Is intimacy safe after a heart attack?

Q:

I had a stent put in five months ago after a mild heart attack.

I’m fine and am back to my daily walks, but I’m anxious about having sex again, and my doctor didn’t bring it up. Is it safe?

A:

You’re not alone: Two-thirds of women who’ve had a heart attack say they received no guidance on intimacy in their hospital discharge instructions. And another study found that having a doctor explain how and when to resume sex is key to a patient restarting normal relations.

Sex might feel scary, but if you can walk a mile in 20 minutes or climb stairs, it’s safe. Since you’re nervous, take baby steps: Your heart rate stays lower when you’re the partner on the bottom, so start there. Think of sex as exercise that strengthens your heart. It also builds intimacy, which decreases loneliness, depression and anxiety—all of which are linked to coronary risk. As with any activity, if you experience chest pain, shortness of breath or palpitations, stop and check in with your doctor.

Yes! While it’s not common, some women with endometriosis report nosebleeds. As you know, endometriosis is a condition where the lining of the uterus grows outside the uterus. While these patches are most common in the pelvic area, it’s possible for them to implant elsewhere—even in nasal passages. And wherever they land, they respond to your hormone cycle, so these areas also bleed when you have your period.

The most effective treatment is a combination of oral contraceptives and surgery to remove the patches. But since endometriosis usually regresses with menopause, many perimenopausal patients opt to wait it out. If you’d like to take that approach, I advise stopping nosebleeds with Afrin nasal spray and pinching just above the nostrils until the bleeding subsides.

I’m 50 and have endometriosis. Lately I’ve been

experiencing nosebleeds during my period. Are they related?