Sex and sexuality

Brain injury can cause a range of physical, cognitive, emotional and behavioural issues that can affect various aspects of a brain injury survivor’s sex life. Their interest in sex may be altered or they may no longer be able to engage in sexual activities the way they did prior to their injury.

Sex is sometimes divided into a number of aspects, for instance: sexual functioning, which relates to the physical aspect of sex (such as sexual arousal, intercourse and orgasm), and sexual well-being, which relates to the emotional and psychological aspect of sex (such as sexual satisfaction).

There are a number of sexual issues caused by the physical, cognitive, emotional and behavioural effects of brain injury that are common to individuals regardless of their gender. However, due to typical differences in physiology and sexual behaviour, men and women can have different sexual issues.

Impact of sexual problems on sexual partners

Sexual activities are often undertaken with a partner. The sexual partner is therefore often also affected by any sexual issues experienced by the brain injury survivor.

The survivor’s effects may cause the partner to no longer be sexually interested, aroused or satisfied. This can often produce feelings of guilt, confusion and sexual frustration, which can be particularly upsetting if they feel unable to speak to the survivor openly about such feelings. This, in turn, may have an impact on the relationship itself.

Conversely, a brain injury survivor may lose interest in their sexual partner, for instance if they cannot remember key moments of intimacy or are no longer interested in sex. This can be deeply upsetting for a sexual partner who is still sexually interested in the survivor and wants to be intimate with them. Unsuccessful attempts to arouse or engage the survivor may cause the partner to question themselves as an adequate lover.

The sexual partner may also struggle to satisfy or no longer enjoy the pace of sexual activities if the survivor has developed a change in their sexuality or has developed different sexual interests. An overall personality change in the survivor can be particularly distressing, as the partner may feel that they are in a sexual relationship with someone they no longer have the same sexual feelings for as before the injury.

Treating sexual problems

Sex is a topic that people often feel embarrassed to talk about, as it is a very personal and sensitive aspect of our lives. However, sexual activity is both important and completely natural, and professionals will be familiar with supporting patients with a range of sexual issues. It is therefore important that brain injury survivors and their sexual partners feel able to discuss and seek support with sexual issues.

There are a number of different professionals that can help with sexual issues after brain injury, depending on the nature of the problem, such as Clinical Neuropsychologists, psychosexual counselling and sex therapists.

Depending on the cause of sexual difficulty, some people may benefit from taking medication or hormone therapy to improve their sexual functioning. Any consideration of medication should be discussed with your GP or neurologist, as they will be able to tell you whether medication or hormone therapy is a suitable option depending on a number of factors, such as what may be underlying your sexual issues or whether you are already taking medication.