How Are Sex and Relationships Impacted by Heart Failure?

Reviewed by: HU Medical Review Board | Last reviewed: November 2019

You may wonder if sex is safe to have if you or your loved one has heart failure (HF). If you have experienced shortness of breath or feel winded with physical activity you may have concerns that sex could endanger your heart.1 Many people have concerns about changes in desire and fear associated with their ability to have sexual intercourse.1-3 In fact, reports indicate that more than 60% of people with heart failure have said they have sexual problems.1 Having heart failure can bring about a range of feelings including anxiety, frustration, or depression. You and your family may all experience similar concerns.4 Over time these feelings may lessen, but readjusting can be difficult.4-5

Living with heart failure will change your life. It also changes the lives of those who love you. Relationships are both physical and emotional; they are critical to our quality of life which is important to good heart health.2,4 Staying connected, including intimacy, is an important component of most relationships. Communication is a key element in addressing any concerns you may have.

Talk to your healthcare team

When you talk to your healthcare team about managing your heart failure and lifestyle changes that may be recommended, be sure to address any concerns you have about intimacy.1-2 Try not to feel embarrassed. They can help you by answering questions and help you set realistic expectations about your recovery and your sexual activity.2

Exercise in a safe way

Engaging in sexual intercourse is equivalent to engaging in moderate exercise.1 It could be considered equivalent to climbing 1-2 flights of stairs or walking half a mile at a brisk pace.2 For most people with heart failure having sex is a safe activity. Your doctor will let you know if you have any restrictions. These are most likely to occur if you have had recent surgery or are in end-stage heart failure.1

Engage in intimacy when you are relaxed and comfortable, and not under pressure.6 Touching and kissing should be safe activities in which to engage.1 Try a position that may be less strenuous and remember that it is okay to take a break.3

Sexual dysfunction

Talk with your partner about any concerns you may have. Whether you are nervous or have performance anxiety, it is important to be open. Explaining how you feel can help your partner be a part of the solution. To get started there are different ways for couples to show affection. Honesty, care, love, and support can get most people through this phase.2 After your symptoms are under control, most people are able to resume all normal relations.3

Medications and emotions may interfere with arousal and performance. Sometimes medications can be adjusted to help with any sexual dysfunction.2-3,5 Impotence and other physical problems like difficulty with ejaculation or the inability to orgasm or climax are also associated with heart failure.3


It is best to avoid sex after a big meal or too much alcohol. Also, it's better to avoid extreme heat or cold.3 As with other activities, you shouldn’t engage in sexual relations if you don’t feel well, experience increased shortness of breath, or have chest pains.3 Better to stop and then to call your healthcare team.

Coping with change can affect how you interact with others.7 Keep an open line of communication, talk about how you feel and your needs. It will help you and your partner through what can feel like a difficult time.

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