A new comprehensive review published by the American Heart Association highlights the often-overlooked issue of sexual health following a stroke, calling for increased awareness and tailored support from healthcare professionals worldwide, including Thailand. As stroke survivors face numerous physical and psychological challenges, the report underscores that the impact on sexual function and intimacy is significant, yet remains rarely addressed in standard care.
Sexual health plays a crucial role in overall quality of life, particularly for stroke survivors, whose relationships and sense of self can be deeply affected. In Thailand, where over 250,000 people experience a stroke each year and the number of survivors continues to rise due to advances in acute care, the topic frequently falls outside the scope of post-stroke rehabilitation programs. According to the American Heart Association review, addressing the sexual wellbeing of stroke survivors should be an integral part of recovery—not only for physical rehabilitation but also for emotional and social reintegration (ahajournals.org).
The review’s authors point out that neurological damage caused by a stroke—such as weakness, spasticity, speech or cognitive impairments—can directly disrupt sexual arousal, response, and intimacy. Additionally, medications commonly prescribed for stroke risk factors—including certain antihypertensives and antidepressants—may further reduce libido or cause erectile dysfunction and vaginal dryness. These side effects are often under-reported by patients and rarely discussed by clinicians, due to cultural sensitivities and lack of professional training.
International studies cited in the review indicate that up to 75% of stroke survivors report some form of sexual dysfunction, with both men and women affected. For Thai patients, cultural taboos and the tendency to avoid discussions about sexual health can exacerbate feelings of isolation and anxiety, further impeding psychosocial recovery. A senior physiatrist at a leading Bangkok hospital explained, “Sexual issues are not routinely assessed in stroke units, partly due to discomfort from both health professionals and patients, but also because of time constraints and a lack of clear guidelines.” The expert emphasized that open dialogue, culturally sensitive counseling, and practical interventions could greatly improve outcomes.
The review recommends that healthcare professionals receive specific training to initiate conversations about sexual health respectfully and provide evidence-based advice. Even small changes—such as offering written information, addressing the impacts of stroke-related disabilities, and reviewing medication side effects—can empower patients and their families. In Thailand, the National Stroke Association has started to include sexual health topics in certain rehabilitation workshops, reflecting a gradual shift in attitudes.
Historical context is crucial. Traditional Thai society has viewed sexuality as a private—sometimes taboo—subject, particularly among older adults. However, growing recognition of the holistic needs of stroke survivors has spurred local advocacy groups to promote more robust, patient-centered discussions about sexual wellbeing. This transition mirrors trends seen in Western countries, where patient input is valued as part of personalized care plans.
Experts believe that including sexual health as a routine aspect of stroke recovery would mark a significant advance for Thailand’s healthcare system. It would reduce stigma, enhance mental health, and support the nation’s ageing population with greater dignity. As the prevalence of stroke increases due to demographic changes and lifestyle factors, integrated care that acknowledges both the physical and intimate dimensions of recovery is expected to yield better long-term results.
Looking ahead, continued research is needed to understand the specific challenges and preferences of Thai stroke survivors regarding sexual health. Local universities and hospitals are encouraged to collaborate on culturally-adapted training programs, information materials, and support groups. Thai policymakers and professional associations can play a key role by establishing national best practices informed by international research.
For Thai readers caring for a loved one after stroke, healthcare experts recommend: do not hesitate to ask medical teams about sexual health, seek out rehabilitation providers who address intimacy, and consider counseling if needed. As the conversation about sexual wellbeing after stroke grows, it is important for patients and families to remember that recovery goes beyond mobility or speech—it encompasses satisfaction, self-esteem, and meaningful relationships.
For further information, health professionals and patients can refer to the full review article from the American Heart Association and explore resources provided by the National Stroke Association of Thailand.