Impaired sexual activity in young ischaemic stroke patients: an observational study

Background and purposeThe present study sought to determine the impact of stroke on sexual function and well-being in a cohort of young ischaemic stroke patients and identify factors associated with impairment. MethodsOver a 2-year period, all patients aged 60 or under with ischaemic stroke or transient ischaemic attack (n=156) were included. Information on sexual function and well-being was obtained by means of a paper questionnaire mailed to participants 1year after their stroke. Impaired sexual activity (ISA) was defined as a decline in sexual function and/or satisfaction. Psychological well-being was evaluated on the Hospital Anxiety and Depression Scale (HADS). ResultsThe response rate was 67% (n=104). Thirty of these responders (29%) reported ISA. Patients with ISA had a higher HADS score (19.7 vs. 11.2 in patients with no impairment; P<0.001), anxiety score (10.0 vs. 6.3; P<0.001) and depression score (8.7 vs. 4.8; P<0.001) and were more likely to have left brain lesions (70% vs. 30%; P<0.001) and use angiotensin-converting enzyme (ACE) inhibitors (73% vs. 31%; P<0.001) and diuretics (50% vs. 19%; P=0.003). In a stepwise logistic regression, depression (odds ratio 9.1, 95% confidence interval 2.45-33.46; P=0.001) and ACE inhibitor use (odds ratio 6.0, 95% confidence interval 2.11-17.28; P=0.001) were associated with ISA. ConclusionsImpaired sexual activity was reported by almost one-third of younger patients 1year after ischaemic stroke. Factors associated with post-stroke ISA may include specific medications and depression rather than the characteristics of the stroke per se.