( CNN ) -- Having a heart attack is often a wake-up call for people to change their lives , whether that means quitting smoking , eating healthier or simply focusing on doing the things they enjoy . But surviving a heart attack can trigger anxiety , too : What if it happens again ? And while many men and women may worry that their heart will give out during a vigorous exercise session , an even bigger concern seems to be sex . To address this fear , the American Heart Association recently released its first-ever guidelines for helping health care providers advise patients about resuming a healthy sex life following a heart attack , stroke , heart transplant or other cardiovascular procedure . It may sound pretty standard , but the truth is that , until now , patients have received little to no counseling about this important issue . In fact , a study last year of 1,900 heart attack patients suggests that just one-third of women and less than half of men received instructions about resuming sexual activity after they left the hospital -- and were 44 % more likely to report that they still had n't had sex a year later . Another recent study found that very few female heart attack patients are given advice from their physicians about resuming sex . The new AHA guidelines are aimed at educating health care professionals about the importance of discussing sex with their cardiovascular patients , but they also offer insight for patients themselves . `` These are important recommendations that acknowledge the hesitancy of couples to resume their sexual activity , even though the actual risk of worsening with sexual activity is extremely low , '' says my colleague Dr. Madeleine Castellanos . Does your relationship need a 'love drug ' ? Here are some highlights from the guidelines : . Sex is n't as risky as you fear . It 's natural to be concerned about being sexually active after a heart attack or other cardiovascular problem . But it 's unlikely that sex will trigger another attack in most people . According to the AHA , if you do n't experience cardiac symptoms ( such as chest pain , shortness of breath , and dizziness ) during exercise , you probably wo n't experience them in bed . It 's helpful to think of sex the way you might think of other activities that require exertion , such as walking up stairs , exercising , or returning to a generally active lifestyle . If your doctor does n't offer , ask for an exercise `` stress '' test : If you can walk on a treadmill at a pace of about 3 to 4 miles per hour , you should be fine , says the AHA . Your sex life may change -- and that 's OK. As I mentioned earlier , many people take a cardiac event as an opportunity to make some changes to their lifestyle . While you certainly may be able to return to the same sex life you had before , you may want to reassess things between the sheets . The AHA recommends considering positions that are comfortable -- the partner on top during intercourse usually exerts more energy , for example . If you 're not ready to return to sex completely , do n't miss out on other forms of physical intimacy , such as hugging , kissing , cuddling , and touching each other . Masturbation can be a healthy way of easing back into things , too . When your child walks in during sex . Women are not small men . Research suggests that rates of erectile dysfunction among men with cardiovascular disease are twice as high as those without the condition . But women may experience their own sexual challenges , both before and after a heart attack . `` I appreciate that the AHA was careful to point out that women 's sexuality can often get marginalized , and that their sexual complaints regarding lubrication and excitation should be seen as a serious indicator of possible cardiovascular disease , just as it is in men with ED , '' says Castellanos . Communication is key . The major takeaway message from the AHA guidelines is that doctors and patients must put aside any embarrassment and talk about sex openly . `` I hope that all health professionals will recognize the importance of sexual counseling and appreciate the importance that it has for people 's quality of life , '' says Castellanos . Unfortunately , not all doctors and nurses may feel comfortable broaching the subject , so you may have to raise it yourself . Just think of your sexuality as part of your overall health , and be sure to ask all of your questions , from when can you have sex again , to how to deal with fears and anxieties . It may not be easy at first , but talking with your doctor -- and your partner -- about your concerns can go a long way to helping you get back in the swing of things . Do 's and dont 's for summertime sex .
Studies show many doctors do n't talk to heart attack patients about their sex life . Comment: It 's unlikely sex will trigger another attack , the AHA guidelines say .