Intimacy after mild traumatic brain injury
Sexuality and intimacy are an important part of who we are as human beings. A mild traumatic brain injury (mTBI) or concussion can also impact this aspect of life.
How mTBI and concussion can affect sexual functioning
Sustaining a mild traumatic brain injury (mTBI) or concussion can lead to a variety of physical, cognitive, emotional, and behavioral issues. This can include changes in sexual functioning and activity, including:
- Decreased desire or interest: Many people may have less desire or interest in sex.
- Increased desire or interest: Some people have increased interest and may want to have sex more often than usual. Others may have difficulty controlling their sexual behavior. They may make sexual advances in inappropriate situations or make inappropriate sexual comments.
- Decreased arousal: Many people have difficulty becoming sexually aroused. This means that they may be interested in sex, but their bodies do not respond. Men may have difficulty getting or keeping an erection. Women may have decreased vaginal lubrication.
- Difficulty or inability to reach orgasm or climax: Both men and women may have difficulty reaching orgasm or climax. They may not feel physical satisfied after sexual activity.
- Reproductive changes: Reduction in sex hormones can affect reproduction. However, if pregnancy was possible before the injury, it will likely still be possible after the injury.
Why do these changes happen?
Some challenges are directly related to changes to the brain’s functioning. Others are related to physical problems or changes in thinking or relationships. Possible causes include:
- Hormonal changes: Women and men may experience sexual changes differently. For example, lower testosterone levels in men can cause problems in achieving an erection or ejaculating too soon. Low levels of estrogen can lead to decreased genital sensitivity for women.
- Medication side effects: Many medications commonly used after a mTBI and concussion can have negative side effects on sexual functioning.
- Increased stress levels: Many people experience increased stress after a mTBI or concussion related to changes in health, financial, employment, housing, or relationships. These changes may affect their desire to engage in sexual intimacy.
- Fatigue or tiredness: Physical limitations, pain, or weakness may make it difficult to have sex.
- Self-esteem problems: Some people feel less confident and this can affect their comfort with sexual activity.
- Changes in thinking abilities
- Emotional changes: Individuals recovering from mTBI or concussion can also feel sad, nervous, or irritable. These feelings may have a negative effect on sexual functioning, especially their desire for sex.
- Changes in relationships and social activities
Strategies for addressing sexual concerns
Some people may feel embarrassed talking openly about sexual issues. Keep in mind that sexuality is a normal part of human functioning, and problems with sexuality can be addressed just like any other medical problem.
- Talk with your doctor: Talk with your doctor, therapists, and behavioral health providers so they can help you find solutions. Find a health professional who you feel comfortable talking with. Get a comprehensive medical exam, including blood work. Make sure you discuss with your provider any role your medications may play. Ask your doctor to check your hormone levels.
- Seek counseling or therapy: Consider psychotherapy or counseling to help with emotional issues that can affect sexual functioning. Adjusting to life after a TBI often puts stress on your intimate relationship. If you and your partner are having relationship difficulties, consider marital or couple’s therapy.
- Plan intimacy when you have the most energy: Talk with your partner and plan sexual activities for when you have the most energy and are less tired.
- Limit distractions: For example, be in a quiet environment without background noise, such as television.
- Adjust positioning for comfort: When having sex, position yourself so that you can move without being in pain or dizzy. Talk with your partner about how they can help.
- Expand your social connections: Increasing your social network can increase the opportunity to form intimate relationships. You may consider joining a club or becoming involved in other social organizations.