Stroke and sexual functioning: A literature review.

BACKGROUND: Stroke has multiple impacts on patients' sexual functioning, be it directly caused by the neurological lesion (s) or indirectly triggered via other psychophysiological processes. Despite a growing number of publications, sexuality is still rarely addressed in the stroke literature - yet, patients have indicated their need for sexual rehabilitation services. OBJECTIVE: To provide a literature review on post-stroke sexual functioning as well as available rehabilitation programs targeting patients' sexuality. METHODS: A systematic literature review was conducted on PubMed using the following key words and their combination: "stroke", "sexuality", "stroke characteristics", "hemisphere", "sexual", and "sexual dysfunction". RESULTS: Existing data suggests the existence of significant associations between stroke and male and female sexual dysfunction (SD) as well as desire/libido and sexual satisfaction. The exact contribution of patients' neurological profile (stroke laterality, location, and severity) on their SD remains inconclusive with research providing mixed findings. Psychological factors are shown to play a significant part in the development of patients' SDs. A few intervention programs have been developed to specifically guide health professionals when addressing patients' needs regarding their sexual recovery. CONCLUSION: Sexual rehabilitation needs to be an integrative part of stroke patients' rehabilitation process, preferably at the interdisciplinary level.