Sexual Dysfunction Following Stroke

  • David C. Good
Part of the Current Clinical Neurology book series (CCNEU)


I am writing to you regarding one of my patients, in the hope you can help me. He suffered an ischemic stroke seven months ago and has shown considerable recovery. However, he has had problems with erectile dysfunction since that time. I cannot find in my references whether this occurs following a stroke. I would appreciate your thoughts concerning if this is a normal manifestation of this stroke, or if this problem could perhaps be due to something different. I am sorry to bother you with this question.


Sexual Activity Sexual Partner Stroke Patient Erectile Dysfunction Sexual Function 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Lefebvre KA. Sexual assessment planning. J. Head Trauma Rehabil. 1990; 5: 25–30.CrossRefGoogle Scholar
  2. 2.
    Monga TN, Lawson JS, Inglis J. Sexual dysfunction in stroke patients. Arch. Phys. Med. Rehabil. 1986; 67: 19–22.PubMedGoogle Scholar
  3. 3.
    Sjögren K, Fugl-Meyer AR. Adjustment to life after stroke with special reference to sexual intercourse and leisure. J. Psychosom. Res. 1982; 26: 409–417.PubMedCrossRefGoogle Scholar
  4. 4.
    Bray GP, DeFrank RS, Wolfe TL. Sexual functioning in stroke survivors. Arch. Phys. Med. Rehabil. 1981; 62: 286–288.PubMedGoogle Scholar
  5. 5.
    Fugl-Meyer AR, Jääkö L. Post-stroke hemiplegia and sexual intercourse. Scand. J. Rehabil. Med. 1980; 7: 158–166.Google Scholar
  6. 6.
    Agarwal A, Jain DC. Male sexual dysfunction after stroke. J. Assoc. Physicians India 1989; 37: 505–507.PubMedGoogle Scholar
  7. 7.
    Coslett HB, Heilman KM. Male sexual function: impairment after right hemisphere stroke. Arch. Neurol. 1986; 43: 1036–1039.PubMedCrossRefGoogle Scholar
  8. 8.
    Hawton K. Sexual adjustment of men who have had strokes. J. Psychosom. Res. 1984; 28: 243–249.PubMedCrossRefGoogle Scholar
  9. 9.
    Sjögren K, Damber J-E, Liliequist B. Sexuality after stroke with hemiplegia. I. Aspects of sexual function. Scand. J. Rehab. Med. 1983; 15: 55–61.Google Scholar
  10. 10.
    Boldrini P, Basaglia N, Calanca MC. Sexual changes in hemiparetic patients. Arch. Phys. Med. Rehabil. 1991; 72: 202–207.PubMedGoogle Scholar
  11. 11.
    Sjögren K. Sexuality after stroke with hemiplegia. Scan. J. Rehab. 1983; 15: 63–69.Google Scholar
  12. 12.
    Goddess ED, Wagner NN, Silverman DR. Poststroke sexual activity of CVA patients. Med. Aspects of Hum. Sex. 1979; 13: 16–30.Google Scholar
  13. 13.
    Monga TN, Ostermann HJ. Sexuality and sexual adjustment in stroke patients. Phys. Med. Rehabil.: State of Art Rev. 1995; 9: 345–359.Google Scholar
  14. 14.
    Aström M, Asplund K, Aström T. Psychosocial function and life satisfaction after stroke. Stroke 1992; 23: 527–531.PubMedCrossRefGoogle Scholar
  15. 15.
    Niemi M, Laaksonen MA, Kotila M, Waltimo O. Quality of life 4 years after stroke. Stroke 1988; 19: 1101–1107.PubMedCrossRefGoogle Scholar
  16. 16.
    Kinsella GJ, Duffy FD. Psychosocial readjustment in the spouses of aphasic patients. Scan. J. Rehab. Med. 1979: 11; 129–132.Google Scholar
  17. 17.
    Goldstein V, Regnery G, Willin E. Caretaker role fatigue. Nurs. Outlook 1981; 29 (1): 24–30.PubMedGoogle Scholar
  18. 18.
    Seidl A, Bullough B, Haughey B, Scherer Y, Rhodes M, Brown G. Understanding the effects of a myocardial infarction on sexual functioning: a basis for sexual counseling. Rehabil. Nurs. 1991; 16 (5): 255.PubMedCrossRefGoogle Scholar
  19. 19.
