Evaluation of Sexual Changes After Stroke. [CME]
J Clin Psychiatry 2003;64:302-307
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Sexual difficulties may arise after
stroke. This study was aimed at evaluating and quantifying sexual
changes 1 year after stroke.
Method: Sixty-eight stroke patients,
consecutively admitted to our rehabilitation unit, were enrolled
in the study. Sixty-two patients were available for response
after 1 year--46 men and 16 women with a mean age of 64 years (SD
= 9.2). Time interval between stroke event and admission to
rehabilitation unit was 15 days. None of the patients presented
with lack of comprehension. Methods of data collection at
admission were clinical examination, computed tomographic scan or
magnetic resonance imaging, the Cumulative Illness Rating Scale,
laboratory data, and data collection on sexual life from patients
and, separately, from their partners. After 1 year, they were
interviewed again to assess sexual performance; the Center for
Epidemiologic Studies-Depression scale, Structured Clinical
Interview for DSM-IV, and Functional Independence Measure were
also performed. A questionnaire designed for this study was also
administered for collecting data on patients' private lives.
Results: Sexual decline was common in the
poststroke period. Age (p = .009) and disability (p = .0059) were
significant variables. There was no correlation between sexual
decline and gender, nor injured hemisphere. There was also no
correlation to marriage duration, education duration, or
depression. Evaluation and analysis of the questionnaires
revealed, however, that patients' partners played a substantial
role in the decline of sexual activity. Many partners experienced
fear of relapse, anguish, lack of excitation, or even horror,
which withheld them from encouraging sexual activities.
Conclusion: Data from this study demonstrated
that sexual decline in the aftermath of stroke is pronounced.
Patients suffer from their sexual impairment, but do not conceal
that problem. Psychological, rather than medical, aspects account
for discontinuity of sexual activity in stroke survivors, and
proper counseling is clearly warranted.