By Dennis Thompson, HealthDay Reporter

THURSDAY, Dec. 6, 2018 (HealthDay News) -- Heart patients taking part in cardiac rehabilitation could receive a spicy side effect from the program -- a boost in their sex life.

Attending cardiac rehab is associated with improved sexual function and more frequent sex, according to a new evidence review.

The program likely helps by increasing the patient's physical fitness, said lead researcher Celina Boothby, of the University of Calgary, in Canada.

"There is a relationship between sexual health and physical health. If you're more able to be physically active, you're more able to be sexually active," said Boothby, a research assistant in the department of community health sciences.

However, the researchers did not find any strong link between cardiac rehab and sexual satisfaction.

Cardiac rehabilitation is a medically supervised program designed to improve the heart health of people who've had a heart attack or heart failure, or have undergone angioplasty or heart surgery, according to the American Heart Association.

Rehab involves exercise counseling and training to improve fitness, education on heart-healthy living, and counseling to reduce stress.

For this review, Boothby and her colleagues pored through medical literature and found 14 studies that evaluated cardiac rehab's potential effect on a person's sex life.

Of six studies pertaining specifically to sexual function, three showed improvement after cardiac rehab and two showed mixed results, the researchers found. Only one showed worsened function following rehab.

Study results also showed that people tend to have sex more often after attending cardiac rehabilitation, compared with those who don't take part in the program.

Most of the research focused on men, Boothby said. But it could be expected that women would benefit similarly from cardiac rehabilitation.

"There is just a lack of research being conducted on females right now for this whole topic," Boothby said.

There are three ways heart disease can impact sexuality, the researchers explained.

For one, physical limitations -- like fatigue, shortness of breath, chest pain, erectile dysfunction and vaginal dryness -- are common among people recovering from a heart problem.

In addition, blood pressure drugs have been associated with sexual dysfunction in men and decreased sexual response in women.

Finally, feelings of anxiety, fear and depression are common in heart disease patients, increasing apprehension around sex.

These problems can become a "vicious circle that is hard to break," said Dr. Claudio Gil Soares de Araujo, director of research and education for the Exercise Medicine Clinic (CLINIMEX) in Rio de Janeiro, Brazil.

"Regularly attending a cardiac rehabilitation program that will help to lose body fat, to gain muscles, to become more flexible, and to improve balance and the capacity to tolerate higher exercise intensity for longer periods of time is perhaps one of the best ways to help the sexual life of a man or woman with heart disease," said Araujo, who wrote an editorial accompanying the study.

The positive benefits appear to stem largely from the exercise portion of cardiac rehab. There was no clear association between sexual activity and rehab programs that included psychological counseling, the findings showed.

Sex is on the minds of many people with heart problems, Boothby said, and their concerns aren't likely to be addressed while they're in the hospital or preparing to leave for home.

"Sometimes discharge is very hectic. Patients are often getting a lot of information about their medications and physical activity, and then they're discharged," she said. "That's not necessarily the best place to receive that information."

Previous research has shown that couples are very open to receiving sexual activity support within a cardiac rehabilitation program, Boothby added.

However, more study needs to be done on sex during recovery, she suggested, as there are still gaps in knowledge.

"Sexual activity is very important to overall quality of life, and heart patients are living longer with cardiovascular disease than they ever were before," Boothby said. "It's important to be addressing the non-clinical aspects of heart disease just as much as the clinical aspects."

The new evidence review was published Dec. 6 in the Canadian Journal of Cardiology.

SOURCES: Celina Boothby, MSc, research assistant, department of community health sciences, University of Calgary, Canada; Claudio Gil Soares de Araujo, M.D., Ph.D., director, research and education, Exercise Medicine Clinic-CLINIMEX, Rio de Janeiro, Brazil; Dec. 6, 2018, Canadian Journal of Cardiology
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Here are some questions and conversations from MyHeartDiseaseTeam:

• "I have congestive heart failure. My injection fraction went from 31% to 40% doing cardiac rehab."

• "I had a defibrillator fitted back end of October, takes some time getting used to having this thing in me. I start cardio rehab in 2 wks, just gotta take things slowly, complete life change for now."

• "Have now completed 12 weeks of cardiac rehab two sessions of 1 hour each session and I am feeling very good. Will be going to the gym now to keep up with the fitness."

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