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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Reader Comments

Wonderful to see sexuality being addressed here. All life experiences can be altered following stroke and aphasia, but this is one that is sadly, often ignored by rehab professionals. Thanks for posting.

Written By Shirley Morganstein on July 13th, 2011 @ 4:17 pm

Thank you for speaking, advising and reassuring about a difficult subject.

Written By Eileen Erickson on July 14th, 2011 @ 2:41 am

You are very welcome. You might also want to see the Fact Sheet "Recovery after Stroke: Redefining Sexuality" available from the National Stroke Association ( Other sources of information on sexuality after stroke are listed in the Resources section of my book, When Your Spouse Has a Stroke.

Written By Sara Palmer, Ph.D. on July 20th, 2011 @ 7:05 pm

Thanks for your comment. You are right that professionals often neglect discussion of how a stroke or aphasia can affect sexuality. However, it's my experience that if you take the initiative to ask doctors (or other health care provider) about sexual concerns, they will try to help you. Don't be shy!
Please check out the chapter, A Fine Romance:Sex and Intimacy after Stroke, in my book, When Your Spouse Has a Stroke, for more information.

Written By Sara Palmer, Ph.D. on July 20th, 2011 @ 7:13 pm

It’s not really clear why, but men and women have struggled with their different intimacy urges for centuries. However, this is not a trivial issue. A healthy intimate life is one of the most critical features of a fulfilling relationship. In fact, low drive for intimacy is probably the single most troubling symptom married women face and the one problem most likely to damage their relationships permanently. Intimacy in marriage is vital because it proves the willingness of each person to be vulnerable to the other.

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On our first day of a planned vacation, my fiancee suffered a stroke. He was in acute inpatient care then acute rehab for two weeks before we could get back home from Utah. At the age of 49, we were just starting the passionate part of our relationship when this happened. We have many years left to be intimate and I was beginning to feel guilty for wanting to initiate sexual contact until he finally told me how scared he was to have sex again for fear of having another stroke. I want to thank you for addressing this issue. It has reassured me as a caregiver, and him to the point of our relationship has now blossomed into a much more passionate togetherness.

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