As a former military psychologist and writer on topics related to psychology and health, I am often asked questions about sexual problems. For many veterans, sexual dysfunction is a harsh reality that creates a profound and negative impact on a service member’s self-esteem and self-worth as well as interpersonal relationships.
Although I am not a physician or sex therapist, I have learned quite a bit about sexual problems as they relate to posttraumatic stress disorder, depression and general health issues. Below are two questions and my responses related to issues some of your current patients may be experiencing.
Over the past year, I have had a difficult time getting and maintaining an erection. My doctor said it may be because of my Posttraumatic Stress Disorder. What has one got to do with the other?
Erectile dysfunction (ED) has many causes. Medical conditions such as diabetes, heart disease and low testosterone are common culprits — although these are typically seen in older men, but not exclusively.
Other causes include excessive alcohol use, smoking, prolonged periods of stress, loss of emotional intimacy with your partner and antidepressant medications.
Regarding the last culprit, sexual dysfunction (low libido, delayed ejaculation, inability to achieve orgasm) is one of the more common side effects from the mainstay medication treatments for depression, anxiety and PTSD.
Some estimates report sexual side effects in men to be as high as 50 percent. Less known is the surprising connection between PTSD and ED. A 2015 study found that veterans with PTSD were more likely to suffer from ED than their civilian counterparts.
Another study found that approximately 85 percent of combat veterans with PTSD experienced ED compared to only 22 percent of combat veterans with no psychiatric diagnosis.
What’s the connection? It is not fully known. We do know that PTSD is a disorder that negatively impacts emotional, physical and relationship health.
We also know that these same areas are important to maintaining healthy sexual functioning. ED is one of those topics men just do not like to talk about. It is embarrassing for many and can cause a man to question his masculinity.
If you are having this issue, then you need to put those feelings and doubts behind you and see a doctor. The exact cause can often be identified, and good treatments are available.
I have always had a strong sex drive. But for some reason, I just don’t care about it anymore. I think it started sometime after my third deployment. My husband thinks I don’t love him anymore, but I do very much.
Sexual dysfunction comes in many different forms. Some people experience disturbances in arousal, whereas others struggle with desire or completion (achieving orgasm).
Low sex drive, or what experts refer to as hypoactive or inhibited sexual desire, is a relatively common problem for women. For some, it may be short-lived and tied to a transient period of increased stress or fatigue.
For others, it is more chronic and can wreak havoc on intimate relationships.
The first step is to visit a healthcare provider to rule out hormonal abnormalities. Just like with men, certain hormones that are too high or too low can lead to sexual problems. If things check out medically, then it is time to consider psychological causes.
You may need to rid your life of stress, increase your sleep or have an overdue conversation with your partner to assess the health of your relationship.
Whether it is the inability to gain or maintain an erection, achieve an orgasm or an all out drop in sex drive, sexual dysfunction is nothing of which to be ashamed. It is very common among people struggling with psychological and interpersonal difficulties as well as overall “healthy” people.
The important thing is to receive help as there are a variety of causes and cures.
*A previous version of this article was published in Military Times for Dr. Moore’s column Kevlar for the Mind.