Resuming sexual activity shortly after MI could improve survival

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Resuming sexual activity shortly after MI could improve survival

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Patients who resumed sexual activity a few months after MI may have an improved long-term survival compared with those who abstained or decreased sexual activity, researchers found.

Yariv Gerber

“We found that maintaining or increasing the frequency of sexual activity within the first months after an MI was associated with better survival,” Yariv Gerber, PhD, professor of epidemiology and head of the School of Public Health at Tel Aviv University, told Healio. “The reduction in risk for mortality was approximately 35%. The benefit was mostly attributable to reduced non-cardiovascular disease mortality.”

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Gerber added that despite use of advanced statistical methods, it is difficult to conclude whether this association is causal. “Indeed, numerous physical and psychosocial health parameters are required for maintaining regular sexual activity. In light of this, the ‘net benefit’ of sexual activity per se is still a matter of debate. We believe that resumption of sexual activity soon after an MI may be a part of one’s self-perception as a healthy, functioning, young and energetic person. This may lead to a healthier lifestyle in a broad sense.”

Young patients with acute MI

In the study published in the European Journal of Preventive Cardiology, Gali Cohen, MSc, PhD student in the department of epidemiology and preventive medicine at Tel Aviv University School of Public Health, and colleagues analyzed data from 495 patients (median age, 53 years) aged 65 years and younger hospitalized for acute MI from 1992 to 1993.

All patients were sexually active before the MI, as reported during an interview within 1 week after the index MI. Patients attended follow-up interviews between 3 and 6 months after MI to report on whether they resumed sexual activity and to what frequency. Patients were then categorized my sexual activity frequency after MI: abstained/decreased (n = 232; mean age, 54 years; 13% women) or maintained/increased (n = 263; mean age, 52 years; 8% women).

Patients were followed up for a median of 22 years for all-cause and cause-specific mortality.

At index MI, 73% of patients reported they were sexually active at least once per week, which decreased to 60% at the follow-up interview. Sexual activity resumed in 88% of patients after MI, of whom 53% maintained or increased frequency from before their MI. The remaining patients (n = 232) either decreased (n = 171) or entirely abstained (n = 61) from sexual activity after MI compared with before MI.

Patients who maintained or increased their frequency were more likely to be slightly younger, had lower depression scores, more likely to perceive their health as good and had higher socioeconomic status compared with those who abstained or decreased frequency.

During follow-up, 43% of patients died after MI. Maintaining or increasing the frequency of sexual activity was inversely linked to all-cause mortality compared with abstaining or reducing frequency (HR = 0.65; 95% CI, 0.48-0.88). This association was stronger for non-CVD mortality (HR = 0.56; 95% CI, 0.36-0.85) than for CVD mortality (HR = 0.9; 95% CI, 0.53-1.51).

“Sexuality and sexual activity are markers of well-being,” Gerber said in an interview. “Resumption of sexual activity after an MI is likely an important part of a wider perception of one’s self and general quality of life. General better perception of oneself may lead to a healthier lifestyle. These data should serve to reduce unnecessary patients’ concerns and support a recommendation to maintain a level of sexual activity soon after MI.”

Studies to assess gender differences

Further research is needed in this area, Gerber told Healio.

“Larger and more contemporary follow-up studies are required that include a larger number of women participants and can thus assess gender differences in the sexual activity-survival association,” he said. “Also, combining other sources of information regarding sexual activity habits (eg, spouse/partner reports) — beyond patients’ self-reports — can reduce misclassification and recall biases.”

For more information:

Yariv Gerber, PhD, can be reached at yarivg@tauex.tau.ac.il.