Sex After Stroke: What Couples Need to Know

Henry Hoffman
Monday, April 17th, 2017
Last modified on October 19th, 2022

Sex After Stroke What Couples Need to Know, Sex After a Stroke

The subject of sex can be sensitive for many stroke survivors. A stroke can come with enormous physical and emotional changes that may affect your desire, abilities, and confidence. While it does present new challenges to overcome, it is not only possible to have a healthy sex life after stroke, but it can also be a key aspect to getting back into a normal routine.

There are many concerns that stroke survivors may have when resuming sexual intimacy with their partners. They may be worried about having a second stroke, incontinence, or even impotence. Resuming sexual relations can be difficult for the survivor’s partner as well. How do you switch from a caretaker role to the role of their lover?

Before resuming sexual relations after stroke, you should speak to your doctor about any concerns you may have. They will be able to let you know when it is safe to start having sex again. Once you have the go ahead from a medical professional, communicate with your partner and make sure you are both ready to take that step.

Romantic senior couple sitting on a sofa and looking at camera. Portrait of a mature couple enjoying their retirement. Happy smiling senior couple embracing together at home.

Common Concerns When Becoming Intimate After Stroke


Post-stroke depression affects more than a third of stroke survivors. Depression can affect a stroke survivor’s sex life in many ways. Some of the common symptoms of depression, like loss of interest in activities, fatigue, feelings of worthlessness, and short-term memory loss, can make it difficult to focus on an activity like lovemaking. Depression can also reduce libido, making sex even more of a challenge.

While there are treatment options for depression, many of the drugs that help treat it can reduce libido as well. This can be extremely frustrating and difficult to overcome. If you are experiencing symptoms of depression or a reduced libido due to your medication, talk to your doctor about your options. You may be able to find medication with fewer side effects and start seeing a counselor that can help rebuild your relationship with your partner.


Communication is key to a healthy sex life, but this can be difficult if you or your partner is suffering from speech or language difficulties after their stroke. Luckily, there are plenty of ways to communicate love nonverbally. Through touching, caressing, and gestures, you can still express your sexuality with your partner. Communicating without the language you’re used to can be difficult at first. Don’t be afraid to go slowly and get used to expressing yourself in a new way.


It is common after a stroke for one side of the body to be paralyzed or weaker than the other side. Depending on the severity and location of the paralysis, you might have to alter the positions you are used to in order to find something comfortable for you and your partner. For example, if the man is paralyzed or very weak on both sides, he won’t be able to be on top. Pillows can be helpful when trying out new positions. It is important to keep experimenting until you find a position that is comfortable for both of you.

Stroke During Sex

One of the biggest concerns stroke survivors and their partners have when resuming sexual relations is the possibility of it causing them to have a second stroke. However, it is extremely unlikely that sex will put someone at risk for having another stroke. While your heart rate and breathing will increase, you are only expending about the same amount of energy as if you were climbing two flights of stairs.

Switching Roles

When one person in a relationship has a stroke, their partner will often take on a caretaker role. If you’re feeling more like your partner’s parent than their lover, it can be hard to be romantic with them. If switching roles is a struggle for you, you may need to hire someone to give you a break from providing daily care. It is also important to make time to have fun with your partner. Laughing and playing together can help strengthen a relationship.

Birth Control

For women of childbearing age, it is important to talk to a doctor about family planning. A pregnancy for a stroke survivor will be considered high risk. Birth control pills increase the possibility of blood clots, so they are generally not safe for stroke survivors, therefore other contraceptive options should be discussed with a doctor.


Incontinence after stroke can be uncomfortable and embarrassing, but it is an incredibly common problem that many stroke survivors overcome. If you are afraid of having an accident during sex, it can be hard to feel comfortable and relax. It is important to talk to your partner about your concerns so that they can reassure you and help you take steps to minimize the likelihood of an accident. Before having sex, limit the amount of liquids you drink and use the restroom. Avoid positions that put too much pressure on the bladder. You can also cover the bed with plastic or an incontinence pad to make an accident less of a mess if it occurs.


If you are struggling to keep an erection after your stroke, it is important to speak with your doctor, as it could be a sign of other health problems. Your doctor can also suggest options for treatment. Corrective medicines can put men at risk for heart attack, especially if they are taking certain medications for high blood pressure. You should never stop taking your blood pressure medication in order to take corrective medicines. Some other options to help with impotence include vacuum pumps, injections, and penile implants.

Be Open to Change after a Stroke

Middle-aged couple embracing in front of house

Most concerns stroke survivors have about resuming sexual relations after a stroke can be addressed and overcome, but they might just take a little work and getting used to. Being open to change can help make the process easier for both partners and help get your relationship and sex life back on track.

All content provided on this blog is for informational purposes only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. If you think you may have a medical emergency, call your doctor or 911 immediately. Reliance on any information provided by the Saebo website is solely at your own risk.

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