Generally speaking, adults with heart conditions can engage in sexual activity. Young adults with congenital heart disease should ideally get information about having sex well before they consider becoming sexually active. Sex should always be agreed by both people, and be something you feel ready for. In the UK, the age of consent is 16 years old.
You may be concerned that sexual arousal may be a risk to your heart. These issues need to be discussed with a health professional in order to facilitate healthy physical and emotional relationships. It is important to be aware that some heart drugs can cause decreased sexual desire or impotence. To find out more, you should speak to your clinical nurse specialist. There is no need to be embarrassed asking your healthcare team about sex, they are used to talking about it, and everything you tell a doctor or nurse is confidential. You can also (and are often encouraged to) go into transition clinics on your own, without a parent present.
Arrangements should also be made for birth control; it is very important to find out whether pregnancy poses a risk to you.
Birth control is especially important for women with congenital heart conditions as it is best to try and avoid an unplanned pregnancy. All contraceptives are free of charge on the NHS in the UK. Oral contraceptives (combined oestrogen and progesterone) are generally fine for some women with congenital heart disease but are not appropriate for those with cyanotic congenital heart disease, complex disease or pulmonary hypertension. Specialist contraceptive advice can usually be obtained from your GP or from your cardiology consultant. It is important that the doctor giving advice is familiar with your heart problem.
It is important to remember that not all types of contraception protect you against HIV and other sexually transmitted infections (STIs).
What do I do if my contraception doesn’t work?
If you’ve either forgotten to use contraception, or the contraceptive method used has failed (if a condom splits) then you can buy the emergency contraceptive pill if you’re over 16 for £26, or get it free from your GP or local family planning clinic. It is important to check with your nurse specialist as soon as possible about whether the emergency contraceptive pill is safe for you to take – the emergency contraceptive pill is more effective the sooner after sex it is taken. It is worth noting that emergency contraception doesn’t always work, and it also doesn’t protect you from HIV or STIs.
Women with a heart condition should try to plan their pregnancies and speak to their cardiologist or nurse specialist first. You may need tests to see how your heart would cope with pregnancy and may need some adjustments to your medications that would otherwise harm an unborn baby. There’s an increased risk of a baby having a congenital heart condition if one or both of the parents do, but it’s more likely that the baby won’t have any heart problems at all. Your nurse specialist will be able to discuss the risks with you.