Abstract
As many as three-quarters of stroke survivors experience disruption of sexual functioning, predominately as a result of psychological, rather than physiological, causes. The prevention, assessment and treatment of sexual concerns and dysfunctions in stroke survivors and their partners are discussed in this manuscript. Prevention is focused on dispelling stereotypes, myths and misbeliefs in rehabilitation staff, survivors and partners. Assessment and treatment focus on the myriad of psychosocial, psychosexual, cognitive and physical problems that disrupt sexual functioning following a stroke. Specific treatment suggestions are offered. A case example is used to illustrate the integration of treatment techniques.
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Wolf PA, Kannel WB, McGee DL: Epidemiology of strokes in North America.In Stroke: Pathophysiology, Diagnosis, and Management (Vol. I), HJM Barnett, BM Stein, JP Mohr, FM Yatsu (eds). New York, Churchill Livingstone, 1986, pp 19–29
Bray GP, DeFrank RS, Wolfe TL: Sexual functioning in stroke survivors. Arch Phys Med Rehabil 62:286–288, 1981
Kalliomaki JL, Markkanen TK, Mustonen VA: Sexual behavior after cerebral vascular accident. Fertil Steril 12:156–158, 1961
Boldrini P, Basaglia N, Calanca MC: Sexual changes in hemiparetic patients. Arch Phys Med Rehabil 72:202–207, 1991
Fugl-Meyer AR, Jaasko L: Post-stroke hemiplegia and sexual intercourse. Scand J Rehabil Med Suppl July:158–66, 1980
Sjogren K: Sexuality after stroke with hemiplegia. II. With special regard to partnership adjustment and to fulfillment. Scand J Rehabil Med 15:63–69, 1983
Hawton K: Sexual adjustment of men who have had strokes. J Psychosom Res 28:243–249, 1984
Sjogren K, Fugl-Meyer AR: Adjustment to life after stroke with special reference to sexual intercourse and leisure. Journal of Psychosomatic Research 26:409–417, 1982
Monga TN, Lawson JS, Inglis J: Sexual dysfunction in stroke patients. Arch Phys Med Rehabil 67:19–22, 1986
Coslett HB, Heilman KM: Male sexual function: Impairment after right hemisphere stroke. Arch Neurol 43:1036–1039, 1986
Sjogren K, Damber J, Liliequist B: Sexuality after stroke with hemiplegia. I. Aspects of sexual function. Scand J Rehabil Med 15:55–61, 1983
Muckleroy RN: Sex counseling after stroke. Medical Aspects of Human Sexuality 11(12):115–116, 1977
Goldberg RL: Sexual counseling for the stroke patient. Medical Aspects of Human Sexuality 21(6):86–92, 1987
Burnside IM: Intimacy and sexuality.In Nursing in the Aged: A Self-care Approach, IM Burnside. New York, Plenum Press, 1988, pp 448–483
Hogan R: Human Sexuality. New York, Appleton-Century, 1980
Hendricks J, Hendricks CD: Sexuality in later life.In An Aging Population, V Carter, P Liddiard (eds). New York, Holmes & Meier, 1979;
Kinsey AC, Pomeroy WB, Martin CE: Sexual Behavior in the Human Male. Philadelphia, Saunders, 1948
Kinsey AC, Pomeroy WB, Martin CE, Gebhard PH: Sexual Behavior in the Human Female. Philadelphia, Saunders, 1953
Masters WH, Johnson VE: Human Sexual Response. Boston, Little, Brown & Co., 1966
Becher EM: Love, Sex, and Aging: A Consumers Union Report. Mount Vernon, New York, Consumers Union, 1984
Masters WH, Johnson VE, Kolodny RC: Masters and Johnson on Sex and Human Loving. Boston, Little, Brown & Co., 1986
Ducharme S, Gill KM: Sexual values, training, and professional roles. J Head Trauma Rehabil 5:38–45, 1990
Glass JC, Dalton J: Sexuality in older adults: A continuing education concern. The Journal of Continuing Education in Nursing 19(2): 61–64, 1987
