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Sex and relationships

Managing sex and intimate relationships after a stroke or when living with a neurological condition can be difficult for some. Health professionals may also find it hard to discuss this sensitive topic or feel able to offer appropriate help and support.

The National Clinical Guideline for Stroke (2023) makes a number of recommendations:

A People with stroke should be asked, soon after discharge and at their 6-month and annual reviews, whether they have any concerns about sex.  Partners should also have an opportunity to raise any problems.

B People with sexual dysfunction after stroke who want further help should be:

  • assessed for treatable causes including a medication review;
  • reassured that sexual activity is not contraindicated after stroke and is extremely unlikely to precipitate a further stroke;
  • assessed for erectile dysfunction and the use of a phosphodiesterase type 5 inhibitor (e.g. sildenafil);
  • advised against the use of a phosphodiesterase type 5 inhibitor for 3 months after stroke and/or until blood pressure is controlled;
  • referred to a professional with expertise in psychosexual problems if sexual dysfunction persists.