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Cardiologist’s Tips for Safe Sex with Heart Disease

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Very few people would argue that a good session in the sheets is helpful for the mind, body, and soul. But what about the heart? For those living with heart disease, engaging in physical activity, even as personal and cherished as sexual activity, can cause anxiety.

While often overlooked in the healthcare discourse, the subject of safe sex with heart disease is essential and deserving of a frank conversation. For most individuals grappling with heart disease, engaging in sexual activity isn’t merely safe but often advantageous. That being said, adhering to some key precautions can truly fortify the safety net around one’s intimate experiences.

What happens to the heart during sex?

Sex can be both an emotional experience and a physical journey, an intertwined dance that affects every corner of the body, including the heart and cardiovascular system. When sexual foreplay and arousal begin, the body is stirred into action. As a result, heart rate and blood pressure typically climb, hitting their peak when orgasm is reached. After which, they quickly retreat to their normal levels.

During sex, blood flow in the body changes dynamically. Fueling the intimate act, the blood supply revs up, targeting not only the sexual organs but also select areas of the brain. However, contrary to what one might expect, the heart does not get left high and dry. As it turns out, its thirst for oxygen and nutrients rises, pushing a surge of blood flow to meet its increased demands.

Think about sex as an exercise. It’s quite comparable to taking on moderate physical activities – say, a vigorous walk around the block or hustling up a couple of flights of stairs. The energy expended often matches 3-4 metabolic equivalents (METs), a standard measure of workout intensity.

Some people, especially as they age or those grappling with medical or emotional hurdles, might find achieving orgasm a bit more challenging. Such scenarios can put extra pressure on the cardiovascular system, possibly causing the heart rate and blood pressure to maintain a higher mark for extended periods. For this reason it’s important to listen to the body and understand its limits.

Cardiac risks and benefits of sex

A significant number of heart disease patients harbor fears of suffering a heart attack amidst their intimate moments. However, it’s important to realize that the stakes of encountering a heart attack inch slightly higher during any form of physical exertion, whether it be a casual walk, a challenging hike, or even a relaxed round of golf. In most cases, sex presents the same risk as most of life’s activities.

A 2022 study published in JAMA revealed that sexual activity was associated with a remarkably low percentage of sudden cardiac death cases. In fact, out of 6,848 SCD cases reviewed, only 0.2 percent (or 2 in 1,000 patients) occurred during or within an hour after sexual intercourse. The findings suggest that while individuals with heart disease must understand potential risks, the likelihood of experiencing a cardiac event during sexual activity remains relatively low.

Several studies that point to the benefits of sex on the heart. Sex is a natural vasodilator, opening the arteries and allowing more efficient blood flow throughout the body. Moreover, the act of making love triggers the release of the “love hormone” oxytocin, among others known for their stress-busting effects. And if you’re thinking long-term, lovemaking offers even more health benefits – it has the potential to lower your blood pressure, give your immune system a leg up, and even contribute to better quality sleep.

What if I have trouble in the bedroom?

Cardiovascular disease changes the way that blood flows through the body. Take the penis, for example, home to some of the body’s tiniest blood vessels. For many heart disease patients, their love life can stumble due to restricted blood flow to the genital region, manifesting as erectile dysfunction or issues with sexual arousal.

Believe it or not, erectile dysfunction often sets off alarm bells indicating the onset of heart disease. Atherosclerosis – the medical term for artery narrowing – doesn’t play favorites; it affects every blood highway in your body. More often than not, a stumbling sex life could be your body’s SOS signal about a lurking disease.

Pharmaceuticals like Viagra (sildenafil), Cialis (tadalafil), or Levitra (vardenafil) are often prescribed as solutions to erectile dysfunction (ED). These medicines work by amplifying the blood flow to the penis, thereby bolstering erections. Yet, as is true with most drugs, there are considerable risks tied to their use, especially when combined with other cardiovascular medications. A particularly perilous blend with nitrates or beta-blockers could plunge blood pressure dangerously low, or in the most dire of scenarios, even prove fatal.

The good news is that the same holistic approaches to treat heart disease also treat sexual dysfunction. The root problem of both health conditions is inflammation.

