Sex After Stroke: What You Need To Know

A stroke can have a significant impact on a person's sex life and intimate relationships. It can cause physical and emotional changes that may affect desire, abilities, and confidence. However, it is possible to have a healthy sex life after a stroke, and it can even be a key aspect of returning to a normal routine.

There are several reasons why someone might experience difficulties with sex after a stroke, including emotional changes, relationship problems, and physical disabilities. It is common to feel a loss of independence or a change in how you relate to those close to you. If your partner is caring for you, this can also affect the dynamic of your relationship.

Communication is key to navigating these challenges. Being open about your feelings and working together to find solutions can help you and your partner manage any difficulties. It may be helpful to seek support from a healthcare professional or therapist, as they can provide guidance and counselling related to sex and relationships.

It is unlikely that sex will cause another stroke

A stroke can cause a lot of changes in the lives of couples who are sexually active, both physically and mentally. It is understandable that one might be concerned about the possibility of sex causing another stroke. However, it is extremely unlikely that sexual activity will increase the risk of another stroke.

Sex takes about as much energy as walking up one or two flights of stairs. While your heartbeat and breathing will accelerate, this is a normal response to the activity and is not cause for concern. Nevertheless, it is always a good idea to consult with your doctor before resuming sexual activity to ensure that it is safe for you to do so.

It is important to keep in mind that everyone's recovery process is unique, and you should not rush or force the issue of resuming sexual activity. Returning to a sexual relationship requires patience and the loving support of your partner. Take the time to explore what feels good for you and your partner, and don't be afraid to seek help if needed.

Additionally, it is worth noting that certain medications can affect sexual desire and performance. If you have any concerns about the impact of your medication, be sure to discuss them with your doctor. They may be able to suggest alternative treatments or advise you on the best time to take your medication in relation to sexual activity.

Depression and medication can reduce libido

Selective serotonin reuptake inhibitors (SSRIs) are a common type of antidepressant that can cause sexual dysfunction. SSRIs work by increasing serotonin levels in the body, which can lead to a sense of calm and reduced anxiety. However, this can also lower libido and interfere with the hormones that trigger sexual responses in our bodies. As a result, people taking SSRIs may experience decreased sexual desire, delayed arousal, and difficulties achieving orgasm.

If you are experiencing sexual side effects from antidepressants, it is important to consult your doctor or therapist. They may suggest strategies such as lowering the dosage, scheduling sexual activity for times when side effects are less pronounced, or switching to a different medication that is less likely to cause sexual problems, such as bupropion (Wellbutrin) or mirtazapine (Remeron). It is important to note that discontinuing or altering your medication regimen should only be done under the guidance of a medical professional.

Communication is key to a healthy sex life

A stroke can have a significant impact on your sex life and intimate relationships. It can change your body and the way you feel about yourself, which may affect how you see your own sexuality. However, it is possible to have a healthy sex life after a stroke.

Communication is a key ingredient in a satisfying sex life. It is important to talk openly with your partner about how the stroke has affected you both and to share your feelings. Discuss what sexual activity would be comfortable for you and explore what works best. If you are not ready for sex, you can simply enjoy being close with your partner through touching, kissing and hugging.

If you or your partner is suffering from speech or language difficulties after a stroke, there are still ways to communicate love nonverbally. Touching, caressing and gestures can all express your sexuality with your partner. It may be difficult at first to communicate without the language you are used to, so take it slowly and get used to expressing yourself in a new way.

If you are struggling with communication difficulties that make it hard to speak or understand speech, a speech and language therapist can help you and your partner find a way to communicate with each other.

If you are finding it difficult to talk about sex, consider seeing a sex therapist. They can offer counselling and therapy relating to sex and relationships.

Common Concerns After a Stroke

There are many concerns that stroke survivors may have when resuming sexual intimacy with their partners. They may be worried about having a second stroke, incontinence, or even impotence. It can be difficult for the survivor's partner to switch from a caretaker role to that of a lover.

