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Sexual Problems in Veterans with PTSD

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Updated April 16, 2014

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Military veterans have been found to be at high risk for a number of mental and physical health problems, including pain, substance use, and post-traumatic stress disorder (PTSD); however, one problem that may not be discussed as commonly is sexual problems in veterans with PTSD.

Sexual problems or sexual dysfunction can refer to a wide range of issues, including decreased sexual desire, premature ejaculation, or erectile dysfunction. Additional information on the many forms sexual dysfunction may take can be found at the About.com website on Sexuality. Studies have found that people who have been exposed traumatic events may be more likely to experience sexual dysfunction.

This may be due to a number of a reasons. For example, the experience of a traumatic event (such as a sexual assault) may contribute to a person not feeling comfortable in intimate settings. Injuries sustained during a traumatic event may also interfere with sexual functioning. Finally, the high level of anxiety (or even PTSD) that results from traumatic exposure may also contribute to sexual problems. One population that can have extensive exposure to traumatic experiences and PTSD is military veterans.

Sexual Dysfunction among Veterans

Most studies on sexual dysfunction among veterans with PTSD have looked at Vietnam veterans. In those studies, rates of sexual dysfunction were as high as 80%. The high rates led some mental health professionals to suggest that decreased sexual desire should be considered as a symptom of PTSD.

What about Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) veterans with PTSD? Well, one study by a researcher at the Veterans Affairs Pacific Islands Health Care System in Honolulu, Hawaii, looked at rates of sexual dysfunction among 53 male OEF/OIF veterans. All of the veterans were receiving mental health care for PTSD.

In reviewing the medical charts of the veterans, the researcher found that only 6 of the 53 veterans did not have sexual dysfunction. This means that almost 90% of the veterans were experiencing some form of sexual dysfunction. Thirty-nine veterans have reduced sexual desire, 26 had erectile dysfunction, and 8 had some form of ejaculatory problem.

The Relationship between PTSD and Sexual Dysfunction

There are a number of reasons why a diagnosis of PTSD may increase risk for sexual dysfunction. First, high levels of anxiety can interfere with sexual functioning, and people with PTSD suffer from constant anxious arousal. In addition, many people with PTSD may feel disconnected and detached from loved ones, which can greatly interfere with intimacy. PTSD symptoms of anger and irritability have also been found to interfere with intimacy.

If you have PTSD and are experiencing some form of sexual dysfunction, it will be important to seek out help from a medical professional. Sexual dysfunction often does not resolve itself without some form of intervention. There are a number of effective treatments for sexual dysfunction.

In addition, given that it appears as though many forms of sexual dysfunction may be linked to PTSD symptoms, sexual problems may decrease if symptoms of PTSD are addressed. There are a number of effective treatments for PTSD. There are a number of helpful websites that can help you find treatment providers in your area who specialize in PTSD.

Sources:

Cosgrove, D.J., Gordon, Z., Bernie, J.E., et al. (2002). Sexual dysfunction in combat veterans with post-traumatic stress disorder. Urology, 60, 881-884.

Green, B.L. (2003). Posttraumatic stress disorder: Symptom profiles in men and women. Current Medical Research and Opinion, 19, 200-204.

Hirsch, K.A. (2009). Sexual dysfunction in male Operation Enduring Freedom/Operation Iraqi Freedom patients with severe post-traumatic stress disorder. Military Medicine, 174, 520-523.

Kaplan, P.M. (1989). Post-traumatic stress syndrome and sexual dysfunction. Journal of Sex and Marital Therapy, 15, 74-77.

Kotler, M., Cohen, H., Aizenberg, D., et al. (2000). Sexual dysfunction in male post-traumatic stress disorder patients. Psychotherapy and Psychosomatics, 69, 309-315.

Letourneau, E.J., Schewe, P.A., & Frueh, B.C. (1997). Preliminary evaluation of sexual problems in combat veterans with PTSD. Journal of Traumatic Stress, 10, 125-132.

Litz, B.T., Keane, T.M., Fisher, L,. Marx, B., & Monaco, V. (1992). Physical health complaints in combat-related post-traumatic stress disorder: A preliminary report. Journal of Traumatic Stress, 5, 131-141.

Solursh, L.P., & Sorlush, D.S. (1994). Male erectile disorders in Vietnam combat veterans with chronic post-traumatic stress disorder: A special issue on sexuality and disability in adolescence and beyond. International Journal of Adolescent Medical Health, 7, 119-124.

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