Cardiologist’s top seven tips for safe sex with heart disease

1. Reduce inflammation in the body

Chronic inflammation is the root cause of heart disease and sexual dysfunction. As a result, the best tip for safe sex with heart disease is to reduce inflammation in the body. Inflammation-lowering strategies include:

2. Collaborate with your doctor 

Sadly, many of us were conditioned to avoid the topic of sex. However, your doctor should be one of your best allies when it comes to health, including sexual intimacy. Always seek clearance for physical activity from your doctor and thoroughly discuss your specific concerns. 

Be sure to touch upon any medications you may be taking, discussing possible interactions and their impact on sex. For example, many heart disease drugs, such as beta-blockers, list sexual dysfunction as a side effect. Remember, your goal should be to reduce and eliminate pharmaceuticals. If your doctor does not support that goal, seek a second opinion.

3. Take it slow

Take sexual intercourse slowly, warming up and cooling down just as you would with exercise. Enjoy the process instead of aiming for the result. Avoid sudden and strenuous activities in the bedroom.

4. Listen to your body

Your body is an excellent communicator, but you must tune in. Listen to your body during sex. If you experience any abnormal symptoms, slow down. Chest pain, dizziness, shortness of breath are all immediately stop signals.

5. Communicate with your partner

Anxiety and stress in the bedroom can severely impair sexual arousal. Anxiety increases sympathetic tone, which shunts blood away from the genital area. Poor blood flow to the sexual organs often results in poor erections in men or a reduction in lubrication for women. Talking openly to your partner about your fears may help to relieve stress, resulting in a more fulfilling sex life.

6. Explore the best timing for sex

Many times, sexual intercourse happens at the end of a long day. However, there are many advantages to morning sex. First, sleep is essential for lowering inflammation and restoring the body. Most people have more energy in the morning, which may help with stamina during sex, especially as we age.

Moreover, studies show that testosterone levels peak in the morning hours between 7:00 and 10:00 am. This spike in testosterone can actually help lower blood pressure over time.

7. Consider evidence-based supplements

Many of the same nutritional deficiencies that cause heart disease also contribute to sexual problems. For example, studies show that adding omega-3 fatty acid supplements to the diet improves sexual performance by increasing blood flow to the pelvis, reducing the risk of small blood clots in the pelvic area, and improving inflammation.

Other excellent supplements that provide a one-two punch for both cardiac and sexual health include B-complex, L-arginine, and vitamin D. Additionally, the supplements in our Hypertension Complete Support Protocol also achieve the same goal.

Next Steps

For most people, sex enhances emotional well-being and supports cardiovascular health. Both a robust heart and an active sex life hinge on the common factor of managing inflammation. This underlying cause of many health issues can impact our hearts and sexual health. Addressing inflammation can promote both heart health and a satisfying sex life.

If you’re looking for more guidance or have questions about your heart health or sex life, we’re here to help. Schedule a free 20-minute health consultation with an NHD health coach today. We’re ready to support you on your journey towards better health.


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About Dr. James Kneller, M.D., Ph.D., FHRS

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Dr. James Kneller is one of the nation’s leading heart rhythm specialists. Dr. Kneller is certified by the American Board of Internal Medicine (ABIM) in Clinical Cardiac Electrophysiology, Cardiovascular Disease, and Internal Medicine.

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Beyond guideline-directed therapies, Kneller is passionate about optimized personal health. With a deep interest in complimentary alternative medicine (CAM), he strives to reduce the need for pharmaceuticals, invasive procedures, and exposure to harmful radiation. With Natural Heart Doctor, he strives to help each and every client to Live Well, Eat Well, and Think Well to attain their 100-year heart!

About Dr. Lauren Lattanza NMD, FACC

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I dedicated the next 4 years to the Southwest College of Naturopathic Medicine in Tempe, Arizona where I attained my Doctorate of Naturopathic Medicine. I served as Class President all 4 years, Board of Trustees – Student Trustee, spoke as the Club President for our branch of Toastmasters, and was voted by my peers and attending physicians to earn the Outstanding Leadership Award for the Class of 2020. Throughout medical school I took it upon myself to work alongside MDs, DOs, chiropractors, and functional medicine practitioners in addition to naturopathic physicians.

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About Dr. Jack Wolfson DO, FACC

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Dr. Jack Wolfson is a board-certified cardiologist, Amazon best-selling author, husband, father, and the nation’s #1 Natural Heart Doctor.

