Sexual Functioning Among Stroke Patients and Their Spouses

TLDR

This study assessed how stroke affects sexual functioning in patients and their spouses and examined how clinical and psychosocial factors relate to poststroke changes. One hundred ninety‑two stroke patients and 94 spouses in Finnish stroke adjustment courses completed a self‑administered questionnaire measuring pre‑ and poststroke libido, coital frequency, sexual arousal (erectile and orgasmic ability, vaginal lubrication), and sexual satisfaction. Most patients experienced marked declines in libido, coital frequency, erectile and orgasmic ability, vaginal lubrication, and sexual satisfaction, with the strongest predictors being attitudes toward sexuality, fear of impotence, inability to discuss sexuality, unwillingness to engage sexually, and functional disability; spouses similarly reported significant reductions in libido, activity, and satisfaction.

Abstract

Background and Purpose —The aim of this study was to assess effects of stroke on sexual functioning of stroke patients and their spouses and to study the associations of clinical and psychosocial factors with poststroke changes in sexual functions. Methods —One hundred ninety-two stroke patients and 94 spouses participating in stroke adjustment courses sponsored by the Finnish Stroke and Aphasia Federation completed a self-administered questionnaire concerning their prestroke and poststroke sexual functions and habits. The main outcome measures were (1) libido, (2) coital frequency, (3) sexual arousal, including erectile and orgastic ability and vaginal lubrication, and (4) sexual satisfaction. Results —A majority of the stroke patients reported a marked decline in all the measured sexual functions, ie, libido, coital frequency, erectile and orgastic ability, and vaginal lubrication, as well as in their sexual satisfaction. The most important explanatory factors for these changes were the general attitude toward sexuality (odds ratio [OR] range, 7.4 to 21.9; logistic regression analysis), fear of impotence (OR, 6.1), inability to discuss sexuality (OR range, 6.8 to 18.5), unwillingness to participate in sexual activity (OR range, 3.1 to 5.4), and the degree of functional disability (OR range, 3.2 to 5.0). The spouses also reported a significant decline in their libido, sexual activity, and sexual satisfaction as a consequence of stroke. Conclusions —Sexual dysfunction and dissatisfaction with sexual life are common in both male and female stroke patients and in their spouses. Psychological and social factors seem to exert a strong impact on sexual functioning and the quality of sexual life after stroke.