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Redefining Sexuality after Stroke



Redefining Sexuality after Stroke
You can have a healthy sex life after having a stroke. In fact, itís 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 coupleís 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
Donít 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 doctorís 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 doesnít 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.