Sexuality and Traumatic Brain Injury

The connection between sexuality and traumatic brain injury (TBI) may not be immediately apparent, but decidedly, it exists.

When an individual sustains a traumatic brain injury and is in the acute and sub-acute stage of care, the primary goals are sustaining life and limiting the short and mid-term effects of the traumatic brain injury by appropriate care. Once that care has succeeded in achieving the immediate goals and the individual discharged for post-acute rehabilitation at a facility such as NeuLife Rehab in Mount Dora, Florida many other factors may surface and become relevant to the individual’s rehabilitation. Sexuality can be one of them.

When an injury involves the brain, it can be catastrophic or mild. Depending upon the part of the brain that is injured, comorbities and even the gender of the individual who sustained the injury, sexual issues may result. They can be of various types, including:

• Decreased desire for sex
• Increased desire for sex
• Decreased arousal. This essentially means that while the individual has a desire for sex, his or her body does not respond in a way that allows sex to occur. Naturally, depending upon whether the traumatic brain injury occurred to a man or to a woman, the type of dysfunction will differ
• Lack of or reduced ability to achieve ultimate satisfaction through sexual activity
• Reproductive changes. In women, this can be caused by hormonal changes based upon the location of the traumatic brain injury and can result in the cessation of menstrual cycles for varying periods of time. Men can experience reduced sperm production. Either, or both, can result in difficulties in a woman becoming pregnant. In turn, this can result in psychological and relationship problems that may require specialized rehabilitation.

The sexual issues that can accompany a traumatic brain injury may be caused by one or more of a variety of factors, including:

• Physical damage to those parts of the brain that control sexual function. For example, damage to the orbital parts of the frontal lobes may result in hypersexuality (increased desire) by reducing what might be called “ethical restraints” to indiscriminate sex. Likewise, hyposexuality (decreased desire) can result and this often attends a depressive state which many Clients experience during the course of their rehabilitation[1]
• Hormonal changes, such as in the production of estrogen, progesterone and testosterone
• Side effects of medication
• Fatigue
• Problems with movement, including spasticity and pain that makes sex difficult
• Self-esteem issues
• Thinking, planning, communicating and related executive-level functions can affect sexuality
• Emotional changes that accompany traumatic brain injuries can have a great impact on sexual function. Individuals with traumatic brain injuries often feel sad, nervous or irritable, all of which can impact both the desire and the ability to engage in sex[2].

Upon becoming a residential Client of NeuLife Rehab in Mount Dora, Florida, an individual undergoes a comprehensive, independent functional evaluation. It is conducted by a multidisciplinary team of professionals that include but are not limited to:

• Board Certified Neurologist
• Board Certified Behavior Analyst
• Board Certified Physiatrist
• Neuropsychologist
• Psychologist
• Board Certified Psychiatrist
• Speech Language Pathologist/Cognitive Therapist
• Physical Therapist
• Occupational Therapist
• Nurses
• Certified Rehab Counselor

The independent functional evaluation permits the development of a Client Goal Plan around which NeuLife Rehab’s innovative post-acute care is centered.

Proper and timely post-acute rehabilitation that may determine the difference between disability and independence is what NeuLife refers to as the “platinum post-acute period” —  the crucial window following acute care that is needed to nurture the whole person to health with specialized, clinically relevant services.

NeuLife’s philosophy is that healing, wellness and personal fulfillment are best achieved in a positive and uplifting therapeutic environment where caring staff encourages, assists and supports each client so he or she may achieve specific goals. NeuLife believes personal fulfillment is equally as important as goals to achieve function and independence.

NeuLife, in Mount Dora, Florida, is an accessible residential post-acute program providing specialized rehabilitation to individuals diagnosed with Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI), Amputations, Burns and other Catastrophic Injuries and Challenging Diagnoses.

2725 Robie Avenue

Mount Dora, Florida 32757

[1] Principals of Neurology by Adams, Victor, and Ropper, Sixth Edition

[2] Sexuality After Traumatic Brain Injury, http://uwmsktc.washington.edu/TBI_sexuality.pdf