Sex is involves some physical exertion and in high risk individuals physical exertion can trigger a cardiovascular event. A cardiovascular event is a heart attack or a stroke and is a medical emergency. So just how much exertion does sex involve? The table below will give you an idea as it compares sexual activity to other everyday tasks. But keep in mind that this is based on sexual activity that takes place in a couple in a long term relationship, so if you’re swinging from the chandeliers with a new partner who’s 20 years younger than you are and who’s keeping you going all night then you may be exerting a lot more effort.

All men who are diagnosed with erectile dysfunction (ED) are at increased risk for heart disease. In fact the latest guidelines recommend that when a doctor makes a new diagnosis of ED in a man they should evaluate whether that patient is at risk for a heart attack or stroke from sexual activity before they prescribe an ED treatment. Apart from examining the patient, the doctor may also ask about the patient’s current level of physical activity. Some doctors will also perform an “exercise tolerance test” where they will make the patient exercise whilst monitoring the effects of the exercise on the patient’s heart using an ECG machine. This will enable them to determine whether a patient is at high risk or low risk. High risk patients will need to delay sexual activity until a cardiologist checks them out. Low risk patients will be able to start ED treatment.

The table below describes some of the conditions that would cause a patient to be classified as high risk.

References
Lue T, Giuliano F, Khoury S et al. Clinical Manual of Sexual Medicine Dysfunctions in Men. 2004 Health Publications LTD.
Nehra A, Jackson G, Miner M, et al. The Princeton III Consensus Recommendations for The Management of Erectile Dysfunction and Cardiovascular Disease. Mayo Clin Proc. Aug 2012; 87(8):766-778.