Stroke and sexual functioning: A literature review

Grenier-Genest, Anabelle; Gérard, Marina; Courtois, F.

doi:10.3233/nre-001481

Cited by 36 publications

(26 citation statements)

References 62 publications

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“…Importantly, more than threequarters of HCPs in this study reported having little or no knowledge about working with sexual health after stroke. Similar findings have been reported by others (8,17,20,21) as one of the major barriers to provide information about sexuality to patients and their partners. Most HCPs expressed a need for knowledge within several areas of sexual medicine/ sexology and preferred an interdisciplinary model for sexological education and training.…”

Section: Perceived Low Level Of Knowledge: a Barrier To Be Overcomesupporting

confidence: 90%

“…HCPs' age and gender were not found to be associa ted with level of comfort addressing sexuality, while those reporting a higher level of knowledge were more likely to feel comfortable. This confirmed previous studies describing knowledge as an important factor for being comfortable (8,21). Being employed at centres scoring high on sexual health policy was also asso ciated with being comfortable addressing sexuality.…”

Section: Perceived Low Level Of Comfort: a Multifactorial Barriersupporting

confidence: 88%

“…Given the complexity of the impact of stroke and the diversity of sexual problems, we believe that expertise should be available in the interdisciplinary team. The need for training and education in sexual health among all professions is emphasized by others (8). Perceived lack of knowledge is a barrier that can be overcome by supporting the correct education and training in sexual health.…”

Section: Perceived Low Level Of Knowledge: a Barrier To Be Overcomementioning

confidence: 99%

“…I nternational guidelines on stroke recommend that sexual health should be addressed as an integral part of standard stroke care (1)(2)(3)(4)(5)(6). There is a high preva lence of sexual problems and dysfunction among stroke survivors and their partners (7)(8)(9). A previous multina tional study, conducted within the same research net work as the present study, found that patients reported their sexual life to be one of the most dissatisfactory areas in life (10,11), confirming the need for sexual rehabilitation after stroke.…”

mentioning

confidence: 99%

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Sexual health policies in stroke rehabilitation: A multi national study

Vikan¹,

Nilsson²,

Bushnik³

et al. 2019

J Rehabil Med

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Stroke survivors and their partners have been found to have unmet sexual rehabilitation needs. Stroke guidelines recommend that sexual health should be part of standard care, but sexuality is not consistently addressed in stroke rehabilitation. This study explored sexual health policies at 9 specialized stroke rehabilitation centres around the world and the perspectives of health care personnel on working with sexual health. Five centres had routines on sexual health, while 4 had few or none. Personnel working at centres with routines felt more knowledgeable and comfortable working with sexual health, and responded more positively to having routines at their workplace concerning sexual health than did personnel at centres having few or no such routines. Those who felt comfortable more often felt knowledgeable addressing sexuality and more often worked at a centre having routines on sexual health. Sexual health policies should be implemented in stroke care in order to meet the needs of patients and their partners. Objective: To identify and explore sexual health policies at specialized stroke rehabilitation centres in relation to the perspectives of healthcare personnel concerning sexual health. Design: Cross-sectional study. Subjects: Nine specialized rehabilitation centres representing 7 countries, and healthcare personnel (n = 323) working with stroke rehabilitation at the 9 centres were included in the study. Methods: Two structured questionnaires were used: (i) an organizational-audit on sexual health policies; (ii) an anonymous web-questionnaire assessing the perspectives of healthcare personnel concerning sexual health. Results: Of the 9 centres, 5 scored high on having sexual health policy in stroke rehabilitation and 4 scored low. Healthcare personnel working at centres with high scores reported higher levels of knowledge and comfort in working with sexual health, and looked more positively on the workplace sexual health policies, than personnel working at centres scoring low on these factors. Most personnel expressed a need for knowledge on the topic. Being comfortable about addressing sexuality was significantly associated with higher levels of knowledge about sexuality and working at centres having sexual health policies. Conclusion: A lack of sexual health policy represents a barrier to evidence-based practice in stroke rehabilitation. Such protocols need to be implemented in standard care in order to meet the sexual rehabilitation needs of stroke patients and partners.

