From the Guidelines
Orgasm can potentially trigger atrial fibrillation (AFib) in some individuals, particularly those with pre-existing heart conditions or risk factors, due to the temporary cardiovascular stress and autonomic nervous system activation during sexual arousal and orgasm. This is supported by the fact that myocardial ischemia can trigger atrial fibrillation, and sexual activity increases heart rate and blood pressure, creating a similar stress on the heart 1. The study published in Cardiovascular Research in 2021 highlights the association between atrial fibrillation and ischemic heart disease, and the potential for myocardial ischemia to trigger atrial fibrillation 1.
Some key points to consider include:
- Sexual activity increases heart rate and blood pressure, which can precipitate AFib episodes in susceptible individuals
- The autonomic nervous system activation during sexual arousal and orgasm causes a surge in catecholamines (stress hormones) that can affect heart rhythm
- Individuals with known heart disease, uncontrolled hypertension, or previous AFib episodes should be aware of this potential trigger
- If symptoms such as palpitations, shortness of breath, dizziness, or chest discomfort occur during or after sexual activity, consultation with a cardiologist is recommended
It is essential for individuals with diagnosed AFib to discuss their condition with their healthcare provider, especially if they notice sexual activity as a trigger, as medication adjustments or taking rate-controlling medications before sexual activity might be beneficial 1. However, for most healthy individuals without cardiac risk factors, the risk of developing AFib solely from sexual activity is low.
From the Research
Atrial Fibrillation and Climax
- There is limited direct evidence on the relationship between climax and atrial fibrillation (AFib) in the provided studies.
- However, studies suggest that sexual activity, which includes climax, is generally safe for most patients with cardiac conditions, including those at risk for arrhythmias like AFib 2.
- The risk of cardiovascular complications during sexual activity is low, and sexual activity is comparable to mild to moderate physical activity 3, 4, 5.
- Certain cardiovascular diseases, such as those associated with arrhythmias, may pose a higher risk for sexually induced arrhythmias and arrest, but this is rare 2.
- Open dialogue and education between healthcare providers and patients are essential to provide reassurance and guidance on safe sexual activity, including climax, for patients with cardiac conditions 2, 5.
Relevant Findings
- A study published in 2022 found that arrhythmias and sudden cardiac death with sexual activity are rare, but the demographics of those at risk are changing, with younger individuals and a higher proportion of female decedents 2.
- Another study from 2018 noted that stress testing can be useful in evaluating the safety of sexual activity in patients with questionable or undetermined risk 3.
- A 2017 study reported that approximately 60% to 87% of patients with heart failure experience sexual problems, but the physical effort related to sexual activity is comparable to mild to moderate physical activity 4.
Key Considerations
- Healthcare providers should approach patients individually and provide counseling on sexual activity, including climax, to address concerns and improve quality of life 3, 4, 5.
- Patients with cardiac conditions should be evaluated on an individual basis to determine their risk for cardiovascular complications during sexual activity 6, 3.
- The use of medications, such as phosphodiesterase inhibitors, can be safe and effective in treating sexual dysfunction in patients with cardiac conditions 3, 5.