If you have hypertension (high blood pressure) you may fear that sexual activity will increase your blood pressure to dangerously high levels. Unless sex occurs with a new partner in unusual or unfamiliar surroundings or involves a high level of physical activity, it should be tolerated as well as any other kind of moderate physical activity of a non-sexual kind.
See your doctor regularly in order to keep your blood-pressure under control and discuss possible side effects of your medication. Depending on which medicine you are taking, possible side effects include decreased lubrication in women and diminished erections in men. Do not stop taking your medicine if side effects occur. Your doctor may be able to improve the timing, lower your dose and/or combine several medications in order to reduce the side effects you are experiencing.
Women with decreased vaginal lubrication can use water-soluble lubricants (K-Y jelly, Astroglide, etc.), sold over the counter in most pharmacies.
Erectile dysfunction can have psychological and/or physical causes. Sometimes, erectile problems are resolved after the medication has been adjusted. Sexual counseling or sex therapy may be helpful. Various treatment options for physical erectile insufficiency exist.
Remember that erectile dysfunction does not prevent you from being sexually active and giving towards the one you love. This may be a good time to explore alternative ways of being loving and intimate with your partner without having firm erections.
If you feel a reduced interest in sex, remember that you still can have a loving relationship with your partner without sexual activity. There are many ways of expressing your love and fondness without having sex, including cuddling and kissing each other.
If you feel very tired, try to plan intimate time with your partner at times when you are most rested.
Angina (pain) during sexual activity should be judged in the same way as angina during exercise. Coronary dilators can be used before intercourse. Activity should not continue if ischemic symptoms persist. In this case, you should slow down or take a short rest until the pain has resolved completely.
If you have experienced a myocardial infarction (heart attack), you and your spouse may fear that sex will put too much stress on your heart. Research has shown that patients after a MI benefit from enrolling into a cardiovascular rehabilitation program. The low risk of triggering a MI during sexual activity is nearly unchanged whether you have a history of heart disease or not. Regular exercise can even reduce the risk further (Muller et al. 1996).
Use the positions during intercourse that feel most comfortable and relaxing. The stress on your heart differs little whether you are on top, or on bottom. If the male is on top it may require less muscle activity if he is prone on his elbows, rather than extending his arms to support his upper body. A side-by-side position, or use of a low wide chair may be comfortable. Some of these positions are well illustrated in the reference book by Sipski & Alexander.