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While heart attack survivors may be wary about hopping back in the saddle too soon after recovery, new research out of Israel suggests that getting back into your regular sex routine may actually help boost survival.

A team of researchers analyzed data of 500 sexually active people aged 65 and under who were hospitalized for a heart attack in 1992 or 1993. The patient population had a median age of 53 and about 90% were male. About 43% of patients died during the following 22 years, according to the data, but those who maintained or increased sexual activity during the first six months of recovery were found to have a 35% lower risk of death compared to those who abstained.

Additionally, they found an apparent association between sexual activity and a reduction in non-cardiovascular mortality such as cancer.

“Sexuality and sexual activity are the markers of well-being,” Yariv Gerber, lead researcher and head of the School of Public Health at Tel Aviv University, said, in a press release. “Resumption of sexual activity soon after a heart attack may be a part of one’s self-perception as a healthy, functioning, young and energetic person. This may lead to a healthier lifestyle generally.”

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The authors note that sexual activity is a form of physical exercise and has been shown to increase heart rate and blood pressure, which to some may sound like a potential trigger for heart attack. However, regular physical activity reduces the long-term risk of adverse heart-related outcomes.

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“Improved physical fitness, stronger spouse relations, and a mental ability to ‘bounce back’ from the initial shock of the event within a few months are among the possible explanations for the survival benefit observed among the maintained/increased group,” Gerber said in the press release. “On the other hand, patients who perceive their health as poor might be less likely to start having sex again. They may also be less likely to adhere to cancer screening tests and other prevention practices during follow-up. This may explain the strong inverse association between [the] resumption of sexual activity and cancer mortality that was seen in our study.”

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The study, which was published last week in the European Journal of Preventive Cardiology, doesn’t prove that sex after a heart attack improves long-term survival, but shows an apparent association, the authors noted, while also acknowledge that the data did not properly represent women or older people.

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However, Gerber said the findings should reduce anxiety surrounding sexual activity and heart attack recovery.

“Numerous physical and psychosocial health parameters are required for maintaining regular sexual activity,” Gerber said. “In light of this, the net benefit of sexual activity itself is still a matter of debate.”

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