Experts say health providers should broach the subject but routinely don’t, and patients are often reluctant to bring it up. “I think people are really interested in this topic and oftentimes afraid to ask their physicians,” says Dr. James Stein, a cardiologist and director of preventive cardiology at the University of Wisconsin Hospital and Clinics.
“That’s coupled with the fact that there’s … not a lot of high quality research about s*xual function and safety in large part because s*xual activity is very safe in general.”
Stein makes it a point to speak about s*x with inpatients he sees who have been hospitalized due to a heart attack or other issues before they leave the hospital. “I assume it’s on their mind – even if they don’t ask,” he says. “So I just bring it up to make it more comfortable for them.”
He notes that the American Heart Association guidelines say it’s OK to resume having s*x one week after an uncomplicated heart attack. “Uncomplicated means that you’re no longer having symptoms, that you’re not having heart failure or didn’t have electrical problems with your heart” – like the heart stopped or beat too slow or fast, he says.
However, as with more complicated or involved ongoing heart issues – like when the condition isn’t stable or a person experiences chest pain, or angina, with exertion – the best medical advice on how to proceed is typically specific to the patient. There are many shades of gray when it comes to exactly how long to put off s*x for health reasons, experts say, largely because the clinical judgment needs to be tailored to the individual. That’s all the more reason to talk it over with your health provider – even if that information isn’t offered upfront.
“There’s a huge body of research on breast cancer, for example, and gynaecologic cancers that often have pelvic radiation among the treatments, and those studies consistently show that most patients don’t get any information about s*x from their health care providers,” says Debby Herbenick, a professor at Indiana University School of Public Health in Bloomington, and director of the Centre for s*xual Health Promotion in the School of Public Health.
Anecdotally, she’s heard the same type of concerns about s*x not being discussed between providers and patients for all kinds of health matters. “Most of the people that I’ve talked with who have had some type of either major health condition or surgery have not had a conversation with their doctor about s*xuality,” she says.
One exception to this is immediately after childbirth, when women are routinely instructed to avoid having s*x until their postpartum doctor’s visit. Though that visit typically occurs at six weeks, some women are able to resume having s*x earlier, while others aren’t yet ready to do so.
The American College of Obstetricians and Gynaecologists recommends waiting at least two weeks to resume s*x after a vaginal delivery with no complications, says Dr. Jennifer Balash, an OB-GYN at Advocate Good Samaritan Hospital in Downers Grove, Illinois. “However, if a patient has a tear or an episiotomy or a C-section it could be six-plus weeks. It depends,” she says. Some women sustain injuries during childbirth that can make s*x afterward painful, and full recovery takes longer.
By contrast, one instance where many women and their partners abstain from s*x due to concerns about health or safety when it’s generally not necessary is during pregnancy. “A lot of women think they can’t have s*x when they’re pregnant, and unless your doctor tells you so, that’s generally not the case,” Balash says.
Exceptions when a doctor might recommend avoiding s*x include if a woman is at risk for preterm labour – or having the baby prematurely – or has placenta previa, in which the flat round organ that supplies nutrients through the umbilical cord, is abnormally low and near or covering the cervix.
In men and women, clinicians also recommend refraining from s*x when either partner has a newly diagnosed s*xually transmitted infection or s*xually transmitted disease, such as syphilis, gonorrhoea or HIV, until it’s controlled by treatment. Then experts recommend taking precautions, such as using a condom and taking medication to prevent its spread.
But across the board – with very few exceptions – a temporary delay in s*xual activity is meant to be just that, and certainly not an indefinite time-out from bedroom theatrics.
However, for the same health reasons why one might be warranted in initially putting s*x off, like a heart attack, many put the kibosh on a good time for much longer than necessary. Or sometimes embarrassment or awkwardness about something like haemorrhoids may cause a person to shy away from s*x, though that’s not necessary from a health standpoint. For men with a condition called Peyronie’s disease, characterized by curved erections caused by scar tissue in the penis, both awkwardness and discomfort during s*x may lead them to avoid having s*x.
“I have a lot of men who come in with a new diagnosis of Peyronie’s disease, or penile curvature, and either the man or his partner is afraid that continuing to have intercourse while they have the penile curvature may make it worse,” says Dr. J. Patrick Selph, an assistant professor of urology at University of Alabama at Birmingham. “Generally speaking that is not the case. If a man is able to engage in intercourse satisfactorily with their partner, then it’s fine to have s*x.” Still he recommends men with the condition see a urologist who specialises in treating it. Those treated surgically are advised to generally abstain from s*x for four to six weeks; those treated with an injection of medicine should refrain from s*x for two weeks, Selph says.
Similarly, for most people who undergo major surgery, experts say it’s important to get practical and specific in talking with a health provider about how it might affect s*xual activity.
For example, the recommendation to abstain from all s*xual activity immediately following a heart attack aims to avoid taxing the heart; but after joint replacement surgery, a little excitement is fine. It’s the stress on the artificial joint and physical (not cardiovascular) limitations that may cause one to temporarily avoid intercourse or be more careful in choosing s*xual positions.
Herbenick encourages patients to ask health providers to elaborate if they recommend avoiding s*x. “Does that mean no intercourse? Does that mean no masturbation? Because for some [procedures], like a hernia surgery, yeah you might not want your patient masturbating for at least a week or two or longer,” she says. Whereas for some other health conditions, like a hip replacement, it’s probably fine, Herbenick says.
Source –US news
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