What Your Sex Life Says About Your Heart Health

When something’s “off” in your sex life, heart disease probably isn’t the first thing that comes to mind. But what’s going on in the bedroom could be a sign that something’s not right with your heart — and we don’t mean romantically.

For women, changes in arousal, painful sex, or even feeling unusually fatigued might actually be early signs of cardiovascular disease (CVD). Heart disease is the leading cause of death in women in the U.S., and over 44% of American women (that's more than 60 million) are living with some form of heart disease, according to the Centers for Disease Control and Prevention (CDC). And yet, only about half of U.S. women recognize that heart disease is their number one killer. Recognizing the early, less obvious signs (including those that show up in the bedroom) can lead to earlier diagnosis, better outcomes, and even save lives.

So if things have shifted in your sex life and you can’t quite put your finger on why, it might be time to listen to your heart, literally.

The link between heart health and your sex life

Sexual function is complex. It’s influenced by hormones, mental health, relationship dynamics, and physical health, among other things. But what often gets overlooked is the role your cardiovascular system plays.

For sexual arousal and satisfaction to occur, blood flow to the genitals is essential. The clitoris, vagina, and surrounding tissues rely on a healthy vascular system to become engorged and responsive. If that blood flow is compromised due to clogged arteries, high blood pressure, or stiffening vessels, your body simply won’t respond in the same way.

The link between cardiovascular health and female sexual dysfunction (FSD) is well-documented. A systematic review and meta-analysis published in the European Journal of Preventive Cardiology found that women with cardiovascular disease have a 51% greater risk of developing FSD than those without CVD. 

Meanwhile, a study in The Journal of Sexual Medicine showed that common heart-related risk factors — like hypertension, diabetes, high cholesterol, and metabolic syndrome — can impair endothelial function (the lining of your blood vessels), which plays a critical role in sexual arousal.

Another study, also in The Journal of Sexual Medicine, found that lower sexual function in postmenopausal women was associated with increased arterial stiffness, which is a marker of deteriorating heart health.

So, if your sexual function changes and you don’t have a clear explanation like menopause or a medication side effect, it may be your heart waving a little red flag.

Signs of a heart problem in the bedroom

Here are some sexual symptoms that may have cardiovascular roots:

• Difficulty becoming aroused, even with adequate stimulation

• Vaginal dryness or discomfort during sex, especially if it’s new

• Pain during intercourse due to decreased lubrication

• Unusual fatigue or shortness of breath during or after sex. 

Alone, none of these mean you have heart disease, but together, especially if they come with other signs (like fatigue, dizziness, or high blood pressure), they should spark a deeper conversation with your doctor.

Beyond the bedroom: Other subtle signs of heart disease in women

Women’s heart symptoms often don’t look like the dramatic chest-clutching we see in movies. They tend to be more subtle and often misinterpreted. Some lesser-known symptoms to look out for include:

• Persistent fatigue (especially if it worsens with activity)

• Shortness of breath even when lying down or during mild exertion

• Nausea, lightheadedness, or cold sweats

• Discomfort in the neck, jaw, back, or shoulders

• A feeling of pressure, tightness, or fullness in the chest rather than sharp pain. 

Women’s heart symptoms are often misdiagnosed or dismissed entirely. While men’s heart issues tend to show up as chest pain, women’s signs can be more subtle, things like back or jaw pain, nausea, fatigue, or breathlessness. And unfortunately, due to a long-standing gender health gap in research and clinical practice, many women’s concerns still don’t get taken as seriously as they should (including heart health). Data shows that middle-aged women experiencing heart disease symptoms are twice as likely to be diagnosed with mental health issues compared to men with the same symptoms. 

This can lead to delays in diagnosis, and sometimes, no diagnosis at all until it’s too late. Women are more than twice as likely to die after a heart attack than men. That’s why it’s so important to trust your instincts and advocate for your health. If something feels off, even if it’s “just” a change in your sex drive, don’t ignore it.

Advocating for yourself in the doctor’s office

If you suspect something’s off, here’s how to make sure your concerns are heard:

• Come prepared: Write down your symptoms, even if they seem minor or unrelated. 

• Be specific: Describe when symptoms occur, how often, and what makes them better or worse. 

• Don’t downplay things: Women are socialized to minimize their pain and discomfort. Be honest and don’t feel embarrassed about talking about your sex life with your healthcare provider. 

• Ask for testing: If heart issues are a concern, ask about getting your blood pressure, cholesterol, EKG, or a stress test. If your doctor refuses any test, ask them to make a note in your file stating that they’ve done so. 

• Get a second opinion: If you feel dismissed, find another provider. 

What you can do to look after your heart (and sex life)

The good news? A lot of the same things that are good for your heart are also great for your sex life. Here’s how to keep both strong:

• Get moving: Regular physical activity boosts circulation which helps with blood flow to your clitoris and vagina, lowers blood pressure, and improves energy and mood. 

• Eat a heart-healthy diet: Think Mediterranean: fruits, veggies, whole grains, fish, nuts, and healthy fats.

• Prioritize sleep: Sleep is essential for hormone balance, a healthy libido, stress regulation, and heart health.

• Manage stress: Chronic stress can increase blood pressure and kill your libido. Try mindfulness, yoga, therapy, or journaling.

• Quit smoking: Smoking damages blood vessels and impairs circulation, including to sexual organs.

• Take your meds: If you’ve been prescribed medication for blood pressure, cholesterol, or diabetes, stay on top of it.

What about heart health and erectile dysfunction?  

Let’s not forget your partner. Erectile dysfunction (ED) is present in over half of men with a history of CVD, and it’s often one of the first outward signs of cardiovascular disease in men, sometimes appearing up to five years before a heart attack.

If your partner is struggling with ED, especially if he has other risk factors like high blood pressure or diabetes, it’s not just a bedroom issue. It could be a heart issue, and it’s time for a check-up.

Our bodies are smarter than we give them credit for, and often, they send warning signs we choose to ignore. The bedroom can be one of the first places you notice that something just isn’t right.

So, if yours or your partner’s sexual function has changed, and it doesn’t feel like “just getting older,” don’t chalk it up to stress or hormones without checking in on your heart. After all, a healthy heart isn’t just about living longer, it’s about living to the fullest. And that includes a satisfying, joyful, and vibrant sex life.

FAQ

Can changes in sexual performance be an early sign of heart disease?

Yes, changes in sexual performance can be an early sign of heart disease. For women, issues like difficulty getting aroused, reduced desire, or pain during sex can sometimes be linked to poor blood flow and vascular problems, both of which are central to cardiovascular health. These changes may occur before more classic heart symptoms appear, making them important early warning signs.

Can fatigue during sex indicate a heart problem? 

Fatigue during sex can also point to a potential heart problem, especially if it’s new or gets worse over time. Sexual activity is a form of physical exertion, and if the heart is struggling to keep up due to narrowed arteries or other cardiovascular issues, it can cause unusual tiredness or breathlessness during sex. This is often overlooked or mistaken for general tiredness, but it's a symptom worth discussing with a doctor.

How can erectile dysfunction (ED) be a sign of heart disease?

Erectile dysfunction is one of the most well-known sexual signs of possible heart disease in men. Because the blood vessels in the penis are smaller than those in the heart, they’re often the first to show signs of reduced blood flow. If a man develops ED, particularly without any clear psychological cause, it can signal underlying heart problems, and often appears several years before more serious cardiac events like a heart attack.