For the longest time, I was convinced that I would die the way Rose Nylund’s late husband died on The Golden Girls — of heart complications during sex.
I was diagnosed with Postural orthostatic tachycardia syndrome (POTS) when I was 16, a diagnosis that required a tiresome run on the treadmill and the dizzying tilt-table test. POTS means your heart does not get enough blood pumped to it whenever you switch position from standing to sitting and vice versa.
Besides the body’s inability to regulate its own blood pressure, it also causes patients to have hypovolemia or a low volume of blood in the body. Everyone experiences the condition differently, and it can be so severe to the point of preventing mobility. While my POTS isn’t as debilitating, I do struggle with horrible balance, near-constant heart palpitations, dizziness, low exercise tolerance and dehydration despite drinking fluids nearly all day long.
As you can imagine, these symptoms make sex kind of tricky.
I first noticed this about a year before my diagnosis when I was masturbating in my room one afternoon. Since I wasn’t used to or familiar with the ways my body and heart was reacting to the cardio I was doing on my back, I didn’t try pacing myself or managing the symptoms. By the time I was near orgasm, my heart was beating so hard, I found myself gasping for breath and completely afraid I was having a heart attack. I didn’t have time to ruminate much on this though in the moment because I became increasingly dizzy and eventually passed out when I finished.
When I came to, I struggled to get up because of the way my blood doesn’t get to my heart in time when I move positions. In the aftermath, I was too embarrassed to tell anyone because the episode had happened while I was masturbating, which in and of itself was intimate, and I didn’t want anyone to judge the fact that I was so out of shape that I’d pass out from what I thought was exhaustion after sex.
Even though just a year after that incident I started getting the help I needed to manage my POTS, its impact on my sex life was still felt.
For me adjusting has meant staying propped up during sex to decrease the dizziness I experience or if I start out having sex with someone lying flat on my back, then I can’t move from that position for at least an hour. Adjusting has also meant finding ways to actually talk about POTS with my partners.
At first, no matter how much the palpitations worsened during sex, I would ignore them out of fear for my lover judging me. I wanted to feel young and sexy, but my body was making me feel geriatric and fragile.
By the time I started dating my current partner, I started getting serious about taking better care of myself, so I told them about my limitations with sex and how my body has special needs to keep it functioning and happy.
Of course, being the amazing person that they are, they didn’t see any reason not to take my POTS seriously, nor did they seem to feel as though it was taking away from our sexual intimacy in any way.
With their support, I started having safer sex. As we made love, I stayed engaged with them while also staying mindful of how my heart was doing. If the palpitations got to be too much, we’d stop as I let myself catch my breath. I even found a way to breathe through my heart palpitations, a breath I can only describe as deep and matching the rhythm of the palpitation. With this method, I was able to have more sex with less breaks. And like clockwork, whenever we’ve finished, my partner gets me a tall glass of water to gulp down, knowing exactly what I need to recover from this particular exercise. They lay with me too as I slowly adjust to being back in the upright position, and help me walk to the bathroom if I have to pee before my body has finished adjusting.
Despite the harmonious way we go about having sex with a heart condition, it still upsets me that I am not in total control of my body. As it stands now, I’m receiving minimal treatment due to insurance limitations and it scares me. My symptoms can get bad, especially after strenuous sessions of sex, and it triggers my worst fear to take over my mind — me dying of a heart attack in the middle of sex with my fiance. Realistically, this is not going to happen at the age and health that I am now, but the fear itself sometimes keeps me from sex.
My POTS makes me feel feeble, which doesn’t exactly inspire one to feel sexy and turned on.
Trusting the process, I decide to get intimate with them anyway, which does make me feel bold and brave. One of the newer coping mechanisms I have with POTS is to also remind myself that avoiding sex altogether will only makes me feel worse, less confident and in a worse mood overall. So if I really did have a heart attack during sex, it would be worth the risk prioritizing living life to the fullest. I won’t let fear run my life.