Sexual dysfunction in combat veterans with post-traumatic stress disorder

Cosgrove, Daniel J.; Gordon, Zachary L.; Bernie, Jonathan E.; Hami, Shadha; Montoya, Daniel; Stein, Murray B.; Monga, Manoj

doi:10.1016/s0090-4295(02)01899-x

Cited by 100 publications

(89 citation statements)

References 21 publications

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“…The few research studies of sexual function following a traumatic experience without serious physical injury have focused on sexual dysfunction in men with posttraumatic stress disorder (Kotler et al, 2000) who are most commonly combat veterans (Cosgrove et al, 2002;Kaplan, 1989;Letourneau, Schewe, & Frueh, 1997). To a lesser extent, negative mood also tends to be associated with a decrease in sexual interest and response.…”

Section: Discussionmentioning

confidence: 99%

Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Chiasson¹,

Hirshfield²,

Humberstone³

et al. 2005

Arch Sex Behav

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Numerous studies on the mental health effects of terrorist attacks have been published, with some reporting increases in smoking and drug and alcohol use. None have reported on changes in sexual behavior. To investigate the impact of the September 11 attacks on sexual and drug- and alcohol-using behaviors of men who have sex with men (MSM), an anonymous Internet survey was conducted to obtain information retrospectively on behavior during three month periods before and after the attacks. A total of 2,915 MSM from all 50 U.S. states completed the survey. Men who were exposed to the attacks were not differentially targeted for the survey since the online banner ad used to recruit did not mention September 11. Exposure to the attacks varied: 11.4% lost a friend or relative; 5% witnessed the attacks in person; and nearly all saw the attacks on television within one hour of their occurrence. Nearly equal proportions of men reported increases and decreases in the number of sex partners following September 11. Small, statistically significant increases in unprotected anal intercourse and alcohol use, but not illicit drug use, were found when behavior after September 11 was compared to that before the attacks. Men who lost a friend or relative in the attacks were significantly more likely to report unprotected anal intercourse, an increased number of sex partners, and increased alcohol use after September 11 than those who did not. Counseling about substance abuse and risky sexual behavior should be incorporated into trauma-related programs for adolescents and adults.

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Section: Discussionmentioning

confidence: 99%

Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Chiasson¹,

Hirshfield²,

Humberstone³

et al. 2005

Arch Sex Behav

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show abstract

“…PTSD combat veterans experience a significantly higher rate (85%) of sexual dysfunction than do non-PTSD veterans (22%). Moderate-to-severe erectile dysfunction is present in 45% of PTSD patients versus 13% of controls [171]. …”

Section: Cardiovascular Disease and Mortalitymentioning

confidence: 99%

Posttraumatic Stress Disorder and Cardiometabolic Disease

Levine¹,

Levine

Levine³

2013

Cardiology

133

118

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The need for addressing posttraumatic stress disorder (PTSD) among combat veterans returning from Afghanistan and Iraq is a growing public health concern. Current PTSD management addresses psychiatric parameters of this condition. However, PTSD is not simply a psychiatric disorder. Traumatic stress increases the risk for inflammation-related somatic diseases and early mortality. The metabolic syndrome reflects the increased health risk associated with combat stress and PTSD. Obesity, dyslipidemia, hypertension, diabetes mellitus, and cardiovascular disease are prevalent among PTSD patients. However, there has been little appreciation for the need to address these somatic PTSD comorbidities. Medical professionals treating this vulnerable population should screen patients for cardiometabolic risk factors and avail themselves of existing preventive diet, exercise, and pharmacologic modalities that will reduce such risk factors and improve overall long-term health outcomes and quality of life. There is the promise that cardiometabolic preventive therapy complementing psychiatric intervention may, in turn, help improve the posttraumatic stress system dysregulation and favorably impact psychiatric and neurologic function.

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“…It is well characterized by intrusive memories (i.e., flashbacks), a hyperarousal state and avoidance of stimuli associated with the trauma (Pitman 1997;Yehuda 2002). Clinical data have indicated increased rates of sexual dysfunction, including erection and ejaculation difficulties, in men with PTSD (Cosgrove et al 2002;Kaplan 1988Kaplan , 1989. Most combat veterans with PTSD experience clinically relevant sexual difficulties, and 69% of veterans have erectile dysfunction (ED) (Letourneau et al 1997).…”

Section: Effects Of Severe Stress On the Circulating Androgen Level Amentioning

confidence: 99%

The gastrin-releasing peptide system in the spinal cord mediates masculine sexual function

Sakamoto

2010

Anat Sci Int

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The lumbar spinal segments are of particular interest because they are sexually dimorphic and contain several neuronal circuits that are important in eliciting male sexual responses such as erection and ejaculation. Gastrin-releasing peptide (GRP) is a member of the bombesin-like peptide family first isolated from the porcine stomach. A collection of neurons in the lumbar spinal cord (L3-L4 level) of male rats projects to the lower lumbar spinal cord (L5-L6 level), releasing GRP onto somatic and autonomic centers known to regulate male sexual reflexes. All these target neurons express and localize specific receptors for GRP. This system of GRP neurons is sexually dimorphic, being prominent in male rats but vestigial in females. The system is completely feminine in genetically XY rats with a dysfunctional androgen receptor gene, demonstrating the androgen-dependent nature of the dimorphism. Pharmacological stimulation of GRP receptors in this spinal region remarkably restores sexual reflexes in castrated male rats. Exposure of male rats to a severe traumatic stress decreases the local content and the axonal distribution of GRP in the lumbar spinal cord and results in an attenuation of penile reflexes in vivo. Administration of a specific agonist for GRP receptors restores penile reflexes in the traumatic stress-exposed male rats. This review summarizes findings on this recently identified spinal GRP system, which may be vulnerable to stress, that controls male reproductive function. The identification of a male-specific neuronal system regulating sexual functions offers new avenues for potential therapeutic approaches to masculine reproductive dysfunction.

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Sexual dysfunction in combat veterans with post-traumatic stress disorder

Cited by 100 publications

References 21 publications

Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Increased High Risk Sexual Behavior After September 11 in Men Who Have Sex with Men: An Internet Survey

Posttraumatic Stress Disorder and Cardiometabolic Disease

The gastrin-releasing peptide system in the spinal cord mediates masculine sexual function

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