Sexual life after stroke

INTRODUCTION: Sexual satisfaction is increasingly considered as an important part of individual wellbeing. The development of medical sexology made assessment of sexual satisfaction one of the standard indicators of sexual health. OBJECTIVE: To determine the sexual interest after stroke and the impact of satisfying sexual needs on the total life quality of the individual patients. METHODS: The survey questionnaire included 40 patients aged 25-69 years, average 50 years, 25% of them women, who had an ischemic or hemorrhagic stroke and were on stationary rehabilitation, from the third week of stroke onset to the end of rehabilitation which on average lasted six weeks and who had the FIM (Functional Independence Measure) index above 70 points. Almost two thirds of participants were married (65%), 17% were unmarried, 10% divorced and 8% widowed. RESULTS: About two-thirds of participants have not been sexually active in the month before survey, about a quarter of them were generally (20%) or completely satisfied (3%), while the rest were neither satisfied nor dissatisfied (5%), mainly (2 %) or extremely (2%) dissatisfied with their sexual life. For 52% of participants an intimate relationship with their partner changed after stroke, while for 45% of them remained the same and 3% did not know the answer. About two-thirds (68%) of participants believe that their partners never perceive them differently in intimate relations after stroke, 23% that it sometimes happens, 1% said it happens often and 5% always. Male respondents answered question about self- esteem related to achieving erections before and after stroke and responses show that a significant part of them after stroke have very little or little (34%) confidence, while before stroke that was the case for only 8% of respondents. Main specified difficulties during sexual intercourse after stroke are reduced mobility (10%), paralysis (8%), contractures (3%) and pain (3%). After stroke, number of patients who received information about sexuality is sporadic (3%), although there is a great need and 65% of the participants would visit sexual adviser if they exist. Slightly more, but statistically insignificant, patients considered that sex life after stroke affects their quality of life (47% after vs. 45% prior to stroke). Subjective mood disorders such as depression/anxiety were present in 58% of the participants, among them in 15% permanently, in 3% frequently and in 40% sometimes. CONCLUSION: The majority of participants has a need for advice on sexuality after stroke, but only sporadically receives it. Almost two thirds of them would use the help of a psychologist or sex therapist if he was a member of the team during the rehabilitation. In males there is a drop of confidence in achieving erection after stroke. The main problems with sexual relations are related to paralysis and impaired mobility, pain and contractures. In more than half of participants an intimate relationship with their partner altered after stroke. However, sex life after stroke does not affect their quality of life to a greater extent compared to the time before stroke.