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Sexuality and Stroke Sexuality and Stroke Fear, frustration, the need to adjust to a new self-image, adapting to a new, often very different "self," being disappointed by one's performance in many life areas, and doubts about one's ability to deal with these changes - all of these are elements of stroke recovery. Hemiplegia, personality change, communication impairments, and a lessened ability to learn new things are additional factors that often have to be dealt with. With all of these issues to face, sex may not seem like an important matter in the initial stages of stroke recovery. However, as recovery progresses and survivors and their spouses begin to have sexual feelings again, an informed and positive approach to the effects of stroke on sexuality can enhance recovery and strengthen self-esteem. A stroke does not have to mean the end of one's sex life, which can often continue to be an important source of pleasure, relaxation and intimacy. Straight Talk What is the reality of sexuality after a stroke? There is rarely any medical reason why stroke survivors should not become sexually active again, should they wish to do so, and their doctor agrees. Sex is usually good for the physical and mental well being of stroke survivors and their partners, improving their quality of life, and strengthening bonds of closeness. However, though stroke survivors often continue to have sexual feelings and desires, these are often experienced through a filter of their disability. One study of 79 men and women who had had their strokes from three months to three years earlier found that only one couple in six had maintained their sexual relationship. Sexual Consequences of Stroke The possible and normal sexual consequences of a stroke include:
All these areas may be affected in the weeks or months following a stroke, resulting in less sexual activity, or a change in how sexual feelings are expressed. Sexual feelings may diminish or become less enjoyable, and often, sex ceases altogether. Sexual activity may be reduced for many different reasons:
*(For more information, see pamphlet "Emotional and Behavioral Changes after Stroke) Sexual Readjustment Attitudes towards sexuality play an important part in an individual's and couple's adjustment to stroke. Most of us have learned to keep the details of our sexuality to ourselves, a tradition of privacy that often makes it difficult for survivors and their spouses to openly discuss the effects of stroke on their sexual relationships. Without frank, open communication, however, sexual readjustment following a stroke can't begin. Consider this only a brief period of discomfort- it could be the first step back to sexual fulfillment. Doctors or counselors can help break the ice when partners are uncomfortable talking about sexual feelings. Traditional sex roles can also work to the disadvantage of individuals and couples adjusting to a stroke. There are those, men in particular, who feel that without intercourse, their sexual lives are over. Reducing the emphasis on sexual intercourse as the only way to enjoy sex would make other types of sexual expression, such as tenderness, touching, self-pleasuring, and other types of sex more acceptable, and allow stroke survivors a more positive outcome when contemplating sex after a stroke. Adjusting to Physical Changes in Sexual Functioning
Your doctor can help by providing information, clearly discussing sexual function, arranging for sex counseling if necessary, or by prescribing an antidepressant if depression is a factor. Planning for Success Sexual expression is a way to convey feelings of love and tenderness, reduce stress, and promote closeness. Couples can benefit from having open discussions about their desires and how to achieve them. They should also try to:
In situations where sex is not possible,
there are still options that will allow the expression of your closeness as a
couple. The tenderness and warmth conveyed in
For more information on stroke recovery, please contact: Stroke Recovery Canada
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