    Kavanagh T, Shephard RJ. Sexual activity after myocardial infarction. Can. Med. Assoc. J. 1977; 116: 1250–1253.PubMedGoogle Scholar
  20. 20.
    Hellerstein HK, Friedman EH. Sexual activity and the postcoronary patient. Arch. Intern. Med. 1970; 125: 987–999.PubMedCrossRefGoogle Scholar
  21. 21.
    Muller JE, Mittleman MA, Maclure M, Sherwood JB, Tofler GH. Triggering myocardial infarction by sexual activity. JAMA 1996; 275: 1405–1409.PubMedCrossRefGoogle Scholar
  22. 22.
    Monga TN, Deforge DA, Williams J, Wolfe LA. Cardiovascular responses to acute exercise in patients with cerebrovascular accidents. Arch. Phys. Med. Rehabil. 1988; 69: 937–940.PubMedGoogle Scholar
  23. 23.
    Monga TN, Monga M, Raina MS, Hardjasudarma M. Hypersexuality in stroke. Arch. Phys. Med. Rehabil. 1986; 67: 415–417.PubMedGoogle Scholar
  24. 24.
    Miller BL, Cummings JL, McIntyre H, Ebers G, Grode M, Hypersexuality or altered sexual preference following brain injury. J. Neurol. Neurosurg. Psychiatry 1986; 49: 867–873.PubMedCrossRefGoogle Scholar
  25. 25.
    Gorman DG, Cummings JL. Hypersexuality following septal injury. Arch. Neurol. 1992; 49: 308–310.PubMedCrossRefGoogle Scholar
  26. 26.
    Gerstenbrand F, Poewe W, Aichner F, Saltuari L. Klüver-Bucy syndrome in man: Experiences with posttraumatic cases. Neurosci. Biobehay. Rev. 1983; 7: 413–417.CrossRefGoogle Scholar
  27. 27.
    Ducharme S. Gil KM. Sexual values, training, and professional roles. J. Head Trauma Rehabil. 1990; 5: 38–45.CrossRefGoogle Scholar
  28. 28.
    Zencius A, Wesolowski MD, Burke WH, Hough S. Managing hypersexual disorders in brain-injured clients. Brain Inj. 1990; 4: 175–181.PubMedCrossRefGoogle Scholar
  29. 29.
    Freeman JT. Sexual capacities in the aging male. Geriatrics 1961; 16: 37–43.PubMedGoogle Scholar
  30. 30.
    Pfeiffer E, Verwoerdt A, Wang H-S. Sexual behavior in aged men and women. I. Observations on 254 community volunteers. Arch. Gen. Psychiatry 1968; 19: 753–758.PubMedCrossRefGoogle Scholar
  31. 31.
    Verwoerdt A, Pfeiffer E, Wang H-S. Sexual behavior in senescence. Changes in sexual activity and interest of aging men and women. J. Geriatr. Psychiatry 1969; 2: 163–180.Google Scholar
  32. 32.
    Skoog I. Sex and Swedish 85-year-olds. N. Eng. J. Med. 1996; 334: 1140–1141.CrossRefGoogle Scholar
  33. 33.
    Stein M, Chamberlain JW, Lerner SE, Gladshteyn M. The evaluation and treatment of sexual dysfunction in the neurologically impaired patient. J. Neuro Rehab. 1993; 7: 63–71.Google Scholar
  34. 34.
    Garden FH. Sexual function in the elderly. In: Felsenthal G, Garrison SJ, Steinberg FU (eds.), Rehahilitation of the Aging and Elderly Patient. Baltimore: Williams and Wilkins, 1994, 319–325.Google Scholar
  35. 35.
    Davidson JM, Kwan M, Greenleaf WJ. Hormonal replacement and sexuality in men. Clin. Endocrinol. Metab. 1982; 11: 599–623.PubMedCrossRefGoogle Scholar
  36. 36.
    Bray GP. Sexuality in aging. In: Williams TI (ed.), Rehabilitation in the Aging. New York: Raven, 1984, pp. 81–95.Google Scholar
  37. 37.
    Bachman GA. Sexual dysfunction in postmenopausal women: the role of medical management. Geriatrics 1988; 43: 79–83.Google Scholar
  38. 38.
    Labby DH. Aging’s effects on sexual function. Postgrad. Med. 1985; 78: 32–43.PubMedGoogle Scholar
  39. 39.
