For the millions of Americans living with TBI, there is often an unspoken problem: many suffer from sexual dysfunction, something that is easily overlooked as patients struggle with overwhelming physical and emotional issues that can last for years, new research has found.
Neuropsychologist Jhon A. Moreno at the University of Montreal says that the sexual difficulties usually become most apparent about six months after the injury and, if left unaddressed, worsen with time. The nature of the problems and how the victim handles them depend on factors such as age, gender, and the stressors on the victim (who could be an athlete, a soldier or a civilian breadwinner in a car or workplace accident). Dr. Moreno extensive study of TBI survivors published in J. NeuroRehabilitation found that 50% to 60% of people with TBI have sexual difficulties, such as reduced interest in sex, erectile dysfunction, pain during sex, difficulties in vaginal lubrication, difficulties achieving orgasm or staying aroused, and a sense of diminished sex appeal, Moreno said.
The research found that partners of those with TBI experienced personality and emotional changes, and a modification of family roles that can lead to a crisis, Moreno said. “For the spouse, the survivor becomes a different person, a person they do not recognise as the one they fell in love with in the past,” he said. “The spouse becomes a caregiver and this imbalance in the relationship directly affects sexual desire.” Marital separation rates can be as high as 78% among people with TBI, Moreno said. Moreno also said that medications for TBI survivors (such as blood pressure drugs, antidepressants, stimulants and anticonvulsants) can lower sex drive and cause other physical and mental problems. Some develop personality changes, such as reduced social skills and trouble knowing what is inappropriate to say or do with others, the study found. Yet experts said sexual issues associated with TBI don’t get much attention from physicians and rehabilitation professionals. Hence it is crucial to bring up these issues and get help before one’s self-image and sex-life falls apart.