A new study has come to some surprising conclusions about the relationship between sex and heart attacks.

The new findings have both good and bad news in that area, so first the good news: people who have more sex before their first heart attack appear to be less likely to suffer a second one, according to a Los Angeles Times report.

Also, sexual activity like masturbation doesn’t seem to have ill effects on the heart in patients with cardiovascular disease and therefore, those who suffer from a heart attack don’t have to avoid sexual activity.

But it’s not good news. Men who take medications to protect from a heart attack to keep from having a second one, such as beta blockers and diuretics, risk developing erectile dysfunction as a result.

All of this can lead to a very confusing situation for men: Is taking these heart attack medications the right thing to do, when it can lead to erectile dysfunction and therefore make it more difficult to do an activity that studies seem to indicate is actually good for the heart? Fortunately, some guidance was offered in a recent review letter that was published this week in the Journal of the American College of Cardiology.

The study, led by researchers at Ulm University in Germany, focused on the sexual patterns of 536 patients who had gone into a rehabilitation pattern after getting a myocardial infarcation. These patients were asked about their sexual habits, and how often they had sex before their heart attack, and whether it happened within a few hours of having the heart attack.

They found that only three had a heart attack less than an hour after sex, which was about 0.7 percent of the 438 that they collected data from. Meanwhile, about 1.5 percent had sex three to five hours before the heart attack, or seven patients.

With such minuscule numbers, it seems unlikely to scientists that sexual activity is a significant trigger for myocardial infarction.

Researchers spent 10 years tracking study participants and whether they suffered another heart attack, although they didn’t collect info on sexual activity, but assumed that those who had been active sexually before their heart attack continued to have sex.

They found that the more sexually active patients seemed to be less likely to get another heart attack, as those who had reported having sex one ore more times per week were half as likely to get a second heart attack in the next 10 years than those who had sex less often.

Why is this the case? It’s possibly because men and women who have more frequent sex tend to be more active in general and therefore more healthy. They also tended to be younger, and less likely to have diabetes or blood-vessel blockage.

So while it may not mean that sex can outright prevent heart attacks, it does mean that sex isn’t likely to be a trigger for heart attacks, and if you’re having sex regularly, you’re probably not the kind of person who will get them nearly as often.

Sex causing heart attacks in the elderly is a common trope in film and television, but it appears to have little evidence to back it up in reality. Researchers don’t believe that sexual activity is that stressful on the heart, and is no more strenuous then climbing two sets of stairs or even taking a brisk walk. Therefore, if you have a weak ticker, don’t worry: if you can handle a walk around the block to the drugstore, you can probably handle a roll in the hay once in a while. And who knows: it may actually be good for your heart.