Sixty five patients were interviewed on an average of 42 months after a myocardial infarction. Using a semi structured interview, they were systematically questioned on their usual sexual activity just before their infarction and at the time of follow up. All were married men with a mean age of 54.4 years and had resumed a normal active life. Forty six (70%) reported a decrease in frequency of sexual intercourse (mean 6.9 times/month before infarction and 0.8 times/month at time of interview, p less than 0.01). The majority had difficulty in discussing sex with their doctors because of impaired doctor-patient communication, cultural factors and lack of privacy. Discussion concerning sex should be initiated as soon as the patient is stable and pertinent advice is the key to better sexual adjustment after myocardial infarction.