Sex After Stroke

Updated:May 30,2014

Couple holding hands and walkingSex can be a sensitive subject, but the good news is that many stroke survivors and their partners can enjoy satisfying intimacy after stroke. The sooner you resume sexual relations — as long as you’re medically stable — the better.

Everything from depression to impotence to concern over your appearance to side effects of medication to fatigue may be at play. Like many stroke survivors, you may have questions:

Will I have another stroke during sex? The chances are very low. The amount of energy needed for sex is about the same as the energy used to walk up one or two flights of stairs. Talk to your doctor if you’re concerned.

How will my partner respond to me? You may wonder if your partner is turned off by your appearance. Your partner may worry that sex could cause pain. You’ll both need time to adjust. Share your feelings openly, and talk to a counselor if needed.

What if I have trouble communicating? You may be dealing with aphasia (loss of speech). You know what you want to say but can’t make the words come out right, or you may not understand what someone else is saying. Touch can be an important communication tool. It shows warmth, caring and desire.

Start with these tips:

Communicate openly. Talk to your partner. Just having a conversation can relieve your concerns.

Begin slowly. At first you may want to try massage or other ways of being intimate instead of intercourse. Explore what feels good — and speak up! Your partner can’t read your mind.

Rest up and plan ahead for sex. You’ll both be at your best when you’re not tired and when you have uninterrupted time to spend together. Rest can also enhance sexual activity. Be sure and allow enough time to help compensate for slower physical responses.

Keep tabs on the medications you take. Sleeping pills may make you less alert, so avoid them if you can. If you take high blood pressure medication, plan for sex before your daily dose, which may help you avoid impotence caused by some high blood pressure medications.

Other medications like tranquilizers, sleeping pills, antidepressants and antihistamines can reduce sexual desire or cause impotence. If you’re a woman, some forms of birth control may be easier than others. (Talk to your doctor if you want to get pregnant to learn the effects of pregnancy on your body and the risks involved.)

Find a comfortable position. A common effect of stroke is weakness or paralysis on one side of the body, so you may need to alter your usual position for intercourse. If you’re a man with one-sided paralysis, the missionary position (man on top) won’t work for you. Instead, your partner might try being on top, or you might try a side-lying position.

Take time to experiment.  Your sense of touch may be affected after a stroke. For example, if you’re paralyzed on one side, your partner may forget about the affected area, so remind him or her to approach you from the non-paralyzed size. Rediscover what you and your partner enjoy.

Take time for yourself. Careful grooming and attractive clothes can help you feel your best. This may take extra effort at first, but the results are worthwhile. Even small steps can help you accept your new self, regain confidence and fight depression

Caregivers, take breaks — and don’t feel guilty about it. You don’t want to end up feeling like a parent instead of a partner. Encourage fun whenever you can. Laughter and playfulness can help you maintain an adult relationship.


This content was last reviewed on 05/28/2014.