    Martin CE. Factors affecting sexual functioning in 60–79 year old married males. Arch. Sex Behay. 1981; 10: 399–420.CrossRefGoogle Scholar
  40. 40.
    Fowler FJ, Barry MT, Lu-Yao G, Roman A, Wasson J. Wennberg JE. Patient-reported complications and follow-up treatment after radical prostatectomy. Urology 1993; 42: 622–629.PubMedCrossRefGoogle Scholar
  41. 41.
    Shipley WU, Zietman AL, Hanks GE, Coen JJ, Caplan RI, Won M, Zagars GK, Asbell SO. Treatment-related sequelae following external beam radiation for prostate cancer: a review with an update in patients with stages T1 and T2 tumor. J. Urol. 1994; 152: 1799–1805.PubMedGoogle Scholar
  42. 42.
    Milne JF, Golden JS, Fibus L. Sexual dysfunction in renal failure: a survey of chronic hemodialysis patients. Int. J. Psychiatry Med. 1978; 8: 1977–1978.Google Scholar
  43. 43.
    Spencer RF, Raft D. Depression and diminished sexual desire. Med. Aspects Hum. Sex. 1977; 11: 58–61.Google Scholar
  44. 44.
    Mathew RJ, Weinman ML. Sexual dysfunctions in depression. Arch. Sex Behay. 1982; 11 (4): 323–328.CrossRefGoogle Scholar
  45. 45.
    Alexander D. Depression and cognition as factors in recovery. In: Good DC and Conch JR, (eds.), Handhook of Neurorehahilitation. New York: Marcel Dekker, 1994, 129–152.Google Scholar
  46. 46.
    Aström M, Adolfsson R, Asplund K. Major depression in stroke: a 3-year longitudinal study. Stroke 1993; 24: 976–982.PubMedCrossRefGoogle Scholar
  47. 47.
    Zemel P. Sexual dysfunction in the diabetic patient with hypertension. Am. J. Cardiol. 1988; 61: 27H - 33H.PubMedCrossRefGoogle Scholar
  48. 48.
    Ellenberg M. Sexual function in diabetic patients. Ann. Intern. Med. 1980; 92: 331–333.PubMedGoogle Scholar
  49. 49.
    Lipson LG. Treatment of hypertension in diabetic men: problems with sexual dysfunction. Am. J. Cardiol. 1984; 53: 46A - 50A.PubMedCrossRefGoogle Scholar
  50. 50.
    Jensen SB. Diabetic sexual dysfunction: A comparative study of 160 insulin treated diabetic men and women and age-matched control group. Arch. Sex. Behay. 1981; 10: 493–504.CrossRefGoogle Scholar
  51. 51.
    Ellenberg M. Impotence in diabetes: the neurologic factor. Ann. Intern. Med. 1971; 75: 213–219.PubMedGoogle Scholar
  52. 52.
    Faerman I, Vilar O, Rivarola MA, Rosner JM, Jadzinsky MN, Fox D, Lloret AP, Bertein-Hahn L, Saraceni D. Impotence and diabetes: studies of androgenic function in diabetic impotent males. Diabetes 1972; 21: 23–30.PubMedGoogle Scholar
  53. 53.
    Gaskell P. The importance of penile blood pressure in cases of impotence. Can. Med. Assoc. J. 1971; 105: 1047–1051.PubMedGoogle Scholar
  54. 54.
    Abelson D. Diagnostic value of the penile pulse and blood pressure: a Doppler study of impotence in diabetics. J. Urol. 1975; 113: 636–639.PubMedGoogle Scholar
  55. 55.
    Kolodny RC. Sexual dysfunction in diabetic females. Diabetes 1971; 20: 557–559.PubMedGoogle Scholar
  56. 56.
    Tyrer G, Steel JM, Ewing DJ, Bancroft J, Warner P, Clarke BF. Sexual responsiveness in diabetic women. Diabetologia 183; 24: 166–171.Google Scholar
  57. 57.
    Brock GB, Lue TE Drug-induced male sexual dysfunction: an update. Drug Safety 1993; 8: 414–426.PubMedCrossRefGoogle Scholar
  58. 58.
    Weiss RJ. Effects of antihypertensive agents on sexual function. Am. Fam. Physician 1971; 44: 2075–2082.Google Scholar
  59. 59.
    Bansal S. Sexual dysfunction in hypertensive men: a critical review of the literature. Hypertension 1988; 12: 1–10.PubMedCrossRefGoogle Scholar
  60. 60.
