Sexual functioning among stroke patients and their spouses

Background and Purpose-The aim of this study was to assess effects of strok e on sexual functioning of stroke patients and their spouses and to study t he associations of clinical and psychosocial factors with poststroke change s 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 F ederation completed a self-administered questionnaire concerning their pres troke and poststroke sexual functions and habits. The main outcome measures were (1) libido, (2) coital frequency, (3) sexual arousal, including erect ile and orgastic ability and vaginal lubrication, and (4) sexual satisfacti on. Results-A majority of the stroke patients reported a marked decline in all the measured sexual functions, ie, libido, coital frequency, erectile and o rgastic ability, and vaginal lubrication, as well as in their sexual satisf action. The most important explanatory factors for these changes were the g eneral attitude toward sexuality (odds ratio [OR] range, 7.4 to 21.9; logis tic 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 (O R range, 3.2 to 5.0). The spouses also reported a significant decline in th eir libido, sexual activity, and sexual satisfaction as a consequence of st roke. Conclusions-Sexual dysfunction and dissatisfaction with sexual life are com mon in both male and female stroke patients and in their spouses. Psycholog ical and social factors seem to exert a strong impact on sexual functioning and the quality of sexual life after stroke.