There is a great deal of pleasurable sexual activity that is not sexual intercourse. Being near someone, holding, fondling, caressing, are all activities that enhance closeness and pleasure. Since these activities require very little energy, you may engage in these anytime after discharge from the hospital. Many couples find that this expression of love allows them to return slowly to a full sex life with confidence.
Sexual intercourse requires slightly more energy, therefore a waiting time of 1-3 weeks is generally recommended. Another consideration will be position. As the sternum has been cut, a modification may be necessary in order to prevent injury to the sternum or incisional pain. Exercise will strengthen the heart and overall physical condition. So as you engage in the home walking program and witness firsthand increased endurance and confidence, you will know when you are ready. The energy expenditure for intercourse is the equivalent of walking briskly or climb two flights of stairs. The heart rate rarely rises above 120 beats/minute and blood pressure elevations are similarly mild and transient.
The person recovering after open heart surgery may be more conscious of his or her heartbeat, breathing, and muscle tension. This awareness is normal and is no cause for alarm.
Fear of performance and general depression are two psychological factors that can greatly reduce sexual interest and capacity. These are considered normal during convalescence and in most cases disappear within 3 months. If depression continues after 3-6 months, professional counseling should be considered.
Various medications may affect sexual drive and/or function. If this occurs, consult your physician. Often a change in medication or dosage can remedy the problem. Never stop taking any prescribed medication without your physician’s approval.
There are several ways to prepare for the resumption of sexual activity. The first step is to exercise as mentioned above.
The second step is to be tolerant of each others emotions. For a brief time following open heart surgery, emotions are delicately balanced and subject to rapid mood swings. Try to keep day to day events in perspective and remember that a good sense of humor is a good ally.
The third step is to try to adjust mutual sexual expectations. Emotional response as well as physical responses sometimes make the resumption of sexual relations fearful and that is normal. Therefore don’t expect too much at first.
Some general guidelines:
Be relaxed and rested before intercourse. Avoid sex if you are fatigued or upset.
Choose a position that does not restrict breathing or require prolonged muscular support.
Maintain a comfortable room temperature and familiar surroundings and partner.
Speak with your physician if you are experiencing any chest pain, angina, shortness of breath, rapid heart rate, or extreme fatigue in relation to sexual activity.
Wait at least 1 hour after a meal or alcoholic beverages before having sexual activity.
Open communication is important between partners.