Sexual Intimacy after a Stroke

Couple laying in bed

Are you frustrated by the lack or romance in your relationship after a stroke? Do you long for closeness, intimacy and a satisfying sex life with your partner, but find that it’s just not happening? You are not alone—most couples want to be intimate after a stroke, but there are a number of things that can make this challenging. Physical problems, including medication side effects, incontinence, medical illnesses, and limited movement or sensation can cause a drop in sexual desire or function. But the biggest obstacles are psychological—fear of another stroke, depression, and lack of communication between partners. When your spouse has aphasia, sending and receiving messages about love, affection and sexual desire is especially difficult.

But don’t give up! Regaining sexual intimacy after a stroke is possible, and well worth the effort. Here are some tips that may help you:

Tips for Enhancing Sexual Intimacy with Aphasia

  • Find nonverbal activities that you and your spouse can enjoy together, such as listening to music, painting or drawing, daytrips, or dancing. These shared experiences create the emotional closeness that sets the stage for sexual intimacy.
  • Use a combination of communication techniques to develop closeness and intimacy. Smiling and other facial expressions, touching, pictures, writing and gestures are ways that you can enhance communication when your spouse is unable to understand spoken language.
  • Communicate your sexual interests and desires using gestures, caressing, kisses, and loving words, sounds, or even songs.
  • Create the mood for intimacy with romantic music and lighting, wear attractive or sexy clothing, or take a shower with your spouse. These actions speak louder than words!
  • During sex, try using more explicit gestures than you did before the stroke, for example placing your partner’s hand where you want to be touched, or pantomiming particular sexual acts or movements.

General Tips for Enhancing Sexual Intimacy after a Stroke:

  • Don’t be afraid of sex! There is little evidence that sexual activity will cause another stroke. If you have any concerns about this, ask your doctor.
  • Don’t be embarrassed to talk with your doctor about sexual issues. Changing medications, treating other medical conditions or better managing bladder incontinence may greatly improve your sex life.
  • Nothing kills the mood for romance like depression. If you or your partner is depressed, discuss this with a doctor or mental health professional. Treatment for depression is likely to increase your interest in sex and your ability to enjoy relating to your partner.
  • It’s OK to schedule sexual activity. There are many demands on your time, and sex tends to slip to the bottom of the list unless you make it a priority. Putting sex on the calendar can create the excitement of having a “date” and give you something to look forward to.
  • Fatigue is common after a stroke, so it’s important to have sex when you are well rested. “Bedtime” may not be the best time; try having sex in the morning, or after a nap.
  • Try not to worry about your sexual “performance.” Focus on sharing enjoyment and pleasure with your partner.
  • Be creative, experiment and have fun!

Sexual intimacy can also be affected by changes in cognitive abilities, self-esteem, body image, and marital roles after a stroke. For more tips on improving your sexual relationship—as well as many other aspects of your marriage after a stroke—refer to When Your Spouse Has a Stroke: Caring for Your Partner, Yourself and Your Relationship (Johns Hopkins University Press, 2011)

Care to share your own tips for improving sexual intimacy after a stroke? Have any questions? Ask away!

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