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

Background and purpose The 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. Methods Over 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 1 year 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 ). Results The 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 . Conclusions Impaired sexual activity was reported by almost one‐third of younger patients 1 year after ischaemic stroke. Factors associated with post‐stroke ISA may include specific medications and depression rather than the characteristics of the stroke per se .