The second stage of the PLISSIT model looks at the practitioner giving Limited Information. Providing this Limited Information should be within the scope of the practitioner’s knowledge and would include dispelling myths, answering basic questions such as ‘Is it safe to have sex?’ and providing information such as leaflets, telephone numbers for helplines etc.
There are a number of physical factors which can affect sexuality and sexual activity after stroke. All members of the multidisciplinary team should be able to provide Limited information on these factors and be comfortable discussing these with an individual.
Q. What physical factors can affect sexuality after stroke and what information should you be able to provide?
Limited Information to provide:
Tiredness/Fatigue
Discuss timing of sexual activity e.g. am or pm when less tired, beginning of week/end of week. May need to consider position normally used in order for person who has had stroke to conserve energy. Discuss intimacy without intercourse.
Loss of movement
Discuss using pillows for support, experimenting with change of position, having warm bath or shower to relax.
Loss of sensation
Can be either the person being unable to feel their partner touching them or the person being unable to feel themselves touching their partner. Suggest lying on one side of the body or the other to optimise body contact.
Medication
Antihypertensives can cause erectile problems; statins can reduce libido; antidepressants can cause loss of libido and increase fatigue; women using HRT will have to stop doing so and face return of menopausal symptoms; someone who has used the combined pill for contraception will need to discuss an alternative method.
Changes to sexual function
If have loss of sexual sensation must communicate this because what previously was pleasurable may be irritating and vice versa; foreplay activities should be directed to areas of better sensation.
Continence
– Women can tape their catheter forwards and to one side using surgical tape during intercourse.
– Men can bend the catheter back along the penis and hold it in place with either surgical tape or a standard condom or both.
Page last reviewed: 10 Feb 2021
