Sexual dysfunction after traumatic brain injury

Objective: The frequency of self reported sexual difficulties was examined in a group of 322 individuals with traumatic brain injury (TBI) (N = 193 me n; 129 women) and contrasted with reports of sexual difficulties in 264 ind ividuals without disability (152 men; 112 women) residing in the community. Physiological, physical, and body images problems impacting sexual functio ning were examined individually and then summed into a sexual dysfunction s core. Mood, quality of life, health status and presence of an endocrine dis order were examined as predictors of sexual difficulties post TBI. Study design: In this retrospective study, data about sexual difficulties w ere 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 difficulti es were utilized. Results: When contrasted to individuals without disability, individuals wit h TBI reported more frequent: (1) physiological difficulties influencing th eir energy for sex; sex drive, ability to initiate sexual activities and ac hieve orgasm; (2) physical difficulties influencing body positioning, body movement and sensation, and (3) body image difficulties influencing feeling s of attractive and comfort with having a partner view one's body;during se xual activity. Additional gender specific TBI findings were observed. In co mparison to gender matched groups without disability, men with TBI reported less frequent involvement in sexual activity and relationships, and more f requent difficulties in sustaining an erection; women with TBI reported mor e frequent difficulties in sexual arousal, pain with sex, masturbation and: vaginal lubrication. While groups differed in core demographic variables, a ge was the only demographic variable that was related to reports of sexual difficulties in individuals with TBI and men without disability. Age at ons et and severity of injury were negatively related to reports of sexual diff iculties in individuals with TBI. In men with TBI and without disability, t he 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 an d:body images difficulties which negatively impact sexual activity and inte rest. For men post TBI, predictors of sexual difficulties included age at i nterview, age at injury, and having milder injuries, however, depression wa s the most sensitive predictor of sexual dysfunctions. For women post TBI, predictors of their sexual difficulties included age at injury and having m ilder injuries, however, depression and Bn endocrine disorder combined were the most sensitive predictors of sexual dysfunction. implications of this study include the need for broad-based assessment of sexual dysfunction, an d the implementation of treatment studies to enhance sexual functioning pos t TBI.