Sexual dysfunction in stroke patients.

The impact of cerebrovascular accident (CVA) on sexual behavior in stroke patients was studied in 113 patients (78 men, 35 women). Seventy-five patients were interviewed with their spouses present. The mean age of the men and women patients was 68.6 years and 68.0 years respectively. Significant decline in libido after stroke was reported by both men and women. The men had a significant decrease in ability to achieve erection and to ejaculate in the period after stroke. Similarly, significant problems were reported by the women regarding normal vaginal lubrication and orgasm after CVA. Sixty-six men (84%) and 21 women (60%) enjoyed their sex lives before their stroke as compared to only 23 men (30%) and 11 women (31%) after stroke. Seventy-four men (95%) and 27 women (76%) were satisfied with sexual activity before their stroke as compared to only 20 men (26%) and 13 women (37%) after stroke. Women patients with right-sided lesions had lesser decline in sexual function than women with left-sided lesions or men with either right or left hemispheric lesions. The most common factor identified as causing decline in sexual activity was the fear that having sex might adversely affect blood pressure and cause another stroke. The sexual problems of these patients are of sufficient magnitude and frequency to warrant further investigation of the physiologic effects of sexual activity on blood pressure and cardiac function after stroke.