Sexual dysfunction after traumatic brain injury

Abstract

Objective: The frequency of self reported sexual difficulties was examined in a group of 322 individuals with traumatic brain injury (TBI) (N = 193 men; 129 women) and contrasted with reports of sexual difficulties in 264 individuals without disability (152 men; 112 women) residing in the community. Physiological, physical, and body images problems impacting sexual functioning were examined individually and then summed into a sexual dysfunction score. Mood, quality of life, health status and presence of an endocrine disorder were examined as predictors of sexual difficulties post TBI.Study design: In this retrospective study, data about sexual difficulties were analyzed separately for men and women with TBI and without disability. ANOVAs with post hoc analysis for continuous variables, chi-square analyses for categorical variables, and ANCOVAs for predictors of sexual difficulties were utilized.Results: When contrasted to individuals without disability, individuals with TBI reported more frequent: (1) physiological difficulties influencing their energy for sex, sex drive, ability to initiate sexual activities and achieve orgasm;(2) physical difficulties influencing body positioning, body movement and sensation, and (3) body image difficulties influencing feelings of attractive and comfort with having a partner view one's body during sexual activity. Additional gender specific TBI findings were observed. In comparison to gender matched groups without disability, men with TBI reported less frequent involvement in sexual activity and relationships, and more frequent difficulties in sustaining an erection; women with TBI reported more frequent difficulties in sexual arousal, pain with sex, masturbation and vaginal lubrication. While groups differed in core demographic variables, age was the only demographic variable that was related to reports of sexual difficulties in individuals with TBI and men without disability. Age at onset and severity of injury were negatively related to reports of sexual difficulties in individuals with TBI. In men with TBI and without disability, the most sensitive predictor of sexual dysfunction was level of depression. For women without disability, an endocrine disorder was the most sensitive predictor of sexual dysfunction. For women with TBI, an endocrine disorder and level depression combined were the most sensitive predictors of sexual difficulties.Conclusion: Individuals post TBI report frequent physiological, physical and body images difficulties which negatively impact sexual activity and interest. For men post TBI, predictors of sexual difficulties included age at interview, age at injury, and having milder injuries, however, depression was the most sensitive predictor of sexual dysfunctions. For women post TBI, predictors of their sexual difficulties included age at injury and having milder injuries, however, depression and an endocrine disorder combined were the most sensitive predictors of sexual dysfunction. Implications of this study include the need for broad-based assessmen...

Symptoms of gonadal dysfunction are more predictive of hypopituitarism than nonspecific symptoms in screening for pituitary dysfunction following moderate or severe traumatic brain injury

“…It might be expected biologically that erectile dysfunction would be a more specific indicator of endocrine malfunction than nonspecific symptoms, but it should be considered that TBI is associated independently with a number of body images difficulties which impact negatively on libido and erectile potency. In men post‐TBI, depression is the most sensitive predictor of sexual dysfunction, which explains why some patients with referred on the basis of poor libido had normal pituitary–gonadal axes …”

Treating Erectile Dysfunction and Central Neurological Diseases with Oral Phosphodiesterase Type 5 Inhibitors. Review of the Literature

“…An intriguing fact is that the majority of SCI patients suffer the onset of ED at the time of SCI (primary effect) and, therefore, the use of oral PDE5 is appropriate. Another reason for the limited use of PDE5 for other CND may be explained by studies that report the most frequent sexual dysfunction is a decrease of libido for those with PD, MS, stroke, and cerebral trauma [59–62]. Instead, the literature did not focus on the loss of libido for those with SCI, and the Cardoso study did not show a considerable difference in sexual desire between samples of subjects with and without SCI [63].…”

Mild traumatic brain injury/concussion and female sexuality, a scoping review of the literature

“…We used such a broad timespan to ensure that it would capture the earliest and most recent publication years relevant to the project. We conducted a series of pilot searches to ensure that the final search would retrieve three key articles (O'Carroll (1991) (O'Carroll et al 1991, Hibbard (2000) (Hibbard et al 2000a), Anto-Ocrah (2019) (Anto-Ocrah et al 2019a)). The search terms were modified iteratively throughout the process, and the final search was performed in September 2019.…”