Scientific data, doctors’ words and lived realities: diving into a sensitive subject where cardiovascular health intersects with the intimate, without promising miracles but with facts, listening and nuance.
Sexuality and love, discreet but powerful allies for the heart
Sexual intercourse is not a physical feat. According to the World Health Organization, it is a moderate-intensity activity, comparable to climbing two flights of stairs in about ten seconds or walking briskly. An expenditure of energy accessible to the majority of people, to which is added a determining emotional dimension.
On a biological level, the effects are multiple: acceleration of the heart rate, improvement of blood circulation, stimulation of the heart muscle, participation in the elimination of toxins… But sexuality also acts where we least expect it, on immune defenses and mental health.
“By increasing the production of certain antibodies, regular sexual activity also strengthens the immune system and makes the body more resistant to common infections.adds Professor Claire Mounier-Véhier, cardiologist and vascular doctor at Lille University Hospital, co-founder of Agir pour le Cœur des Femmes. It is also beneficial for mental health: the release of different hormones linked to pleasure, endorphins, has a protective effect against stress and improves the quality of sleep..
These benefits are not just about feeling. A recent study shows that people who have less than 12 sexual acts per year have a higher risk of cardiovascular disease and all-cause mortality. As frequency increases, this risk decreases, reaching its lowest level between one and two reports per week.
Love, too, leaves a measurable imprint on health. A meta-analysis of more than 300,000 participants reveals that happy couples have a 20% reduction in mortality risk compared to unhappy couples. “Love reduces cortisol levels and stabilizes blood pressure”comments Thierry Drilhon. “The quality of marital life influences health with an impact comparable to diet or exercise..
Conversely, isolation weighs heavily: single, divorced or widowed people have a 42% increased cardiovascular risk and a 55% increased risk of mortality from stroke. And when the emotional bond breaks, emotional stress acts as an aggravating factor for the heart.
After a heart attack or stroke, fear invades privacy
When a cardiovascular accident occurs, sexuality does not disappear, but it becomes fraught with anxiety. For many patients, the fear of a recurrence acts as a powerful obstacle to any resumption of intimate life. “In patients who have had a traumatic experience of a heart attack or stroke, the fear of recurrence often constitutes a major obstacle to resuming an active sexual life.regrets Professor Claire Mounier-Véhier. “Cardiovascular accident can be a turning point in sexual life with a strong psychological impact..
This fear never stays confined to the bedroom. It infiltrates relationships, self-perception, everyday life. “The fear of recurrence will have harmful consequences on the libido, which can lead, depending on the case, to marital conflicts, a feeling of worthlessness and fragility, excessive mothering of the spouse with overprotection, fatigue, depressive syndrome, isolation, sick leave, etc. It is important to talk to your doctor, who will decide on the real risk and to also broach the subject with your spouse..
The most common fear remains that of cardiac arrest during sexual intercourse. Yet the data is clear. An American study published in 2017 in The Journal of the American College of Cardiology analyzed more than 4,000 cardiac arrests: only 1% of male cardiac arrests occurred during the act or in the following 15 minutes. Among women, this figure drops to 0.1%. Patients suffering from known and managed cardiovascular disease do not present any greater risk than others.
In the majority of situations, regular sexuality therefore remains recommended, including for its protective effect on the heart. Delays may nevertheless be necessary after certain medical events: two weeks after the installation of a pacemaker, several weeks after an acute coronary syndrome or a bypass surgery, the time of rehabilitation. For people with an implantable defibrillator, worry is common.
“This situation occurs very rarely and there is no greater risk of electric shock during sexual activity than during any other physical activity.reassures Professor Claire Mounier-Véhier.
Female sexuality and cardiovascular diseases, the big medical blind spot
Talking about sexuality after a cardiovascular accident remains difficult, but the silence is even heavier for women.
“The subject of sexual activity after a cardiovascular accident unfortunately still remains too taboo: only 12% of women and 19% of men dare to broach it in consultation.deplores Professor Claire Mounier-Véhier. “When the subject is broached, patients mostly receive advice on restrictions of various kinds: limit sexual activity (35%), adopt a more passive attitude (26%), or keep their heart rate at a low value (23%). However, these restrictions are not based on any scientific study..
Female sexual disorders remain largely underdiagnosed, even though they affect 4 out of 10 women of childbearing age and 6 out of 10 women at menopause.
“Female sexual disorders are still poorly understood by health professionals.deplores Professor Claire Mounier-Véhier. “However, they are common and affect 4 out of 10 women of childbearing age, 6 out of 10 women at menopause. They can be of several types: reduction or absence of desire, or even sometimes aversion, disorders of sexual arousal or orgasm, clitoral erectile insufficiency, vaginal pain and dryness..
Hypertension, diabetes, obesity, hypercholesterolemia: these cardiovascular risk factors also alter the vessels involved in the sexual response. Certain treatments may play a role, but the explanation is never limited to medications. “You should never stop your treatment in the face of sexual problems, you must first talk to your doctor”specifies Thierry Drilhon, “and keep in mind that love and hugs are wonderful sources of well-being for the body, mind and heart.”.
Behind the figures and the studies, a message emerges: cardiovascular health is not limited to biological constants. It is also played out in the bond, the desire, the words exchanged. And in this area long left in the shadows, doctors and patients still have a lot to say to each other.