Intimacy and Heart Failure: The Relationship Conundrum

Intimacy is about creating a genuine connection. It can be intellectual, physical, emotional, and spiritual. Managing intimate relationships is a common problem for heart failure patients. This is especially true for those involving physical and emotional intimacy. Physical intimacy is usually affected by physical changes. Some physical changes caused by heart failure are unavoidable. They can worsen as the disease worsens. Emotional changes also happen. These changes can cause the disease or be caused by the diagnosis. Understanding both is key to reclaiming intimacy in relationships.last

Unwanted side effects of necessary medications

Physical changes caused by heart failure are treated first with medications. The goal is to improve heart function. Unfortunately, some medications cause other changes leading to sexual problems in both men and women. Two medications used to make a person’s heart better are digoxin and spironolactone. Unfortunately, both cause sexual problems.¹

Diuretics and beta-blockers are other medicines given to heart failure patients but for different reasons. Diuretics, such as Lasix, keep fluid down and prevent swelling. Beta-blockers, such as metoprolol and carvedilol, lower blood pressure. Both diuretics and beta-blockers can also cause sexual problems. These changes can lead to problems with physical intimacy. Furthermore, some medications and physical issues lead to mental health issues. These cause problems with not only physical intimacy but also mental or emotional intimacy.²

It’s not you, it’s M.E. (Mental and Emotional)

A strong relationship exists between mental health and heart disease. If a person is depressed, certain medications, biochemical changes, and lifestyle choices (e.g., smoking or drinking to cope) can lead to heart disease. Heart disease can also cause depression or anxiety. No matter which happens first, depression or anxiety can cause or make sexual problems worse. This causes physical intimacy problems.^1,3-4

Depression can also cause a person to isolate themselves. They may not even realize it. The physical issues added to isolation can make it even harder to have emotional intimacy. Emotional intimacy is special by itself. It allows a person to share their feelings and fears about mental illness with trusted friends, family members, and partners. Therefore, the presence of mental health or emotional health issues in heart failure patients can make it hard to form new or maintain existing close relationships. There is a delicate balance when trying to manage intimacy and relationships.

There is still hope

There’s more than one way to be intimate, just like there is more than one way to have a relationship. Find ways to get closer to each other intellectually or spiritually. Be creative and try new ways to stimulate each other physically or emotionally. Thinking “outside of the box” may be the key.

Regardless of your approach, talk with your healthcare provider about your intimacy issues. Alternative medicines for both heart failure and mental health issues, as well as treatment methods for mental health conditions, are available. It may even be helpful to have your partner or loved ones join you. This may bring you closer and improve their understanding of what you are facing. Intimacy and relationships are possible for heart failure patients.^2,3

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