Stroke is a major cause of morbidity and mortality and sometimes comes with multifaceted complications including sexual dysfunction. Even though there is some evidence that living with a stroke can result in sexual dysfunction, there are contradictory views regarding the causal association between sexual activity and stroke. In 2017, while conducting a study on community perceptions on chronic disease and stroke in Ghana, participants mentioned factors such as hypertension, diabetes, poor lifestyles (e.g. excessive alcohol consumption, physical inactivity, and smoking), poor dietary practices, and supernatural factors (e.g. witchcraft, sorcery, curses, etc.) as causes of stroke and other chronic non-communicable diseases (NCDs). During the group discussions, one thing that was striking was when the community participants mentioned sexual activity as one of the main causes of stroke. When this came up in the first community that we went to, we decided to explore this further in the remaining four communities and similar discussions ensued.
Participants generally believed that sexual activity can cause a stroke. They mentioned that the dynamics through which sex can trigger a stroke include sex positions (i.e. having sex while standing and on the floor), high frequency of sex, having sex when older and engaging in indiscriminate sex. This study highlights that discussion about sexual activity in Ghana is more complex than the current health education programme allows, and so demands a ‘comprehensive sex education approach’ rather than a ‘disease-centered approach’. This study also raises the importance of addressing issues around stroke mimics to avoid unnecessary acute treatment and secondary prevention at the emergency department.
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