Between the sheets: sex after stroke

While everyone’s experience of sex is personal to them, there are some issues that are common after stroke. It is important to know that stroke survivors can enjoy sex after stroke. You might need to work on getting back to enjoying intimacy, masturbation and partnered sex as part of your recovery - and you can!

How stroke can affect your sex life

Everyone’s different, but a life changing and often traumatic experience such as stroke can have a big impact on you. After a stroke, getting back to sex might be a big priority for you, or it may be way down on the ‘to do’ list. Stroke can also change how your body feels and works and how you feel about yourself. Some things you may face include:

Emotion and mood changes. It’s common to feel angry, irritable, low or depressed and you may lose interest in sex as a result. It may also change how you feel about yourself and your sexuality. Simply put, you just may not feel very sexy after stroke.

Physical challenges. Sexual activities can be impacted by physical changes caused by the stroke. Muscle weakness, stiffness, spasticity, pain, altered sensation, mobility, fatigue and incontinence can have a big impact.

Relationship issues. Relationship changes can also have a big impact. Interest in sex and your feelings about it can be very different for you and your partner. As in all relationships, interest in and openness to sex can shift and change.

Medications. Some medications such as anti-depressants, anti-hypertensives and sleeping tablets can cause sexual dysfunction. Your doctor may be able to make adjustments if this is the cause of the problem but make sure you do not stop taking any medication without medical advice.

Everything you wanted to know, but were afraid to ask

Being a telephone service, StrokeLine gets lots of questions about sex! Some common ones include:

Will I have another stroke during sex?

This is the number one question we get asked. There’s actually no need to worry as studies have not shown that sex can trigger a stroke. You can ask your doctor or a health professional to confirm this, specific to your type of stroke.

How will my partner respond to me?

You might be worried about how a sexual partner will feel about you sexually after stroke. They in turn may be worried that sex could cause you worry or pain. Adjusting to changes after stroke can take time. Communicate openly, and get some professional advice if needed.

What if I have incontinence?

If you’re having trouble with controlling your bladder or bowel, you may be fearful of sex or avoid it due to embarrassment. One tip is to go to the bathroom if you can before sex. If you have a catheter then you can ask your doctor’s permission to remove it, cover it or tape it to one side, and place it back later.

What if things just aren’t working right?

Stroke is not usually a cause of sexual dysfunction. If you experience problems with getting or maintaining an erection, vaginal lubrication or reaching orgasm, speak with your doctor. Don’t suffer in silence about this – it causes a lot of misery and often something can be done.

My partner’s sexual behaviour has changed since the stroke, is this normal?

This can happen if the stroke survivor’s thinking and behaviour has been affected by the stroke. Like any personality or behaviour change, this can be very distressing. Try talking to your partner about it directly. If it’s really worrying you, speak to their doctor, or even to your own, about what’s happening and what might help.

Other strategies that may help

Begin slowly. Start your ‘sex rehab’ when you are ready. You may wish to begin with connecting again through touching, cuddling, massage or other ways of being intimate. If you are recently out of hospital and are home with your partner, just sleeping in the same bed again and enjoying working things up slowly from there can be a lovely experience.

Rest up and plan ahead for sex. Plan for a time you are well rested and have uninterrupted time. If required, make sure you allow enough time to help compensate for slower physical responses.

Know the medications you are taking. Be aware that some medications can cause problems. Speak to your doctor for advice about your medications.

Talk about it. Just having a conversation can help, although this takes some courage if you are new to this. Talk about any changes, the things you’re finding difficult and the things you are enjoying and how you are feeling. Encourage your partner to talk to you.

Adapt to any changes. You may need to find new positions and ways of doing things to bring you or your partner pleasure. Occupational therapists can provide great advice on positioning.

Start with activities you think may be easiest and progress to more challenging things as your confidence increases. Don’t be afraid to use gentle touch or massage in areas of the body that are painful or lack feeling. Some people use sex toys, which can be a great help.

Talk to a health professional. Talk to your doctor or health professional about your concerns. Like all of us, health professionals have varying levels of comfort in talking about sex. Pick someone you feel comfortable with, and remember that while they may not have thought to ask you about sex, they may be perfectly happy to discuss it once you bring it up. If they aren’t helpful, try someone else.

Remember that health professionals have heard most questions before. And if you do come up with something they haven’t been asked before, you can wear that as a badge of pride.

If you want to start with a completely private telephone conversation, call StrokeLine on 1800 787 653.

Check out:

Stroke Foundation: Sex and relationships after stroke fact sheet.

This UK website has fantastic videos of stroke survivors and their partners discussing sex after stroke:

http://www.healthtalk.org/peoples-experiences/nerves-brain/stroke/sex-life-and-impact-relationships

This discussion on current affairs program Insight, has some interesting discussion on sex and disability:

SBS Insight Episode: Sex and disability:

http://www.sbs.com.au/news/insight/tvepisode/sex-and-disability