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Section: Perceived Low Level Of Knowledge: a Barrier To Be Overcomesupporting

confidence: 90%

Section: Perceived Low Level Of Comfort: a Multifactorial Barriersupporting

confidence: 88%

Section: Perceived Low Level Of Knowledge: a Barrier To Be Overcomementioning

confidence: 99%

mentioning

confidence: 99%

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Sexual health policies in stroke rehabilitation: A multi national study

Vikan¹,

Nilsson²,

Bushnik³

et al. 2019

J Rehabil Med

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show abstract

“…22 Prevalence of sexual complaints in the present study was among the highest reported compared to previous findings on sexuality after stroke. [12][13][14] Experiencing manifest sexual complaints is more likely to cause ongoing distress than those occurring occasionally, 44 explaining the strong association to sexual dissatisfaction. In gender-specific analyses, only sexual complaints perceived as distressing turned out to be significant for sexual satisfactions in both women and men.…”

Section: Discussionmentioning

confidence: 99%

Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation

et al. 2021

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Introduction: The consequences of stroke on sexual life in stroke patients in need of specialized cognitive rehabilitation have been limited explored. A biopsychosocial perspective in post-stroke sexuality studies is warranted to capture the complex picture of stroke consequences and sexual life after stroke and sexual satisfaction is an important outcome measure when exploring such multifactorial associations. Aim: To explore sexual satisfaction and associated biopsychosocial factors in stroke patients admitted to specialized cognitive rehabilitation. Methods: A cross-sectional study was performed including 91 consecutive stroke patients admitted to specialized cognitive rehabilitation. Data were collected from medical records and by face-to-face interviews using a structured interview guide and questionnaires. Descriptive and inferential statistics were applied. Main outcome measures: A wide range of biopsychosocial variables including medical and sociodemographic characteristics, social support, sexual complaints, aspects of sexual life, psychological distress and life satisfaction were analyzed in relation to the main outcome "Satisfaction with sexual life." Results: Only 33 % were satisfied with sexual life. Prevalence of sexual complaints was high, more frequent in women (84%) than in men (64%). Three-quarters were less sexually active than before stroke. Multivariable analyses showed that anxiety, sleep problems, manifested sexual complaint, decrease in sexual activity and fear of partner rejection were significantly associated with low odds of sexual satisfaction, while affectionate support and partnership satisfaction were significant for sexual satisfaction. When combined in a biopsychosocial multivariable model only fear of partner rejection (OR 0.07; 95 % CI: 0.01−0.42) and decrease in sexual activity (OR 0.11; 95 % CI: 0.02−0.58) showed significant contribution to sexual satisfaction. Conclusion:The variety of predictors for sexual satisfaction indicates that therapeutic actions need to be individualized and points towards a broad assessment and interventional approach to meet the sexual rehabilitation needs of stroke patients with cognitive impairments in need of specialized rehabilitation. Vikan JK, Snekkevik H, Nilsson MI, et al. Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation. Sex Med 2021;XX:XXXXXX.

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Interventions for sexual dysfunction following stroke

Stratton

Sansom

Brown-Major

et al. 2020

Cochrane Database of Systematic Reviews

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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,

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Stroke and sexual functioning: A literature review

Abstract: Sexual rehabilitation needs to be an integrative part of stroke patients' rehabilitation process, preferably at the interdisciplinary level.

Cited by 36 publications

References 62 publications

Sexual health policies in stroke rehabilitation: A multi national study

Sexual health policies in stroke rehabilitation: A multi national study

Sexual Satisfaction and Associated Biopsychosocial Factors in Stroke Patients Admitted to Specialized Cognitive Rehabilitation

Interventions for sexual dysfunction following stroke

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