There is something hypnotic about the legacy of rock stars who died prematurely of suspicious circumstances. Kurt Cobain or Jim Morrison, for example, are celebrities who are alleged to have perished following substance abuse. Their legacy in the music scene left them iconic status following their demise. Kurt Cobain, the legendary lead singer of Nirvana, reportedly had difficulties coping with fame. Cobain and his obsession with Courtney Love made the circumstances of his death at the age of 27 the topic of public fascination and speculation. Another lead singer of The Doors, Jim Morrison, is worshiped as a singer-songwriter. The exact cause of his death in Paris at the age of 27 is still fiercely disputed. “Sex is full of lies. The body tries to tell the truth. But, it’s usually too battered with rules to be heard, and bound with pretenses so it can hardly move. We cripple ourselves with lies.” On that famous quote by Morrison, we dissect the truth and lies about the danger of sex for a loving wife. Dear Dr G, I am 36 and recently married to a man 20 years my senior. My husband was a widower for many years after his wife died of breast cancer. We met at work and he really the love of my life. My husband and I have been together for more than two years, and we enjoy each other’s company. Although we have been intimate on many occasions, however, this is usually foreplay. In truth, I am scared. I understand there is a possibility of sudden death that may be associated with sex in men of senior years. Can you please tell me whether sex is safe for couples in our situation? Is the big age gap between us a real risk for my husband? What is the risk of my husband dying during sex? Are there any precautions we can take to reduce the risk? Please advice. Yours truly, A loving wife. It is a myth that sex is dangerous. In fact, sex should be considered as an extension of normal exercise. During sexual intercourse, the heart rate may increase to 120-130 beats per minute. This is in response to the excitement, arousal and exertion. The blood pressure also elevates responsively to 150-180mmHg. Such transient surge in cardiac stress is normal in duration of sexual effort, lasting between 5 and10 minutes (if you are lucky!). In most men, even in men with stable cardiac disease, such stress will not induce serious adversity. The level of exertion can be assessed by METs. The METs exertion of a normal intercourse with a regular partner is 2-3 METs; and effort is increased to 5-6 METs in vigorous sexual act, again with a regular sexual partner. Clearly, the vigorousness of such act is dependent on individuals and open to interpretation (I leave it to your imagination). Interestingly, the METs value for a round of golf is 4-5 and heavy housework, such as scrubbing the floor, has a higher METs rating of up to 6. I guess if a man can play a round of golf comfortably, he is safe for sexual intimacy. If a man has no interests in the game with ball and club, it is reasonable to assess his sexual fitness by making him scrub the floor. Of course, if in doubt, the formal assessment by a cardiologist is more definitive. As a rule of thumb, for individuals with three or more major risk factors such as smoking, dyslipidemia, diabetes and hypertension, the risk of cardiac adversity will also increase. Undoubtedly, the fatality contributed by sex does exist. Sudden deaths related to sex contributed to about 0.18-0.6% in several studies. Surprisingly, the biggest risk factor of sexual fatality is having sexual activities outside a relationship. In 1962, a study from Japan analysed more than 5,000 men in forensic autopsies unearthed 34 deaths which were due to sexual intercourse. Eighty-two percent of the casualties were men and 75% were related to extramarital relationships. In recent years (1998), similar data were released from Germany outlining nearly 27,000 forensic deaths. Forty-eight (75%) such demises were related to mostly men (94%) having “extra-curricular” activities outside a regular relationship. Marilyn Monroe, another famous icon who died in her youth, once said: “Sex is a part of nature. I go along with nature.” I guess Dr G’s advice is to go along with nature, as long as one keeps it at home! Leave a Reply Cancel ReplyYour email address will not be published.CommentName* Email* Website Save my name, email, and website in this browser for the next time I comment.