr. Kłosiewicz-Wąsek. Meanwhile, many patients would be helped by a conversation with a cardiologist who would convince them that in their case sexual activity is not only safe, but also positively influencing the treatment process. For some patients, a consultation with a psychologist or psychiatrist may be necessary. – The key is to inform the doctor about the problem – emphasizes Dr Kłosiewicz-Wąsek.
Drugs that affect sexual activity
It is important to be aware that the side effects of some medications can have a negative effect on sexual activity. These include beta-blockers and aldosterone inhibitors – one of the most commonly used cardiac drugs. These negative symptoms are rarely seen, but must be taken into account when selecting treatment. In the event of sexual dysfunction, the doctor may replace the drugs with other drugs. – Failure to inform the doctor about the problem makes the intervention impossible – adds Dr. Kłosiewicz-Wąsek.
Problems with an erection
Rarely, sexual failure is not due to mental problems, but from organic diseases. One of the causes of problems with erection may be diseases of the blood vessels, especially obstructive arteriosclerosis leading to ischemia of the genital organs, the so-called Leriche’s syndrome. This syndrome is treated by vascular surgeons.
– If your iliac arteries are narrowed, surgery can restore your sexual performance. If the atherosclerosis has damaged many vessels, full efficiency will not be achieved, but starting pharmacological treatment may save the patient’s life – says Prof. Zbigniew Gaciong, head of the Department and Clinic of Internal Diseases, Hypertension and Angiology at the Medical University of Warsaw. He added that starting atherosclerosis treatment protects against stroke and heart attack.
Potency drugs
Patients with cardiovascular diseases with problems with sexual potency can use drugs that stimulate sexual performance, but only after consulting a doctor. – You must remember that potency drugs can cause a sudden drop in blood pressure, which can sometimes have dramatic consequences. That is why you should not buy them online and take them without consulting a doctor – advises prof. Gaciong. Dr. Kłosiewicz-Wąsek warns against taking drugs that increase sexual performance together with nitroglycerin, because it may result in serious complications and even death. Doctors emphasize that thanks to pharmacology, even patients with cardiovascular diseases can achieve full satisfaction from sexual contacts. However, you should consult your doctor before taking such supportive medications. A prescription for such drugs can even be issued by a family doctor, but he must know what we are treating and what other drugs we are taking.
Prevention of atherosclerosis
If we want to avoid problems in bed caused by atherosclerosis, we must prevent its development from an early age. Hypertension, smoking and high cholesterol are the main risk factors. Adequate diet and exercise will prevent excess weight. – A walk is not enough – emphasizes prof. Gaciong. Three times a week, for at least 45 minutes, you should engage in moderate physical activity such as running, swimming, cycling or playing tennis. A low-cholesterol diet is primarily a diet rich in vegetables and fruits. You need to limit the consumption of pork, butter and high-fat dairy products. It is advisable to eat fish and poultry. Professor Gaciong reminds you of regular preventive examinations. Measuring your blood pressure at least once a year and testing your cholesterol and blood sugar levels at least every three years. If someone in the immediate family has died of a heart attack or stroke, or is being treated for atherosclerosis, we need to be examined more often.
Text: Halina Pilonis
The material was created in cooperation with the Allenort Cardiology Center in Warsaw