Poststroke emotional incontinence and decreased sexual activity.

BACKGROUND: Although poststroke depression has been shown to be related to decreased sexual activity (SA), the relationship between poststroke emotional incontinence (EI) and SA has not been properly investigated. METHODS: We examined 70 nondepressed, sexually active patients with first-ever stroke approximately 3 months after stroke and conducted a follow-up interview approximately 2 years after stroke in 55 of them. EI (excessive/inappropriate laughing/crying) and SA (libido, coital frequency, erectile function) were assessed with the use of a standardized questionnaire. RESULTS: Of these 70 patients, 24 (34%) had EI 3 months after stroke, which had resolved 2 years after stroke. Libido, coital frequency and erectile function were reported to have declined in 49, 65 and 26% of the patients, respectively, 3 months after stroke, and in 44, 49 and 20% of the patients 2 years after stroke. Multivariate analyses showed that low coital frequency before stroke (CFBS) was significantly (p < 0.05) related to decreased poststroke coital frequency, while the presence of EI (p < 0.05) and low CFBS (p < 0.05) was significantly associated with decreased erectile function 3 months after stroke. Two years after stroke, the presence of EI 3 months after stroke was significantly related to decreased libido, coital frequency and erectile function (p < 0.05 each). Age, gender, laterality of stroke, Barthel Index score, motor dysfunction and the presence of hypertension and diabetes mellitus were not independently related to SA 3 months and 2 years after stroke. CONCLUSION: The presence of EI is a factor related to decreased poststroke SA, more so in chronic than in subacute stages.