The Stroke Network, Inc )
Fuel for the Journey

By Lin Mouat



Sexuality After Stroke


Sexuality and sensuality are Siamese twins. For me, the term Sexuality has more to do with the physical aspects of sex while sensuality relates to the emotional.


Since my strokes three years ago, I've had a total lack of physical sensation in my genitals. Since other parts of my body had also been thus affected, I wasn't surprised by this problem. However, I continue to be unsettled by the blunting of my emotional connection of the act of having intercourse.


It's hard to not take this lack of emotion personally. Of course this topic couldn't be more personal. I can accept the physical disconnect, or numbness, but not the emotional. And yet, they are both directly related to my strokes.


When I posted a request for input on a message board, I was surprised and pleased by the willingness of others are to share their experience.


One man writes, "I think that even we survivors take a long time to realize and fully appreciate the depths to which we have been affected by stroke. It seems that one situation resolves (pain, dizziness, etc.) only to be replaced by some other deficit or issue."


Another person put the question of having sex with a touch of humor. "With keeping my safety in mind and being aware of my weak left side, is there any time restraints or restrictions that will prevent hubby and I from the Chika Boom, Chika Boom, Chika Boom Boom Boom?" she asked her doctor.


Even though strokes can affect sexual functioning, the problems are usually not permanent. Let's explore two things that influence sexual function: Psychological and Physiological.


Referring to these two aspects of sexual function, Dr. Louis Caplan writes, in his book STROKE, "The entire central nervous system, including the brain, controls sexual functioning."[1]  On the same page Dr. Caplan goes on to explain that the physiology of genital sexual reflex functions are controlled in the general area of the lower spine, sacral region. This is the same region that controls urination and defecation.


These functions might be diminished following strokes, but aren't always affected permanently. The second, the psychological, aspect of our sexuality arises from the brain. Dr. Caplan explains, "The brain has more to do with desire for sex (libido) and for transmission of the desire for sex to the genital organs."


This aspect can be influenced by a multitude of factors beyond the scope of the stroke; this area is, to me, infinitely more difficult to deal with. Prior to my second stroke, I had just completed many years of counseling to deal with the affects of childhood sexual abuse. With the hard work and the patience of my wonderful husband, my therapy ended with the dawning of an open, wonderful sex life. Just a short time later, I suffered two massive Ischemic strokes, one on each side.


Motor deficits and agility may also be practical barriers that provide additional challenges to resuming normal sexual activity.


One man on the Message Board shared this. "Granted, it was a little awkward at first, but compassion and patience go a long way. Now at 67, I'm not ready to give up on anything."


In all likelihood, normal will look different than it did prior to stroke, but for many of us, with patience and ingenuity, we can get through and past the problems caused by our strokes and find a healthy sex life.



[1] Caplan, Louis, “Stroke,” Copyright©, 2005, Demos Medical Publishing

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