Sexual dysfunction in male stroke patients: Correlation between brain lesions and sexual function

Abstract

OBJECTIVES To identify the sexual function of, and effect of the location of brain lesions on sexual function in, stroke patients. METHODS We conducted a survey on 109 stroke patients (64.93 +/- 8.81 years) and 109 age-matched controls (64.69 +/- 8.85 years). We used a questionnaire that included the five-item version of the International Index of Erectile Function (IIEF-5) and questions about changes in sexual desire, ejaculatory function, and sexual satisfaction after a stroke. We analyzed the correlation between the results of the questionnaire and the locations of brain lesions. RESULTS Erectile function was significantly decreased in the stroke patient group (IIEF-5, 5.89 +/- 7.08) compared with the control group (IIEF-5, 10.67 +/- 7.10). In most patients, the frequency of intercourse and sexual desire decreased after stroke, and an ejaculation disorder accompanied intercourse, but fear regarding intercourse was not severe. A lack of sexual desire was the largest cause (59.4%) of an absence of sexual intercourse. In cases with lesions in the right cerebellum and the left basal ganglia, a significant ejaculation disorder and decrease of sexual desire were more likely to occur, respectively. CONCLUSIONS The sexual desire, erectile function, and ejaculatory function were impaired after stroke. A lack of sexual desire was the major cause of an absence of sexual intercourse. The specific locations of the stroke lesions, such as the left basal ganglia and right cerebellum, might be associated with sexual desire and ejaculation disorder, respectively.