The Relevance of Sexual Responsiveness to Sexual Function in Male Stroke Patients

Abstract

Introduction Stroke may have negative consequences for the patients’ quality of life, including sexual function. Whereas physical impairment will influence sexual positions and movement during sex, depression and medication may reduce sexual desire. So far, data on sexual dysfunction after stroke are scant. Although some support for physical as well as psychological explanations has been shown, further research to find the remedies for those patients with sexual problems after stroke is needed. The focus of the present study is on the identification of relevant psychological factors. Aim The aim of this study was to study the impact of anxiety, depression, and sexual responsiveness on sexual function in male stroke patients. Methods Nineteen male stroke patients completed a number of self-report measures to assess psychological and sexual factors. Main Outcome Measures Sexual function based on the International Index of Erectile Function, anxiety and depression based on the Symptom Checklist-90, and sexual responsiveness based on the Sexual Inhibition/Sexual Excitation Scale, including propensities for sexual excitation and sexual inhibition as a result of both performance failure and performance consequences, were assessed. Results Sexual excitation was positively related to sexual desire, whereas inhibition because of the threat of performance failure was negatively related to orgasmic function and sexual desire (P < 0.01). Patients with high levels of inhibition because of threat of performance failure were more likely to report low scores on overall sexual function than those with low levels. Conclusions Although the statistical power is rather low, the results show the relevance of sexual responsiveness to sexual function in male stroke patients. The present study can be considered as a first step toward building a theoretical framework of relevant psychological and physical factors, which is needed to develop adequate interventions for those patients with sexual problems after stroke.

Determinants of sexual function and dysfunction in men and women with stroke: A systematic review

“…Of the 19 studies reviewed, the global rating of quality resulted in five studies rated as moderate and 14 studies that were weak . There were no studies meeting the criteria for a strong rating.…”

“…There were seven studies that focused on men exclusively, twelve studies that included both men and women, and two studies that included patients and spouses . In regards to design, there were 13 descriptive studies, all with a weak global quality rating. There were three case‐control studies, all rated as moderate; one cohort analytic intervention study rated as moderate; and two randomised controlled trials (RCT), with one rated as weak and one as moderate in quality .…”

“…Duits et al. note that sexual inhibition affected both sexual desire and orgasmic function in stroke patients, and was amplified by fear of performance failure . Other factors contributing to sexual dysfunction were memory difficulties, emotional changes, communication difficulties, mobility and functional problems and social participation .…”

“…It would be important for studies to report baseline function prestroke compared with poststroke function. NIHSS scores were only reported in five studies, and this information would be more meaningful if interpreted with the location of the lesion. For example, NIHSS is less discriminatory for posterior circulation strokes .…”

Male Sexual Disorders Following Stroke: An Overview

“…The dual-control model of male sexual responsiveness, developed to explain psychogenic ED, assumes that individuals vary in their propensity for inhibition and excitation (Bancroft & Janssen, 2000) and that these propensities can be regarded as personality traits specifically related to sexuality. Duits, van Oirschot, van Oostenbrugge, and van Lankveld (2009)…”