CORRECTING SEXUAL PERFORMANCE PROBLEMS: BEHAVIOR

The second major factor to consider in evaluating and communicating about your sex life is behavior. Two questions apply here:
(1) Are you orchestrating your sexual interactions in a way that is cardiovascularly sensible?
(2) Are you being sexually sensible in your lovemaking encounters?
Most heart patients experience some form of cardiac symptomatology at some points during lovemaking. It is also true that most people who suffer from arthritis experience arthritic pain sometimes during lovemaking, that many people who have ulcers sometimes notice a stomachache during sex, and so on. The big difference here is that heart patients and their spouses fear these occasional flare-ups of their health problems. The big fear lurking in the bedrooms of many cardiac couples is that someone might die during sex. Both the heart patient and the spouse typically harbor at least fleeting thoughts of this sort.
Just in case you were not adequately soothed by the facts I reported about the physical safety of sexual exertion, I will now add another fact to your arsenal of coping tools: Death during intercourse from a coital coronary is an extremely rare phenomenon.
An often-cited research study in the cardiac literature found that of the sudden deaths that were recorded in the year of investigation, less than one-tenth of 1 percent involved a heart patient dying from a heart attack experienced during lovemaking. Furthermore—and most important—similar studies have found that approximately 80 percent of the individuals who suffer coital coronaries do so while having sex late in the evening after hours of heavy eating and heavy alcohol consumption, and while having sex with someone other than their spouses. The moral of this research is obvious: Behave yourself! Messing around can kill you.
It should now be obvious that, from a cardiac standpoint, sex is safe. Using common sense is all that is required to behaviorally manage any cardiac concerns about sex. Just treat sex like a very special and enjoyable form of exercise. Make choices about when and how to engage in this form of exercise just as you do with other forms of physical exertion.
After all, you know better than to exercise in excessive heat or cold, or when you are fatigued or bogged down from a recent meal. You probably find exercising easier in the morning after a restful night's sleep than in the late evening after a long and tiring day. When choosing your type of exercise, you probably choose something that suits both your tastes and your physical capabilities. You probably avoid forms of exercise that require you to put your body in painful or excessively stressful positions.
On your doctor's recommendation, you might even take nitroglycerin before exercising, to ward off exertional angina. If you do experience chest pains or atypical shortness of breath during exercising, you probably slow your pace, change activities, or simply stop and rest awhile. After exercising, you probably allow yourself a recovery and resting period. This allows you both to recuperate physically and to enjoy for a moment the good feelings that have come from your body's release of energy. Are these descriptions of sensible rules for exercising referring to walking, swimming, jogging, or sexual intercourse? The answer, of course, is yes. It is important to discover, by experimenting with time and place and by talking openly with each other, what forms of sexual relating in which situations are most comfortable for each of you. By so clarifying, you will be able to relax and enjoy the pleasuring at hand and put out of your bedroom (or whichever room you like) any distracting anxieties about cardiac complications from sexual exertion.
Once your concerns about heart symptoms are put aside, you can then concentrate your efforts on being good lovers for each other. To do so, you must take responsibility for learning and teaching each other about effective lovemaking. You must discover your partner's sexual likes and dislikes and learn to provide the forms of loving stimulation that are especially pleasurable for your partner and acceptable to you. And you must learn what your own sexual pleasures are and take responsibility for teaching your partner to be a good lover for you.
Remember, you greatly increase the odds that your sexual needs will be met if you accurately identify and clearly express these needs in a loving and appropriate manner. Being a good lover does not mean knowing what your partner wants; it means knowing how to find out what your partner wants, and being willing to give generously in this very special way. Let each other know what these special sexual gifts might be.
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