Physical Changes

It is common after a stroke for one side of the body to be paralysed or weaker than the other side. This may require you to alter the sexual positions you are used to and experiment until you find a comfortable position. Pillows can be helpful when trying out new positions.

Emotional Changes

Post-stroke depression affects more than a third of stroke survivors. Some of the common symptoms of depression, such as loss of interest in activities, fatigue, feelings of worthlessness and short-term memory loss, can make it difficult to focus on an activity like lovemaking. Depression can also reduce libido, making sex more challenging.

Medication

Certain medications can cause a loss of libido. If you are experiencing a reduced libido due to your medication, talk to your doctor about your options.

Fear of Another Stroke

The fear of having another stroke is one of the most common concerns for stroke survivors and their partners when resuming sexual relations. However, it is extremely unlikely that sex will put someone at risk of having another stroke.

Incontinence can be embarrassing but is common

Incontinence after a stroke can be uncomfortable and embarrassing, but it is a common problem that many stroke survivors can overcome. If you are afraid of having an accident during sex, it can be hard to relax and feel comfortable. However, there are several things you can do to minimise the likelihood of an accident.

Firstly, it is important to talk to your partner about your concerns so that they can reassure you and help you. Before having sex, limit the amount of liquids you drink and use the restroom. Avoid positions that put too much pressure on the bladder. You can also cover the bed with plastic or an incontinence pad to make an accident less of a mess if it occurs.

If you are struggling with incontinence, it is a good idea to consult a healthcare professional, such as a doctor or nurse, who can provide advice and suggest solutions. They may recommend specific products or techniques to help manage incontinence and improve your comfort during sexual activity.

In addition to managing incontinence, there are other aspects of sexual intimacy that may require adjustments after a stroke. For example, muscle weakness or paralysis on one side of the body may require experimenting with different sexual positions to find comfortable options. Communication is key, and it is important to be open with your partner about any concerns or changes you are experiencing.

Remember that it is normal to experience changes in your sexual desires and abilities after a stroke. It may take time to adjust and heal, but most people can return to a healthy sex life with patience and support.

Hormone imbalances can cause sexual problems

Hormone Imbalances and Sexual Problems

Hormones are powerful chemical messengers that coordinate various functions in the body. They are produced in the endocrine glands and travel through the bloodstream, carrying messages to organs, skin, muscles, and other tissues. These signals tell the body what to do and when to do it.

A hormonal imbalance occurs when there is too much or too little of one or more hormones in the blood. This can lead to a variety of symptoms and issues, including sexual problems.

Sex Hormone Imbalance Symptoms for People Assigned Female at Birth (AFAB)

People who are assigned female at birth can experience imbalances in estrogen and progesterone, which are produced by the ovaries. They may also have excess testosterone and androgens. An imbalance in sex hormones can cause the following symptoms:

• Loss of interest in sex
• Acne on the face, chest, and/or upper back
• Hirsutism (excess body hair)

Sex Hormone Imbalance Symptoms for People Assigned Male at Birth (AMAB)

For people assigned male at birth, an imbalance of testosterone, which is produced by the testes, and other sex hormones can cause the following symptoms:

• Decrease or loss of body hair
• Erectile dysfunction (ED)
• Loss of interest in sex
• Gynecomastia (enlarged breast tissue)
• Loss of muscle mass

Other Factors Affecting Sex Drive After a Stroke

While hormone imbalances can cause sexual problems, there are other factors that can affect sex drive and sexual function after a stroke. These include:

• Post-stroke depression, which affects more than a third of stroke survivors, can lead to a loss of interest in activities, fatigue, feelings of worthlessness, and short-term memory loss, all of which can impact sexual desire and performance.
• Medications, such as antidepressants and blood pressure medicines, can reduce libido and cause impotence.
• Communication issues and depression can also affect sexual desire and intimacy.
• Physical changes after a stroke, such as paralysis or weakness on one side of the body, can impact sexual positions and comfort.
• Incontinence after a stroke can cause embarrassment and discomfort, affecting sexual intimacy.
• Fear of having another stroke or health concerns can impact a person's willingness to resume sexual activity.

Frequently asked questions