Talking about sex and intimacy is still sometimes a taboo and sensitive topic. However, concerns about having sex after a stroke is a valid concern. You may be worried that you may have another stroke during sex, you may be concerned about being able to perform or “get up”, you may struggle to feel sexy after your stroke, or you may feel embarrassed by things like incontinence.
Will I have another stroke during sex?
The good news is that your chance of having a stroke during sex is relatively low. Although your heart rate may increase and your breathing may become heavier, having sex takes about as much energy as walking up 1 to 2 flights of stairs. Also, remember sex does not have to be a fast-paced activity. It is okay to slow down.
It is also important to talk to your doctor about resuming sexual activity as they would be most informed about any potential risks and when it would be safe for you to start having sex again.
Where did my sex drive go?
You may find that your sex drive is at an all-time low. This can be particularly frustrating for many people. There could be several explanations for your change in sex drive. It could be related to decreased self-esteem, uncertainty about your current or future relationships, stress over finances, depression and or medications such as antidepressants or high blood pressure medications, or even damage to the sex areas of the brain.
It is important to try to identify what may be standing in the way of your desire to have sex. If you think it could be your medications, it is important to discuss your concerns with your doctor. However, please do not stop taking your medications without first talking with your doctor. If you think it may be related to anxiety or depression you will also want to seek professional guidance for this as well.
How can I help position myself better after a stroke?
Finding the best position during sex can be difficult after having a stroke. Normal pillows may help with positioning, but you may find using wedges, straps, and slings more beneficial.
Here is a download of sex positions you could try with your partner: https://www.uhn.ca/TorontoRehab/Clinics/Outpatient_Stroke_Services/Documents/Comfortable_Sex_Positions_Patients_Who_Have_Had_Stroke.pdf (don’t worry they aren’t explicit photos!)
What can I do about my incontinence?
Understandably, urinary or bowel incontinence can be embarrassing. Here’s a few tips that may help:
- Use the bathroom before having sex
- Limit the amount of liquid you drink before having sex
- Avoid positions that may put too much pressure on the bladder
- If possible, cover the bed or chair with plastic or an incontinence pad (if the incontinence pad doesn't help you feel sexy consider placing a towel over the incontinence pad to disguise it).
- If you have a catheter, it is still possible to have sex, BUT I would strongly recommend consulting with your doctor for the best solution for you.
How can I prevent pregnancy after my stroke?
If you are a woman of childbearing age, it is important to talk to your doctor about alternative contraceptive options. Unfortunately, since birth control pills increase the risk for having blood clots, it is not always the best option for stroke survivors. If you are wanting to get pregnant, it is important to know that pregnancy for a stroke survivor is often considered high risk and it will be vital to discuss family planning with your doctor.
I have difficulty communicating with my partner during sex, what can I do?
When verbal language fails, try using nonverbal language to expressive your love and needs. You can do this through touching, pointing, caressing, gesturing, or demonstrating. It may be difficult, awkward, or time consuming at first, but slowly you and your partner will learn new ways to express yourselves!
I want to have sex, but I’m too tired!
Post-stroke fatigue is common after a stroke. You may find it helpful to plan for and schedule in time to have sex. I know scheduling in sex can be “unsexy.” However, it is important that you don’t do anything strenuous before your night of fun and intimacy. It will also be important to plan for plenty of time to rest after having sex so that you give yourself time to recharge.
What if I laugh or cry during sex? I can’t control it!
When you laugh or cry uncontrollably during what often can seem during an inappropriate time, this is called pseudobulbar affect. Pseudobulbar affect occurs in 25 to 50% of stroke survivors and is nothing to be ashamed of. My best advice would be communicate with and educate your partner on this phenomenon. It will help your partner to better understand if you have an episode during sex. It was also help them not overreact to the situation and it will help you to be more comfortable and relaxed if it occurs.
Take your time and have fun.
Ultimately, sex should be fun and make you feel good. Take the time you need to explore and get to know your body after your stroke. When you are ready, slowly invite your sex partner into your world. Remember, communication is important whether verbal or nonverbal and having a sense of humor will help you get through what may start off as awkward or embarrassing. This is no easy task, but it is possible to have a healthy sex life after your stroke!
