SEXUAL ACTIVITY, particularly sexual intercourse, is believed to contribute immensely to people’s quality of life. In fact, it is said to be one of the best forms of exercise with a few even singling it out as the most rewarding way to work up a sweat.

However, heart patients are sometimes hesitant when it comes to sexual activity. This is oftentimes due to misconceptions about the perceived dangers of sex.

Researchers at the University of Rio Grande do Sul and Federal University of Rio de Janeiro, in a study published in the Canadian Journal of Cardiology, provide practical recommendations regarding sexual activity in heart patients. Using the acronym KiTOMI — kissing (Ki), touching (T), oral (O), masturbation (M) and vaginal/anal intercourse (I) — the researchers suggest heart patients abide by those sexual behaviours.

“Our extensive literature review enabled us to dismiss several myths regarding the advisability of sexual activity in heart patients,” commented lead author Ricardo Stein of the Cardiology Division of the Federal University of Rio Grande do Sul, Brazil, in a recent news release. “Overall, the risk of death during sex is very low for most clinically stable heart patients, and interestingly, even much lower for the women.”

The release said sexual activity is typically well-tolerated by most clinically stable heart patients, who are typically advised to participate in exercise programmes as part of their recovery plan. Occurrence of sudden cardiac death is very rare, corresponding to less than 2 per cent of all exercise-related deaths, it continued.

the researchers admit that counselling regarding how to gradually resume habitual sexual activity is critical for patients who have experienced a cardiac event or undergone a cardiac procedure.

“Our KiTOMI model will allow health-care professionals to provide very simple and objective advice to their patients,” explained lead investigator Claudio Gil S Araújo of the Heart Institute Edson Saad, Federal University of Rio de Janeiro, and the Exercise Medicine Clinic — CLINIMEX. “In almost every case, some type of sexual activity would be permitted. For patients whose condition is more debilitated, KiT would be the best initial option, progressively advancing to KiTOM until all KiTOMI activities are allowed.”

Co-investigator Aline Sardinha, also of the Federal University of Rio de Janeiro, noted that: “Cardiac anxiety, the fear of cardiac-related stimuli and sensations, which are perceived as negative or dangerous, is common in heart patients and surely interfere with the resumption of a normal and regular sexual life.”

The authors emphasise the importance of sexual counselling to provide reassurance and reliable information for patients and their partners, including the proper use of medications to treat erectile dysfunction.

The recommendations resulting from this study are summarised in a “Decision Tree”, which the release said evaluates the patient’s heart condition according to widely accepted definitions, places the patient in one of three risk groups, and defines the advisable sexual activities for each group.

The researchers also equated various sexual activities with walking at different speeds, in order to put the recommendations into perspective. For example, orgasm is noted to be equivalent to a brisk walk across a street.

“Professional sexual activity advice should be offered similar to advice regarding the return to work and enrolment in an exercise programme,” emphasised Dr Araújo. “KiT activities should be a component of positive sexual behaviour toward a healthier sexual life and should be recommended for virtually all heart patients regardless of sexual orientation.

“Often considered ‘taboo’ an objective discussion of sexual behaviour in heart disease has often been put aside,” he continued. “Health-care providers must break this vicious cycle.”