Finger WW, Stack-Hall E, Peterson FL: Sexuality and disability: A workshop for nursing practice. Journal of Sexuality and Disability (10)2:81–89, 1992
Renshaw DC: Stroke and sex.In Sexual Consequences of Disability, A Comfort (ed). Philadelphia, Stickley, 1974, pp 121–131
Kolodny RC, Masters WH, Johnson VE, Biggs MA: Textbook of Human Sexuality for Nurses. Boston, Little, Brown & Co., 1978
Garlinghouse NM: Sexuality of male vascular accident victims. Sexuality and Disability 8(2):67–72, 1987
Bohlen JG, Held JP, Wanderson MO, Patterson RP: Heart rate, rate-pressure product, and oxygen uptake during four sexual activities. Arch Intern Med 144:1745–1748, 1984
Nemec ED, Mansfield L, Kennedy JW: Heart rate and blood pressure responses during sexual activity in normal males. Am Heart J 92:274–277, 1976
Ziff SF: Symbolic sexual vocabulary for the severely speech impaired. Sexuality and Disability 7(1&2): 3–14, 1984–86
Goddess ED, Wagner NN, Silverman DR: Poststroke sexual activity of CVA patients. Medical Aspects of Human Sexuality 13(3):16–30, 1979
Wincze JP, Carey, MP: Sexual Dysfunction: A Guide for Assessment and Treatment. New York, Guilford Press, 1991
Binder LM: Emotional problems after stroke. Stroke 15:174–177, 1984
Ross ED, Rush AJ: Diagnosis and neuroanatomical correlates of depression in brain damaged patients. Arch Gen Psychiat 38:1344–1354, 1981
Kaplan HS: The Evaluation of Sexual Disorders. New York, New York, Brunner/Mazel, 1983
Anders EK, Bradley WE, Krane RJ: Nocturnal penile rigidity measured by the Snap-Gauge band. J Urol 129:964–966, 1983
Bradley WE: New techniques in evaluation of impotence. Urology 29:383–388, 1987
Weinberg JJ, Badlani GH: Utility of RigiScan and papaverine in diagnosis of erectile impotence. Urology 31:526–529, 1988
Giesbers AA, Bruins JL, Kramer JL, Jonas U: New methods in the diagnosis of impotence: RigiScan penile tumescence and rigidity monitoring and diagnostic papaverine hydrochloride injection. World J Urol 5:173–176, 1987
Allen R, Brendler, CB: Snap-Gauge compared to a full nocturnal penile tumescence study for evaluation of patients with erectile impotence. J Urol 143:51–54, 1990
Meisler AW, Carey MP: A critical reevaluation of nocturnal penile tumescence monitoring in the diagnosis of erectile dysfunction. J Nerv Ment Dis 178:78–89, 1990
Roose SP, Galssman AH, Walsh BT, Cullen K: Reversible loss of nocturnal penile tumescence during depression: A preliminary report. Neuropsychobiology 8:284–288, 1982
Garden FH: Sex after stroke. Medical Aspects of Human Sexuality 24(3):27–30, 1990
McCormick GP, Riffer DJ, Thompson MM: Coital positioning for stroke afflicted couples. Rehabilitation Nursing 11(2):17–19, 1986
Turner LA, Althof SE, Levine SB, Tobias TR, Kursh EK, Bodner D, Resnick MI: Treating erectile dysfunction with external vacuum devices: Impact upon sexual, psychological and marital functioning. J Urol 144:79–82, 1990
Fouda A, Hassouna M, Beddoe E, Kalageropoulos D, Binik YM, Elhilali MM: Priapism: An avoidable complication of pharmacologically induced erection. J Urol 142:995–997, 1989
Malloy TR, Malkowicz B: Pharmacologic treatment of impotence. Urol Clin North Am 14:297–305, 1987
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Finger, W.W. Prevention, assessment and treatment of sexual dysfunction following stroke. Sex Disabil 11, 39–56 (1993). https://doi.org/10.1007/BF01102308
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DOI: https://doi.org/10.1007/BF01102308