Sexuality after Stroke

Survivors of stroke experience changes and difficulties in many areas of their spousal and family relationships. Within their role of husband or wife, stroke survivors described a lack of control and dramatic changes in their perception of self.

Sexuality and sexual intercourse is one of the areas that changes after stroke, but it is rarely discussed in rehabilitation.  Poststroke, spousal relationships can be significantly different in terms of sexuality, sexual desire and sexual functioning. Changes in sexual relationships can have a significant impact on survivors’ quality of life particularly in the longer term.

While physical issues like hemiplegia or aphasia and relationship changes are clearly issues in post stroke sexuality, there are many other issues.  Stroke survivors and care partners identified many factors that may be helpful if addressed:

1. difficulty in patients and providers talking about sexual matters,
2. little to no discussion of poststroke sexuality, 
3. need for tailoring education to an individual or couple's unique needs, 
4. provider rapport and competence, and 
5. timing of poststroke sexual education.

Recommendations for practice: Health care professionals and service providers need to understand and recognise the subjective experience of stroke and the complex difficulties that stroke survivors experience within their spousal relationships.

What can stroke survivors and their spouses do?

• Ask your health professional about resources available to help you.
• Seek information: read a pamphlet or a book. 
• Talk to your spouse.

References:

• Thompson, H.S., Ryan, A., (2009). The impact of stroke consequences on spousal relationships from the perspective of the person with stroke. Journal of Clinical Nursing, 18, 1803–1811
• Schmitz MA, Finkelstein M, (2010). Perspectives on poststroke sexual issues and rehabilitation needs. Topics In Stroke Rehabilitation, 17 (3), 204-13
• Kautz DD, (2007). Hope for love: practical advice for intimacy and sex after stroke. Rehabilitation Nursing 32 (3), 95-103;
• Research From Turkey, Tamam Y, Tamam L, Akil E, Yasan A, Tamam B, (2008) Post-stroke sexual functioning in first stroke patients. By European Journal Of Neurology: 15 (7), pp. 660-6

Resources Books:

• The Ultimate Guide to Sex and Disability: For All of Us Who Live with Disabilities, Chronic Pain, and Illness by Miriam Kaufman, Cory Silverberg, Fran Odette

Miriam Kaufman is the author of Easy for You to Say: Q&A's for Teens Living with Chronic Illness or Disability. Cory Silverberg is a founder of Come As You Are, an education-based sex store for people with disabilites. He is the sexuality editor of About.com and has conducted workshops on sex and disability across North America. Fran Odette is a disability activist who speaks on women's health, body image, sexual health, and disability.

US Resources:

• National Stroke Association  
• Resources and Education for Stroke Caregivers
• About.com Sexuality After Stroke Jose Vega M.D., Ph.D.     

UK Resources: 

• Sex after stroke illness  
• The Stroke Org   
• Sex after Stroke Pamphlet

Asia Resources:

• Asia One.com There can be life... and sex after stroke By Dr Lim Poh Hin