Comparison: we compared interventions such as medications against 'fake' medications, which do not contain active substances that a ect sexual function. We compared interventions such as rehabilitation, education, or therapy to usual care or alternative treatment.Outcome: we divided outcomes into primary and secondary outcomes. Primary outcomes focused on sexual function or sexual satisfaction in stroke survivors and their partners. Secondary outcomes focused on quality of life, psychological well-being (anxiety, depression, stress), satisfaction with intervention, sexual knowledge, and marital/relationship satisfaction (including partner satisfaction) in stroke survivors and their partners. We also reported adverse events.Time/duration: we included studies of all durations: short (≤ 6 months), medium (between 6 and 18 months), and long (≥ 18 months). Key resultsWe found three trials designed to reduce sexual dysfunction a er stroke. One trial compared a medication called sertraline to methylcobalamin (vitamin B12) to help with premature ejaculation. A second trial compared a structured rehabilitation programme (which had face-to-face counselling and written education) to written education alone and found no clear di erence in terms of sexual function, mood, stress, or quality of life. A third trial compared pelvic floor training (exercises to strengthen pelvic floor muscles) to standard rehabilitation and found no clear di erences in terms of erection and quality of life. We were uncertain of the results because all three trials were small and of low or very low quality. Also, each trial compared di erent treatments, which meant that results could not be combined.Side e ects (mostly nausea or diarrhoea) were reported for sertraline (20 of 58 participants). No harmful events were reported with pelvic floor training, and no information was provided on harmful events related to sexual rehabilitation. Study funding sourcesThe study that compared the medication (sertraline) to vitamin B12 did not describe any funding sources. The study that compared pelvic floor training to standard rehabilitation was funded through grants from the Association of Danish Physiotherapists Research Foundation, the Association of Danish Physiotherapists Practise Foundation, the Foundation of 12.12.1981, Lykkefeldts Grant,

Comparison: we compared interventions such as medications against 'fake' medications, which do not contain active substances that a ect sexual function. We compared interventions such as rehabilitation, education, or therapy to usual care or alternative treatment.Outcome: we divided outcomes into primary and secondary outcomes. Primary outcomes focused on sexual function or sexual satisfaction in stroke survivors and their partners. Secondary outcomes focused on quality of life, psychological well-being (anxiety, depression, stress), satisfaction with intervention, sexual knowledge, and marital/relationship satisfaction (including partner satisfaction) in stroke survivors and their partners. We also reported adverse events.Time/duration: we included studies of all durations: short (≤ 6 months), medium (between 6 and 18 months), and long (≥ 18 months). Key resultsWe found three trials designed to reduce sexual dysfunction a er stroke. One trial compared a medication called sertraline to methylcobalamin (vitamin B12) to help with premature ejaculation. A second trial compared a structured rehabilitation programme (which had face-to-face counselling and written education) to written education alone and found no clear di erence in terms of sexual function, mood, stress, or quality of life. A third trial compared pelvic floor training (exercises to strengthen pelvic floor muscles) to standard rehabilitation and found no clear di erences in terms of erection and quality of life. We were uncertain of the results because all three trials were small and of low or very low quality. Also, each trial compared di erent treatments, which meant that results could not be combined.Side e ects (mostly nausea or diarrhoea) were reported for sertraline (20 of 58 participants). No harmful events were reported with pelvic floor training, and no information was provided on harmful events related to sexual rehabilitation. Study funding sourcesThe study that compared the medication (sertraline) to vitamin B12 did not describe any funding sources. The study that compared pelvic floor training to standard rehabilitation was funded through grants from the Association of Danish Physiotherapists Research Foundation, the Association of Danish Physiotherapists Practise Foundation, the Foundation of 12.12.1981, Lykkefeldts Grant, the Foundation of Lundbeck (UCSF), and the