Intimacy and sex after a stroke

If you or your partner has had a stroke, how do you approach intimacy and sex afterwards? We look at common concerns and provide tips to help.

Having a stroke is usually a life-changing event for patients and their partners too. 

One side effect which is often not discussed, is how sexual relationships can be affected after a stroke.

Physical and emotional challenges

The impact of a stroke on someone’s sex life will generally differ from person to person, but there are some common issues that affect many people when it comes to resuming a healthy sex life. 

One big fear, which is generally unfounded, is that the rise in blood pressure that typically occurs during sex might cause another stroke.
“Physical disfigurement can also leave people with low self-esteem and feelings that they’re not attractive anymore. Loss of independence can also be an issue and people can experience personality changes’’, says Dr Rob Grenfell, National Medical Director at Bupa Australia & New Zealand. 
“Severe physical disabilities may mean that someone just can’t do the things they used to do, so couples have to explore each other’s bodies and discover what they can and can’t do now.”
Another big challenge can be mood changes that people frequently experience after a stroke, which can quite profoundly impact a person’s ability to be sexual in the first place.
When one person in a couple has suddenly become the ‘cared for’ and the other the ‘carer’, the resulting power imbalance can greatly disrupt a relationship.
older couple cuddling

Seeking professional help

Grenfell suggests that an important place to start is assessing what your sexual relationship was like beforehand and what your expectations are now. Speaking with a psychologist or sex therapist can be very helpful in working through any questions.
“A sexual therapist is the most ideal, as many people find it extremely difficult to talk about sex in frank and non-judgemental ways.”
Having open and honest discussions about fears and the new challenges ahead will be  extremely important for couples in this situation.
“Simply kissing, hugging and holding hands can help re-establish intimacy – many people talk about yearning for touch and connection after a stroke.”

Strategies that can help

  • Start your sexual rehabilitation when you are ready: Some stroke survivors say that having sex, or masturbating, again can help them feel ‘back to normal’.
  • Get answers to your questions: Fear and worry can affect your sexual appetite. Instead of bottling up all your worries, speak to your health care team about any things that are concerning you, including your sex life! 
  • Don’t be scared that having sex will trigger another stroke: Studies have not shown that sex can trigger a stroke. Your GP and health professionals can advise you further.
  • Investigate the cause of any sexual problems: Stroke does not usually cause physical sexual difficulties, but the psychological issues surrounding stroke might.
“After a stroke there comes a big period of adjustment to what the world will be like now. Give it time and don’t hold things inside, but talk about them openly with your partner. Many couples have shown that such an event actually brings them closer together to an even stronger and more loving relationship.”
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