Sex effects a man's heart on many levels
Fun and intimacy aside, sex ranks as mild to moderate in terms of exercise intensity
Empty bed (Vetta photo, Getty Images / August 2, 2012)
Treadmill vs. mattress
To evaluate the cardiovascular effects of sexual activity, researchers monitored volunteers while they walked on a treadmill in the lab and during private sexual activity at home. In addition to 13 women, the volunteers included 19 men with an average age of 55. About three-quarters of the men were married, and nearly 70 percent had some form of cardiovascular disease; 53 percent were taking beta blockers. Despite their cardiac histories, the men reported exercising about four times a week, and they reported having sexual activity about six times a month on average.
Researchers monitored heart rate and blood pressure during standard treadmill exercise tests and during "usual" sexual activity with a familiar partner at home. All the sex acts concluded with vaginal intercourse and male orgasm.
Disappointedly perhaps, the treadmill proved more strenuous. During sex, the men raised their heart rates only 72 percent as high as they did on the treadmill, and the average blood pressure during sex was just 80 percent as high as during maximal treadmill exercise. On an intensity scale of 1 to 5, with 5 being the highest, men evaluated treadmill exercise as 4.6 and sex as 2.7. Sex was even less strenuous for women in terms of heart rate, blood pressure, and perceived intensity of exertion.
Sex as exercise
Men seem to spend more energy thinking and talking about sex than on the act itself. During sexual intercourse, a man's heart rate rarely gets above 130 beats a minute, and his systolic blood pressure (the higher number, recorded when the heart is pumping blood) nearly always stays less than 170. All in all, average sexual activity ranks as mild to moderate in terms of exercise intensity. As for oxygen consumption, it comes in at about 3.5 METS (metabolic equivalents), which is about the same as doing the fox trot, raking leaves, or playing table tennis. Sex burns about five calories a minute; that's four more than a man uses watching TV, but it's about the same as walking the course to play golf. If a man can walk up two or three flights of stairs without difficulty, he should be in shape for sex.
Sex as sex
Raking leaves may increase a man's oxygen consumption, but it probably won't get his motor running. Sex, of course, is different, and the excitement and stress might well pump out extra adrenaline. Both mental excitement and physical exercise increase adrenaline levels and can trigger heart attacks and arrhythmias, abnormalities of the heart's pumping rhythm. Can sex do the same? In theory, it can. But in practice, it's really very uncommon, at least during conventional sex with a familiar partner.
Careful studies show that fewer than one of every 100 heart attacks is related to sexual activity, and for fatal arrhythmias the rate is just one in 200. Put another way, for a healthy 50-year-old man, the risk of having a heart attack in any given hour is about one in a million; sex doubles the risk, but it's still just two in a million. For men with heart disease, the risk is 10 times higher — but even for them, the chance of suffering a heart attack during sex is just 20 in a million. Those are pretty good odds.
Is sex good for a man's heart? Possibly so, according to a report from the United Kingdom. Researchers evaluated 918 men who were in good general health when the study began. Each man provided information on the frequency of his sexual activity; over the next 10 years, the men who reported three or more orgasms per week enjoyed a 50 percent lower death rate than the men who ejaculated less often, showing that sex may be protective.
How about Viagra?
Until recently, human biology has provided unintentional (and perhaps unwanted) protection for men with heart disease. That's because many of the things that cause heart disease, such as smoking, diabetes, high blood pressure, and abnormal cholesterol levels, also cause erectile dysfunction. The common link is atherosclerosis, which can damage arteries in the penis as well as in the heart.
Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) have changed that. About 70 percent of men with erectile dysfunction (ED) respond to the ED pills well enough to enable sexual intercourse. Sex may be safe for most men with heart disease, but are ED pills a safe way to have sex?
For men with stable coronary artery disease and well-controlled hypertension, the answer is yes — with one very, very important qualification. Men who are taking nitrate medications in any form cannot use ED pills. This restriction covers all preparations of nitroglycerin, including long-acting nitrates; nitroglycerin sprays, patches, and pastes; and amyl nitrate. Other treatments for erectile function — such as the vacuum pump, alprostadil injections, or urethral tablets — are safe for men with heart disease, even if they are using nitrates.
For men, whether they have heart disease or not, the best way to keep sex safe is to stay in shape by avoiding tobacco, exercising regularly, eating a good diet, staying lean, and avoiding too much (or too little) alcohol. Needless to say, men should not initiate sexual activity if they are not feeling well, and men who experience possible cardiac symptoms during sex should stop the sexual activity at once.
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