Older people and Stroke

Persons with Vascular disease or high blood pressure (hypertension), both of which can lead to stroke, may have experienced some degree of sexual difficulties caused by these. It is always important to report this type of physical change to your doctor as it may indicate an underlying cause which can be dealt with before it becomes more serious. This may even improve your chances of avoiding a stroke. With heart disease, changes to your sexual capacity and the physical activities you are able to engage in may have been notable for some time, and you may have been able to deal with these or adapt to them. With stroke, the changes can be sudden and perhaps extensive. Psychologically, this can be as traumatic as the stroke itself to deal with.

If you had little or no interest in Sex before a stroke, this is unlikely to change. How a stroke affects your existing sex life depends upon the extent of impairment and the level of your recovery. Many people make a good or even a full recovery with no significant side effects to sexual activity. The more Debilitating the stroke, the greater the difficulties may be in resuming sexual activity. Remember though that recovery can continue for a very long time and is not restricted to only a few weeks.

When making an effort to resume sexual activity the following pointers may be worth your consideration. They may not all apply to you personally.

• Conserve energy for the activity, perhaps waiting until rested or waiting until after having a good night’s sleep.
• Allow yourself plenty of time for the activity to compensate for slowed responses.
• Reduce food and alcohol intake prior to activity to help reduce any excess strain on your heart.
• Difficulties or accidents with Continence can occur following a stroke. Until you regain control more fully over these functions you can try to ensure that you empty your Bladder or bowel well before the activity, and ensure personal hygiene has been attended to. Do not drink anything for up to 2 hours before.
  
• Take your time and learn to be patient. Begin slowly and rediscover what feels good to you now that sensations in various parts of your body may have altered.
• With partners, explain those changes so that they can take them into account in their own behaviour.
  If you are used to Penetrative sex, you may wish to move to this slowly, when you have again become familiar and more confident in other sexual practices.
• It is possible to have Vaginal Intercourse even when catheterised. It requires some manipulation of the Catheter and the use of lubrication and a condom to lessen tugging on the tube.
• You may have to adjust from previous, familiar, sexual positions to take into account any degree of physical impairment. Consider using pillows for support or even handles attached to wall/bed frame for additional support or help with positioning.

Ensure that any difficulties you continue to experience are not as a result of any medication you have to take. Never stop taking any medication without consulting your doctor. It is highly likely that an alternative can be provided that does not reduce your sexual capabilities. If you wish to do so, and are able to, there is absolutely no reason why you should not continue to enjoy sex after having a stroke. Try not to feel embarrassed about discussing any of the issues involved in this - because you have been unwell does not mean you have to withdraw from aspects of your life unnecessarily.