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Our chiropractor is an expert at adjustments and holistic chiropractic care and works closely in conjunction with the other health care experts at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

IV Therapy

We use specially formulated natural vitamins and minerals that are injected into a vein to prevent or treat dehydration. Ideal for people in Arizona.

Call (480) 535-6844 for details and scheduling.


Stimulate your body’s natural healing abilities and promote physical and emotional well-being with acupuncture at Natural Heart Doctor.

Call (480) 535-6844 for details and scheduling.

Health Coaching

Our health coaches use evidence based skillful conversation, clinical interventions, and strategies to engage you actively and safely in health behavior changes.

Call (480) 535-6844 for details and scheduling.

Cardio Tests

We use the most advanced testing in the world to assess heart health and to identify the root cause of your health issues.

Call (480) 535-6844 for details and scheduling.

Office Visits

Schedule an office visit with one of our cardiologists, holistic physicians, chiropractor, or health coaches.

Call (480) 535-6844 for details and scheduling.

Frequently Asked Questions

I’d like to receive an online second opinion from Natural Heart Doctor. What do I do next?

You can initiate a second opinion online through our website at any time. To begin, select the team member you’d like to speak with and open an account.

Click here for cardiologist Dr. Jack Wolfson.

Naturopathic Medical Doctor Dr. Lauren Lattanza. Get details.

Naturopathic Medical Doctor Dr. Tonia Rainier. Get details.

Click here for  Natural Heart Doctor Health Coach.

Alternatively, you can email A member of our care team will help guide you through the process of starting a second opinion.

What is the cost of a Natural Heart Doctor Online Second Opinion?

The cost for most second opinions varies by team member. This fee includes information collection, a phone or video consultation, a second opinion from a Natural Heart Doctor specialist and guidance throughout the process from your personal Care Team at Natural Heart Doctor.

Cardiologist Dr. Jack Wolfson’s Second Opinion Fee is $1500.

Holistic Physician’s Dr. Lauren Lattanza’s Second Opinion Fee is $250.

Naturopathic Physician Dr. Tonia Rainier’s Second Opinion Fee is $250.

Note: We apply the Online Second Opinion Call fee as a credit to any future consultations with Natural Heart Doctor, should you choose them.

Will my insurance cover the cost of a Natural Heart Doctor Online Second Opinion?

Most likely, no. Most health plans do not cover online second opinions or consultations. You are responsible for the cost of our second opinion. Natural Heart Doctor cannot file a claim with your insurance carrier, nor can we provide a procedure (CPT) code for this service.

What is the timeline to receive an online second opinion?

We do our best to schedule your second opinion as quickly as possible. Typically, it takes 5 to 7 business days after your information has been collected to receive your phone or video online second opinion.

What information do you need in advance of our call?

Our office will send you a short questionnaire to complete and return. We DO NOT need your complete medical records.

How many questions can I ask the expert during our call?

You may ask a maximum of five questions. This is to ensure that the expert has sufficient time to devote to each question. All questions must be finalized before your online meeting.

What should I expect to receive once my second opinion is complete?

You will receive a summary of our discussion along with our second opinion. The second opinion will be in written form. After you have reviewed the second opinion, a Natural Heart Doctor clinician will follow up with you by phone to address general medical questions about the information provided in the second opinion.

What if I have follow-up questions for the expert after I have reviewed my second opinion?

If you have a clarifying question about an expert’s response to one of the questions in your second opinion, and the Natural Heart Doctor clinician is unable to address it, then you may request a follow up session for an additional fee. 

Is my medical and payment information secure?

Natural Heart Doctor is strongly committed to protecting the privacy and security of all our patients. Our website meets all federal requirements for protecting personal health information under the Health Insurance Portability and Accountability Act (HIPAA). All financial transactions are processed by Natural Heart Doctor securely using industry standard payment processing tools.

I would rather visit Natural Heart Doctor for an in-person appointment. What should I do next?

If you would prefer an in-person appointment at Natural Heart Doctor instead of an online second opinion, please call (480) 535-6844 for details and scheduling.

Can I schedule a follow up appointment with the specialist who provided my online second opinion?

Yes, we’re happy to help you on an extended basis. Our clinician can discuss options with you when presenting our second opinion summary.