Sexuality is an important and central part of life. Beyond physical pleasure, sex helps strengthen a couple’s relationship and has been proven to be essential for maintaining and improving health and inspiring serenity and calm. After a stroke, patients might experience problems in sexual function for various reasons, sometimes due to feeling uncomfortable or ashamed, and sometimes as a result of functional failure. Sexual disruption can harm the couple’s relationship as they get back to routine and impact the quality of life of patients and their partners after the rehabilitation period.

Since in many cases disrupted sexual function is related to factors other than damage to the nervous system, patients can turn to sexual health professionals for help developing a rehabilitation program that will eventually restore their ability to function sexually.

Factors That Contribute To Decreased Sexual Function After a Stroke

• Depression and Anxiety
  Not infrequently, coming home after a period of hospitalization and rehabilitation leads to stress, anxiety and reduced independence. After a stroke, many patients are very afraid of having another stroke and suffer from low self-confidence due to brain damage and reduced independence, which can often result in depression.

• Motor Function Deficit
  One common characteristic of a stroke is motor function deficit. Often hemiparesis (one-sided weakness or paralysis) greatly limits movement and prevents patients from performing simple tasks independently. In many cases, this weakness goes away with time; but until the situation is resolved, patients experience difficulty with mobility. The motor damage is also reflected in reduced fine motor skills and coordination. In these cases, it is hard for couples to have sex normally, and sexual desire can significantly decrease as a result.

• Medications
  Patients are usually prescribed various medications after a stroke, including medication for lowering blood pressure to prevent a recurring stroke. The medication prescribed to at-risk patients for lowering blood pressure causes decreased sexual function and might even be connected to impotence.

• Difficulties With Language and Communication
  Many stroke patients suffer from communication disorders that manifest in difficulties with speech and understanding. These difficulties can impact the couple’s relationship and affect their level of attraction and desire to have sex.

Improving Sexual Function After a Stroke

There are several recommendations for improving sexual function after a stroke:

• Improving interpersonal communication
  Despite the difficulties, it is important for couples to work on good communication, which helps strengthen the relationship and brings the partners closer.

• Consulting a doctor about changing medication
  In many cases, it is possible to change some of the medications to reduce their effect on sexual function.

• Consulting professionals who are experts in the field
  Sexual consulting services are offered at rehabilitative hospitals, HMOs and private practices.

The following are details about specialized clinics in the field within rehabilitative hospitals:

The Center for Sexual Health, Reuth TLV Rehabilitation Hospital: Most of these services are offered privately.
Director: Professor Rafi Heruti
Sderot HaHayil 2, Tel Aviv (Yad Eliyahu)
03-6383680 | 03-6893712

Sexual Rehabilitation Clinic, Sheba Medical Center (Tel HaShomer): These services may be funded by your HMO (Form 17).
Director: Dr. Manuel Zwecker
Sheba Medical Center
03-5303842 | 03-5303718

Sexual Rehabilitation Clinic, Loewenstein Hospital: These services may be subsidized by your HMO (Form 17).
Director: Dr. Shlomit Shapira
Loewenstein Hospital, Fleischmann Building
09-7709104 | 09-7709034