Returning to Sexual Activity After Heart Bypass Surgery.

Introduction

Return to sexual activity, or continuation of a satisfactory sex life, after heart bypass surgery, also termed coronary artery bypass graft (CABG) surgery, comprises a challenge for the patient and their partner. People experience sexual problems due to insufficient knowledge about the time to return to sex after surgery or psychogenic stress related to heart conditions. This article presents all the aspects of resuming sexual activity after CABG.

What Are the Factors to Consider Concerning Sexual Functions after CABG Surgery?

• Postoperative healing is one of the most salient aspects to consider after a major surgical procedure like a heart bypass surgery.

• Sternal (ribcage) bones require some time to heal after surgery. They are cut open for good access to the heart. Protecting these bones is a long-standing part of post-operative recovery. Without precautions, the sternum may separate during healing.

• Standard guidelines suggest avoiding pushing and pulling out of the chair, out of bed, up the steps, and avoiding lifting and reaching above elbow level or behind the back for at least 6 to 8 and sometimes up to 12 weeks. Even after six to eight weeks of precautions, the collarbone cage and muscles around the affected area may still be sensitive to pressure on sudden movement, and lingering chest pain may be present.

• Fatigue and low energy level are common scenarios after CABG surgery.

What Are the Precautions to Take Before Resuming Sexual Activity After CABG Surgery?

• After surgery, it is important to wait for the breast bone to heal before resuming any physical activity, including sex. This healing of broken bones usually takes six to eight weeks; in some patients, it may take 12 weeks. It is best to consult with a cardiologist about when to resume sexual activity.

• Also, consider the sexual position that does not put pressure on the chest because chest bones are cut open during CABG surgery to gain access to the heart for the surgery.

What Are the Factors Affecting Sexual Functions After CABG Surgery?

1. Hormonal Changes: CABGsurgery can affect serum levels of sex hormones, especially estradiol and testosterone. Studies have noted that post-operative concentration of testosterone in the blood is lower than pre-operative levels. In such cases of hormonal discrepancies, hormonal therapy can help to improve sexual functions.

2. Psychological Well-Being: Most sexual dysfunction in patients after healed bypass surgery is attributed to psychological factors. Anxiety and depression are frequent after stressful surgery like heart bypass surgery. This may give rise to diminished sexual drive and arousal.

• In addition, many people suffer from sexual dysfunction due to their fear of having sex, and thinking sex may trigger heart problem symptoms such as pain or damage to the surgical site. The patient also feared the negative impact of sexual activity on post-operative recovery.

3. Medications: Some evidence suggests that cardiac medications, including lipid-lowering medications and beta blockers, have sexual side effects. But more recent studies concluded that it is not common to have a sexual problem due to cardiovascular medications.

What Are the Common Sexual Dysfunctions After CABG Surgery?

• Lack of sex drive.

• Vaginal dryness.

• Erectile dysfunction.

• A decline in sexual satisfaction.

• Premature ejaculation.

• Impotence.

What Is the Role of Sexual Counseling After CABG Surgery?

• The American Society of cardiology, the Europian society of cardiology, and the American heart association recommend counseling about sexual functions after cardiac disease.

• The aim of sexual counseling in patients who have undergone CABG surgery is to evaluate existing sexual problems, which provides information on the concern and facilitates a safe return to sexual activity. Sexual counseling interventions mostly address specific interpersonal and psychological aspects, sexual performance difficulties, and medication-related issues that may negatively affect sexual functioning.

• Sexual counseling by a health professional may involve one-to-one sessions or a group of cardiac patients. Counseling may involve providing information orally, visual information through projectors, written information, audiovisual materials, and practical training. Sexual counseling interventions may involve CABG patients alone or with their partners. Depending on the circumstances, it can be single or multiple visits.

Is Any Test Needed Before Resuming Sex in CABG Surgery Patients?

American heart association has authorized guidelines that sexual activity can be safely resumed six to eight weeks after surgery if the sternum is fully healed. However healing period for each patient is different. Moreover, how your heart has recovered is also as important. Some patients may still suffer from decreased Heart function despite surgery, and others may still have cardiac blockages after a week. The cardiologist may require you to perform a stress test before clearing the person for sex and other exercises. Suppose a person still has shortness of breath while walking and are experiencing chest pain with exertion similar to the pre-operating period. In that case, the person should hold on to sexual encounters until the cardiologist evaluates the heart condition properly.

When should a person see the doctor?

• A person should consult the healthcare provider in any case of post-operative complications such as fever, infection of the operative site, or persistent symptoms related to the heart.

• If a person encounters any sex-related dysfunction, it is best to consult a cardiologist to rule out any heart-related problems such as shortness of breath or fatigue. Careful evaluation of heart functions is a must.

• After gaining full heart fitness, diminished sexual functions can be discussed and resolved by sexual therapy and professional counseling.

Conclusion

Successful return to sexual activity is a part of the recovery process after surgery and can result in improved quality of life and satisfaction. Declined sexual activity and functions are very common in patients with CABG surgery. They are often related to anxiety and depression after a full-stress encounter during surgery. Most patients might be unable to resume their normal sexual activity after open heart surgery, such as CABG surgery. However, sexual counseling is still not adequately addressed. Participation in the rehabilitation program is important for resuming sexual activities after surgery.