An astonishing 40 percent of recovering heart surgery patients never have sex again for fear they’ll have another heart attack, according to Boston Scientific’s Lifebeat patient interface. This pervasive and often unrealistic fear prevents many heart patients from enjoying physical connection with their partner that is so needed in a healthy relationship.

Many people who have recently experienced a heart attack don’t know how to approach sexual intimacy and don’t know whether it’s safe. While there should be a buffer time, typically a recommended 1 to 4 weeks depending on the heart attack’s severity, most patients who have had a heart attack can still have sex.

Limited risk

As with other health issues, sometimes our paranoia gets the best of us. Many heart attack patients have heard horror stories or seen fabricated movie scenes where people experience a heart attack during sex. Cardiologist James Beckerman, MD, dispels this myth, “Fewer than one percent of heart attacks come from having sex.”

Everyday Health supports this statistic by claiming only 30 out of a million heart attack survivors who are getting back into shape will have a heart attack during sex. The risk is small because the exertion is usually short and without intense physical demands.

In fact, most sexual encounters are comparable to a brisk walk with regard to physical exertion. “Many patients don’t think twice about climbing stairs, yet many worry that sexual activity will cause another heart attack or even sudden death,” said Dr. Glen Levine, professor of medicine at Baylor College of Medicine in Houston.

Sex is good for you

Not only can sex be a healthy form of physical exertion, it can also reduce stress, create a reconnection with your partner, and soothe the partner who experienced the traumatic heart attack. It can also help prepare the body for increased physical exertion such as running, swimming, or other forms of cardiovascular exercise.

A new healthy lifestyle is imperative to life after a heart attack, and healthy relationships and a healthy sex life are a part of that. Sexual intimacy provides a meaningful way to work through the emotional and mental healing process. “Sexual health is a barometer for overall health,” Dr. Beckerman comments.

The obstacles you have to overcome

There are symptoms that have to be overcome to experience a rewarding sex life, however. Heart events can lead to less satisfactory sexual experiences due to emotional and physiological problems. Patients may have feelings of depression and shock, which undermine a sexual appetite.

A reduced amount of blood sent to the sex organs can lead to erectile dysfunction in men and arousal problems in women. This is often due to the side effects of heart medication, but stopping heart medication is not the answer. Ask your doctor if a different dosage or switching to a different drug may relieve the problem.

“A healthy heart is the first prerequisite for an enjoyable sex life,” says Dr. Joanne Foody, director of cardiovascular wellness services at Harvard-affiliated Brigham and Women’s Hospital. While a good sex life is essential, allow you and your partner to take it slow. Be patient if it’s not pleasurable or fun at first. Remember that your heart health is important as you continue to recover.

Symptoms to watch for

Even though there is a minuscule risk of having a heart attack during sexual activity, there are symptoms to be wary of. If you feel chest pain, abnormal shortness of breath, nausea, dizziness, heart palpitations, or an uneven pulse while engaging in sexual activity, then you should postpone intimacy and consult your doctor.

Treat sex like you would other physical exercise. “In general, if a person can do moderate exercise without chest pain or other symptoms, they are good to go with sexual activity, with the caveat being to listen to your body,” says Sari Eckler Cooper, AASECT Certified Sex Therapist.

Consult with your doctor

Just as it is important to maintain open communication with your partner, the same goes for your doctor. Consult with your doctor after your heart attack and before sexual intimacy has resumed. He/she will take into account the seriousness of the event and the speed of your recovery when giving you advice. Talking about sex is not taboo. Combat potential awkwardness with directness and sincerity.

If you experience heart symptoms during sexual intimacy, don’t hesitate to consult your doctor, especially if you’re taking erectile dysfunction medication.