There is no reason a person who has had a heart attack, or been diagnosed with heart disease, cannot work towards resuming a normal sex life. Whilst there is a need for caution, as with any type of exercise, in the initial recovery period, there is no need to fear sex. Often people who have had a cardiac problem, and their partners, may fear that the exertion of intercourse may cause chest pain that leads to another coronary episode. But medical heart attack facts show that this fear is often unfounded.

Sex is considered a mild to moderate form of exercise. If you are at the stage of recovery where you can tolerate this level of exercise, then there is no reason to avoid sex. Sex raises the heart rate to about 120 beats per minute, which is the approximate equivalent of walking up two flights of stairs.

The one thing that should be considered is the effect of stress. For this reason, extra-marital relationships, sex outside of a loving, committed relationship, and paid sexual activities, should be approached with caution, as they are intrinsically more stressful than sex in a stable relationship. Research has shown that sex in a committed relationship, where the couple are comfortable and familiar with each other, is only of minimal risk.

If one or both members of a couple are concerned about the effect of sex on the heart, it is important to talk to each other about the fears they have. Dealing with this beforehand, in an open manner, will not only improve the quality of lovemaking, but help create a safe, stress-free environment during sex, keeping any heart risk to a minimum.

Here are some tips to keep your heart safe during sex:

• Pick a time of day when you are relaxed and free of any stress brought up during the day's regular activities.
• If you are doing meditation or relaxation exercises, try both you and your partner doing them together first.
• Choose a peaceful and familiar setting - and time - where you won't have any interruptions.

Women who have cardiac problems may need to discuss their contraception with their doctor if they were previously using the Pill. There is a link between the pill and arterial disease. In healthy women, this is not so much of a problem, but in women who have a heart condition, the risk may be quite high.

One study found there were increased levels of a protein associated with heart disease in the female participants who took the pill. This particular protein is produced in the liver in response to inflammation. Chronically high levels of this protein have been linked with heart disease, and inflammation is considered to play an important role in the narrowing and hardening of the arteries.