Ask Your Doctor if You Are Healthy Enough for Sex

Ask him how he knows.

Recently, I was watching a commercial about a product for erectile dysfunction. After a long list of possible side-effects, including blindness and deafness, the announcer suggested that before proceeding further, the man should make sure he was well enough to have sex by asking his physician. Speaking as a physician, I want to say that no patient has ever asked me if he was healthy enough to have sex. It’s true, I’m a psychiatrist and am less likely than a cardiologist to have such a conversation, but I am the sort of psychiatrist who gets asked all sorts of questions about sex. “Is it against the law to have sex tied up?” for instance. Or “Is oral sex dangerous to a pregnant woman?” And yet, despite some, at least, of these patients having a perhaps unfounded admiration for my knowledge of all things, I have never been asked such a question.  I would think that if a patient thought that he might be too sick to have sex, he would have decided that on his own. I have seen many husbands who have given up sex long ago, but no one ever mentioned concerns about sudden death as the explanation. Come to think of it, I have known men who got splitting headaches at the moment of orgasm and still never considered abstinence. It never occurred to me to volunteer advice to such men about the pluses and minuses of sex, health-wise. Besides, how am I to know?

I read somewhere that having sex takes about as much physical effort as climbing out of bed in the morning. This is a good example of why physicians do not put much credence in everything they read. I am not witness, of course, to how my patients engage in sex, but judging from what I see in the movies, sex is a much more energetic business. With some, I imagine, sex might be as exhausting as shoveling snow, which is a well-known risk factor for a heart attack, (although most heart attacks occur when someone is asleep. You might as well ask if your heart is well enough to risk going to sleep.) This athletic sort of sex is called acrobatic sex. I was once asked by someone subject to fits of dizziness, if I thought he could safely perform as a gymnast, but I am sure he was not contemplating having sex simultaneously. Anyway, I have been thinking of general advice I can give if someone does, indeed, ask me such a question:

  1. If, during sex, you have sudden pains in your chest, as if a vise was crushing you, and you can’t breathe, stop.
  2. If you are not strong enough to turn over in bed, probably you should not undertake sexual intercourse, because you may get carried away and turn over inadvertently.
  3. If you find yourself falling off the bed and onto the floor every time you have sex, you should not keep trying, at least not with that partner.
  4. If you have had a near death experience (floating out of body), stop having sex since sex is preeminently an in-body experience.

Of course, I could always say that I don’t know. Psychiatrists need not presume to have an answer to every question. Especially tough questions about sex. Patients will think well of me anyway. What is important is that I seem to know the answer, even if I choose not to reply. It is enough to smile knowingly and offer up some platitude, such as “moderation in all things,” or “tomorrow is another day.” The astute patient will fill in the gaps.  (c) Fredric Neuman Author of “The Wicked  Son.”