    Prisant LM, Can AA, Bottini PB, Solursh DS, Solursh LP. Sexual dysfunction with antihypertensive drugs. Arch. Intern. Med. 1994; 154: 730–736.PubMedCrossRefGoogle Scholar
  61. 61.
    Duncan L, Bateman DN. Sexual function in women: do antihypertensive drugs have an impact? Drug Safety 1993; 8: 225–234.PubMedCrossRefGoogle Scholar
  62. 62.
    Finklestein SP, Weintraub RJ, Karmon ZN, Askinazi G, Davor G, Baldessarini RJ. Antidepressant drug treatment for post-stroke depression: retrospective study. Arch. Phys. Med. Rehabil. 1987; 68: 772–776.PubMedGoogle Scholar
  63. 63.
    Robinson RG, Lipsey JR, Price TR. Diagnosis and clinical management of post-stroke depression. Psychosomatics 1985; 26: 769–778.PubMedCrossRefGoogle Scholar
  64. 64.
    Reding MJ, Orto LH, Winter SW, Fortuna I, DiPonte P, McDowell E Antidepressant therapy after stroke: a double-blind trial. Arch. Neurol. 1986; 43: 763–765.Google Scholar
  65. 65.
    Balon R, Yeragani VK, Pohl R, Ramesh C. Sexual dysfunction during antidepressant treatment. J. Clin. Psychiatry 1993; 54: 209–212.PubMedGoogle Scholar
  66. 66.
    Gitlin MJ. Psychotropic medications and their effects on sexual function: diagnosis, biology and treatment approaches. J. Clin. Psychiatry 1994; 55: 406–413.PubMedGoogle Scholar
  67. 67.
    Aldridge SA. Drug-induced sexual dysfunction. Clin. Pharmacol. 1982; 1: 141–147.Google Scholar
  68. 68.
    Smith PJ, Talbert RL. Sexual dysfunction with antihypertensive and antipsychotic agents. Clin. Pharmacol. 1986; 5: 373–384.Google Scholar
  69. 69.
    Annon JS. The PLISSIT model: A proposed conceptual scheme for behavioral treatment of sexual problems. J. Sex Educ. Ther. 1976; 2 (2): 1–15.Google Scholar
  70. 70.
    Burgener S, Logan G. Sexuality concerns of the post-stroke patient. Rehabil. Nurs. 1989; 14 (4): 178–181.PubMedCrossRefGoogle Scholar
  71. 71.
    Conine TA, Evans JH. Sexual reactivation of chronically ill and disabled adults. J. Allied Health 1982; 11: 261–270.PubMedGoogle Scholar
  72. 72.
    McCormick GP, Riffer DJ, Thompson MM. Coital positioning for stroke afflicted couples. Rehabil. Nurs. 1986; 11 (2): 17–19.PubMedCrossRefGoogle Scholar
  73. 73.
    Hubert W. Psychotropic effects of testosterone. In: Nieschlag EB and Behre HM (eds.), Testosterone: Action, Deficiency, Substitution. Berlin: Springer-Verlag, 1990, pp. 51–71.Google Scholar
  74. 74.
    Heller L, Keren O, Aloni R, Davidoff G. An open trial of vacuum penile tumescence: constriction therapy for neurological impotence. Paraplegia 1992; 30: 550–553.PubMedCrossRefGoogle Scholar
  75. 75.
    Aloni R, Heller L, Keren O, Mendelson E, Davidoff G. Noninvasive treatment for erectile dysfunction in the neurogenically disabled population. J. Sex Marital Ther. 1992; 18 (3): 243–249.PubMedCrossRefGoogle Scholar
  76. 76.
    Lipshultz LI. Injection therapy for erectile dysfunction. N. Engl. J. Med. 1996; 334: 913–914.PubMedCrossRefGoogle Scholar
  77. 77.
    Kerfoot WW, Carson CC. Pharmacologically induced erections among geriatric men. J. Urol. 1991; 146: 1022–1024.PubMedGoogle Scholar
  78. 78.
    Borges FD. A new approach to the pharmacologic treatment of impotence. Int. J. Impot. Res. 1994; 6: 137–143.PubMedGoogle Scholar
  79. 79.
    Lewis JH. Treatment options for men with sexual dysfunction. J. ET Nurs. 1992; 19: 131–142.PubMedGoogle Scholar

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© Springer Science+Business Media New York 1997

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  • David C. Good

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