Sexual activity with an established partner is no more stressful to the heart than ironing, polishing or gardening according to new guidelines from the British Society of Sexual Medicine.

The guidelines on erectile dysfunction (ED) contain a section on the safety of sexual activity and therapies for ED in patients with CHD. They suggest that all patients in a 'low risk' group of cardiovascular disease (eg controlled hypertension, mild angina or post successful revascularisation) can have their ED safely managed in primary care.

Sexual activity with an established partner is compared with other common daily activities in terms of metabolic equivalents of the task (METs) - sexual activity is equivalent to light housework (2-4 METs), light gardening (3-5 METs) or walking a mile in approximately 20 minutes on level ground (3-4 METs).

Therefore, most men with CHD can be reassured that their risk of developing cardiac symptoms during sex is roughly equivalent to performing other daily activities.

However, the guidelines caution that 'avoidance of vigorous sexual activity, particularly with an unfamiliar partner, may be advisable in some men'.

Hackett G, Kell P, Ralph D et al. British Society for Sexual Medicine Guidelines on the Management of Erectile Dysfunction. J Sex Med 2008;5:1841-65