Adjustment to life after stroke with special reference to sexual intercourse and leisure

Changes in frequency of sexual intercourse and of leisure activities were related to degree of physical impairment and levels of dependence in primary and secondary ADL in 110 subjects with one stroke. About 75% of the subjects reduced their frequency or ceased having intercourse and active leisure. While changes in frequency of intercourse were temporally independent, changes in leisure activities were less pronounced for subjects examined later than 12 months after the stroke than for those investigated earlier. For intercourse, primarily ADL-dependence and impaired cutaneous sensibility were major negative determinants. Moreover, subjects with previously known arterial hypertension, myocardial infarction or diabetes mellitus had changed relatively less than those without these ailments, probably due to pre-stroke reductions. It is suggested that the marked changes in sexual and leisure activities are accomplished by unsuccessful coping with the vascular catastrophe and its sequelae. Aspects of coping problems, primarily the disease-related, but also those of intra- and inter-personal nature are discussed.