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Redefining Sexuality after Stroke

You can have a healthy sex life after having a stroke.

StrokeSmart Staff Jan 31, 2009

You can have a healthy sex life after having a stroke. In fact, it’s a key part of getting back into a normal routine. The need to love and be loved is significant. Also, the physical and mental release that sex provides is important.

The quality of a couple’s sexual relationship following a stroke differs from couple to couple. Most couples find that their sexual relationship has changed, but not all find this to be a problem. The closeness that a couple shares before a stroke is the best indicator of how their relationship will evolve after the stroke.


However, having sex after a stroke can present problems and concerns for both you and your partner.


Stroke survivors often report a decrease in sexual desire. Women report a strong decrease in the ability to have an orgasm and men often have some degree of impotency. A stroke can change your body, how you feel and impact your sex life.


Having good communication with your partner, managing depression, controlling pain or incontinence and working with impotence can all help you resume a healthy sex life.


Communication is Key

Talking about sex is hard for many people. It gets even more complicated after having a stroke, when you may be unable to understand or say words or have uncontrollable laughing or crying spells. But it is critical to talk openly and honestly with your partner about your sexual needs, desires and concerns. Encourage your partner to do the same. If you are having a difficult time communicating with your partner about sex, an experienced counselor can help.


Depression, Pain and Medication -- How They Effect Your Sex Drive

It is common for stroke survivors and their partners to suffer from depression. When you are depressed, you tend to have less interest in sexual intimacy. Depression can be treated with medications. You may also be taking medicine for anxiety, high blood pressure, spasticity, sleeping problems or allergies. Addressing these medical concerns can increase your sex drive. But know that some medication can also have side effects that interfere with your sex life. If your ability to enjoy sex has decreased since your stroke, talk with your doctor about medicines that have fewer sexual side effects.


Many stroke survivors also have problems with pain, contributing to a loss of sexual desire, impotence and the ability to have an orgasm. This is a normal reaction. Work with your doctor to develop a program to manage your pain and increase your sexual desire.

Controlling incontinence

If you are having trouble with controlling your bladder or bowel, being afraid that you will have an accident while making love is understandable. There are a few steps you can take to help make incontinence during sex less of a concern.

  • Go to the bathroom before having sex
  • Avoid positions that put pressure on the bladder
  • Don’t drink liquids before sexual activity
  • Talk to your partner about your concerns
  • Place plastic covering on the bed, or use an incontinence pad to help protect the bedding
  • Store cleaning supplies close in case of accidents

If you have a catheter, you can ask your doctor’s permission to remove it and put it back in afterwards. A woman with a catheter can tape it to one side. A man with a catheter can cover it with a lubricated condom. Using a lubricant or gel will make sex more comfortable.

Working With Impotence

Impotence refers to problems that interfere with sexual intercourse, such as a lack of sexual desire, being unable to keep an erection or trouble with ejaculation. Today, there are many options available to men with this problem. For most, the initial treatment is an oral medicine. If this doesn’t work, options include penile injections, penile implants or the use of vacuum devices. Men who are having problems with impotence should check with their doctors about corrective medicines. This is especially true if you have high blood pressure or are at risk for a heart attack. Once you have talked to your partner and you are both ready to begin a post-stroke sexual relationship, set yourself up to be comfortable. Start by reintroducing familiar activities such as kissing, touching and hugging. Create a calm, non-pressure environment and remember that sexual satisfaction, both giving and receiving, can be accomplished in many ways.


Ask the Doctor

Things to discuss with your doctor:

1. medications for depression and pain that have fewer sexual side effects.

2. Changes you should expect when having sex and advice on how to deal with them. Be sure to discuss when it is safe to have sex again.

3. impotence and corrective medications.

4. incontinence — a urologist who specializes in urinary functions may be able to provide help in this area.



Tips for Enjoying Sex After a Stroke

  • Communicate your feelings honestly and openly.
  • if you have trouble talking, use touch to communicate. It is a very intimate way to express thoughts, needs and desires.
  • after stroke, your body and appearance may have changed. Take time for you and your partner to get used to these changes.
  • Maintain grooming and personal hygiene to feel attractive for yourself and for your partner.
  • explore your body for sexual sensations and areas of heightened sensitivity.
  • have intercourse when you are rested and relaxed and have enough time to enjoy each other.
  • try planning for sex in advance, so you can fully enjoy it.
  • Be creative, flexible and open to change.
  • the side of the body that lacks feeling or that causes you pain needs to be considered. Don’t be afraid to use gentle touch or massage in these areas.
  • if intercourse is too difficult, remember there are many ways to give and receive sexual satisfaction.

Resources for a Healthy Sex Life


  • Resurrecting Sex: Solving Sexual Problems and RevolutionizingYour Relationship by David Schnarch, James W. Maddock, James Maddock
  • The Art of Tantric Sex by Nitya Lacroix and Mark Harwood
  • Men, Women and Relationship: Making Peace With the Opposite Sex by John Gray
  • Dr. Ruth’s Sex after 50: Revving up the Romance, Passion and Excitement! by Ruth K. Westheimer, with Pierre A. Lehu
  • Rekindling Desire: A Step-by-Step Program to Help Low-Sex and No-Sex Marriages by Barry W. McCarthy and Emily J. McCarthy

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