By D r. Willie Ong

Q. I’ve been taking metoprolol (a heart medicine) for 12 years now. Lately, I am not as “strong” in bed as I once was. Is it the medicine I’m taking?

A: It could be, but I doubt it. You have been taking your medicine for 12 years already and have done well with it so we shouldn’t blame it for what you’re experiencing now. However, it is true that some medicines like the beta-blockers can affect the sex drive. These are the drugs whose generic names end in the syllable “–olol” kind of like metoprolol and atenolol.

I would advice you to see a doctor before stopping these medicines since they are excellent drugs for the heart. I believe this is just a psychological thing.

Erectile dysfunction or impotence could also be due to uncontrolled diabetes, older age, too much alcohol or from smoking. Patients should not be ashamed to ask their doctor. It’s part of their job to care for your sex life!

Q. Why are my male friends having heart attacks?

A: To the guys, I have some bad news, we’re more prone to heart disease than the ladies. Based on statistics, men also die earlier than women. Our life expectancy is on the average 5 years shorter than females.

The reasons are two-fold: genetics and lifestyle. It has long been known that being a male is a risk factor for heart disease. This is especially true if one or both of your parents have heart disease. Some experts attribute this difference to behavioral and cultural factors. Men are expected to work more and thus have to handle more stress and pressure. They are also responsible for earning for the whole family. Young men are being groomed by society to be “macho” and to hide their emotions.

Moreover, more guys smoke, drink alcohol and abuse drugs. Men also have greater fear of doctors than women, thus they see a doctor when it’s too late already. So, to wives and kids, please persuade your dad to have a check-up. Health is the best gift you can give them.

Q. Why is it that my heart beats very fast when I get excited or nervous? What’s the first aid in this situation?

A. During times of emotional stress, the body releases a certain hormone called epinephrine. This hormone is a built-in mechanism of the body to fight off danger. You have heard of somebody able to lift a sofa all by himself during a fire. Well, that’s epinephrine. It brings out the superman in man. The heartbeat can go as high as 150 beats per minute during stress.

Aside from emergencies, more common situations like getting angry, giving a speech, or worrying a lot, also releases this hormone. A little stress is alright, but too much stress will put undue strain on your heart and cause it to fail.

For very anxious people, I sometimes prescribe a sedative (Bromazepam 1.5 mg half a tablet only), which is very effective in relieving temporary stress. You can take it if you need it but just don’t take it too often. Better yet, try to breath deeply and think of a peaceful place to soothe your mind.

Q. My doctor says I have heart disease. I want to know if I can have sex without the pressure? Will my heart stop if I have an exciting sexual encounter?

A. From the tone of your question, I can surmise that you are not planning to have sex with your wife. Studies show that having sex with your usual partner is safer and would make you spend just a minimal amount of energy. However having sex with an unfamiliar and younger partner would make you spend twice as much energy. The excitement, the unfamiliar territory and the desire to prove your manhood further add to the stress.

For your convenience, I have outlined the following safety measures in such situations: (1) Take your regular heart medicines before sex; (2) Let the healthy partner do the work or be on top; (3) Don’t have sex after a heavy meal. Wait at least 2 hours; (4) Schedule the sex act in the morning, if possible; and (5) Get a clearance from your heart doctor.

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