Sexuality after stroke with hemiplegia. I. Aspects of sexual function

In a consecutive series of 51 one-stroke hemiplegics some aspects of sexuality were investigated using structured interviews. Findings were related to treatment with anti-hypertensive drugs. In most subjects the site of brain lesion was visualized by X-ray methods. Moreover, in a sub-sample of 15 consecutive males LH, FSH and prolactin were assessed using standard clinical radioimmunoassay techniques. Serum testosterone including response to HCG-stimulation was also measured. Both in males and females frequency of intercourse and durations of foreplay and of intercourse were markedly reduced. For the males erectile problems were rare before but occurred for the majority after stroke. For the females, but not for the males, orgastic dysfunction was relatively common pre-stroke. After the stroke such dysfunction occurred for 75% of the females and 64% of the males. Partnership sexual drive also decreased. Each of the 15 males hormonally screened had values within the predicted normal and responses to HCG-stimulation were also adequate. Moreover, actual levels of hormones were associated neither with change in sexual function nor with the sexual function per se at the time of the investigation. Thus, in this sample hormonal disarrangement did not appear to be the cause of sexual dysfunction. Surprisingly, no association between erectile dysfunction and use of anti-hypertensive drugs occurred. We believe that sexual dysfunctions in hemiplegics may rather be explained in terms of coping than by endocrine deficits or by anti-hypertensive treatment.