Sex after a Traumatic Brain Injury
The topic of sexual dysfunction after a traumatic brain injury shouldn’t be taboo. Millions of people in the United States live with the physical, cognitive and emotional consequences traumatic brain injury (TBI). Sexuality is often impacted, but not often discussed or addressed. Failure to address this issue can compound the adverse effect of TBI symptoms on important relationships and self-esteem. NeuroRehabilitation: An International Journal recently published a critical review of fourteen studies on this topic.
The review provides perspectives from multiple viewpoints, including professional, survivor, and patient/partner. John Alexander Moreno, the author of the review vigorously advocates that “Assessment, treatment, and systematic follow-up of post-TBI sexual difficulties should always be part of the clinical agenda throughout all rehabilitation and post-rehabilitation stages.” According to Moreno, marital separation rates can be as high as 78 percent among people with TBI. Sexual problems are entwined with the complex psychological and social effects of the injury, dictating a holistic approach to all of these issues.
The causes of sexual difficulties following TBI can be the result of many different factors including endocrine/hormonal changes from the injury itself, physical limitations, medication side-effects, depression, fatigue, loss of self-esteem and relationship changes. TBI victims need to openly discuss the problems with their partner, their treating physicians, rehabilitation professionals and with mental health professionals familiar with TBI and comfortable with frankly discussing this topic.
New York’s Mount Sinai Medical Center, through its Department of Rehabilitation Medicine, provides good practical guidance on this issue in “TBI Consumer Report: Coping with Sexual Problems After TBI.” The authors note that not everyone with a TBI experiences sexual difficulties, but for those who do, getting help, “ is a must,” whether that involves helping them establish and maintain lasting and meaningful relationships or simply reducing problems that occur during sexual activity.