Sexual dysfunction in stroke patients

Objectives - A marked decline in sexual activity has been reported in strok e patients. Little information, however, is available on clinical correlate s of sexual dysfunction, changes in the sexual life of spouses of stroke pa tients, and abnormalities of nocturnal penile erections. Material and metho ds - In this prospective 6-month follow-up study, we assessed the impact of stroke on libido, sexual arousal, coital frequency and satisfaction with s exual life in 50 stroke patients (38 men, 12 women, aged 32 to 65 years) an d in their spouses. We also measured nocturnal penile erections of the male patients using a strain gauge attached around the penis. Results - All the analyzed aspects of sexuality, i.e., Libido, coital frequency, erection, e jaculation, vaginal lubrication, orgasm and satisfaction with sexual life, were commonly decreased as a consequence of stroke both in the patients and in their spouses. Fourteen (28%) patients at 2 months post-stroke and 6 (1 4%) patients at 6 months had ceased having sexual intercourse. Nocturnal er ections at 2 months post-stroke were normal in 17 (45%) of the 38 male pati ents and impaired in 21 (55%) patients, but all of the patients had some no cturnal erections. Sexual dysfunction correlated significantly (P<0.05) wit h the presence of the sensory hemisyndrome. Conclusions - Sexual dysfunctio n and dissatisfaction with sexual life seems to be common both in male and female stroke patients and in their spouses. Decreased libido, sexual arous al and satisfaction are related particularly to the presence of the hemisen sory syndrome. The etiology for sexual dysfunction after stroke is multifac torial including both organic and psychosocial factors.