Best Sex Positions for Mutual Comfort and Safety
The most appropriate sex position for mutual comfort and safety is the one that individuals find comfortable and familiar, with those experiencing cardiovascular conditions being advised to assume their usual position or one of comfort to minimize cardiovascular strain. 1
Cardiovascular Considerations for Sexual Positioning
- The energy expenditure during sexual activity varies by position, with the person on top in the missionary position typically exerting more energy than the person on the bottom 1
- Self-stimulation or partner stimulation generally requires the least amount of energy expenditure, making these options potentially safer for those with cardiovascular concerns 1
- Real-world studies found no significant changes in heart rate and blood pressure when different positions were used during intercourse, suggesting position may be less important than comfort 1
- Blood pressure and heart rate tend to increase when a person uses an unfamiliar sexual position, highlighting the importance of sticking with comfortable, familiar positions 1
Recommendations for Special Populations
- For individuals with cardiovascular disease, stroke, or chronic illness, positions that minimize strain on affected body parts are recommended 1
- People with paraparesis, chronic lung disease, heart disease, or arthritis may benefit from adapted positions that accommodate physical limitations 1
- After coronary artery bypass graft (CABG) surgery, avoiding the superior (missionary) position is recommended to reduce strain on the healing sternum 1
- For individuals with implantable cardioverter-defibrillators (ICDs), specific positioning considerations may be necessary to avoid pressure on the device 1
Energy Expenditure Considerations
- Sexual activity is generally safe for individuals who can achieve 3-5 metabolic equivalents of task (METs) without experiencing cardiac symptoms 1
- The cardiovascular and metabolic response to sex is more closely related to arousal than to physical exertion in most cases 1
- Maximal heart rate and blood pressure changes typically occur during orgasm regardless of position 1
Communication and Adaptation
- Physical impairments may require couples to experiment with new positions, activities, and ways of touching to ensure mutual pleasure and comfort 1
- Clear, direct communication between partners about comfort, pleasure, and limitations is essential, particularly when one partner has physical or communication challenges 1
- Partners may need to be very direct with sexual communication and give specific directions to focus on mutual pleasure 1
Safety Considerations
- For individuals with cardiovascular disease, sexual activity in familiar settings with established partners is associated with lower risk than sexual activity in unfamiliar settings or with new partners 1
- Studies have shown that deaths during sexual activity are rare but more common during extramarital relations, likely due to increased stress and unfamiliar environments 1
- The risk of cardiovascular events during sexual activity is generally very low, with the increase in risk from sexual activity being less than that associated with anger or unaccustomed physical exercise 1
In conclusion, the best sex position for mutual comfort and safety is highly individualized and should be based on physical capabilities, comfort level, and any existing health conditions. For most people, familiar positions that allow for comfortable movement and communication between partners will provide the optimal balance of pleasure and safety.