Sexual Issues in Veterans With PTSD

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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 and alcohol use, and post-traumatic stress disorder (PTSD). One problem that may not be discussed as commonly, however, is sexual dysfunction in veterans with PTSD.

What Is Sexual Dysfunction?

Sexual problems or sexual dysfunction can refer to a wide range of issues, including decreased sexual desire, premature ejaculation, or erectile dysfunction. 

Studies have found that people who have been exposed to traumatic events may be more likely to experience sexual dysfunction.

This may be due to a number of reasons. For example, the experience of a traumatic event (such as a sexual assault) may contribute to a person feeling anxious rather than relaxed 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.

Prevalence of 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 percent. The high rates led some mental health professionals to suggest that decreased sexual desire should be considered as a symptom of PTSD.

Sexual issues are also very common among veterans of Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) who experience PTSD. 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.

Almost 90% of the veterans in that study were experiencing some form of sexual dysfunction.

Thirty-nine veterans have reduced sexual desire, 26 had erectile dysfunction, and eight 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 the risk of 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.

In addition, PTSD may be associated with an increased risk for certain medical conditions that may also contribute to sexual dysfunction.

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

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; find treatment providers in your area who specialize in treating the condition.

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  • Hirsch, K.A. Sexual Dysfunction in Male Operation Enduring Freedom/Operation Iraqi Freedom Patients With Severe Post-Traumatic Stress Disorder. Military Medicine, 174, 520-523. 2009.

  • Tran, JK. Sexual Dysfunction in Veterans With Post-Traumatic Stress Disorder. J Sex Med. 2015 Apr;12(4):847-55.

By Matthew Tull, PhD
Matthew Tull, PhD is a professor of psychology at the University of Toledo, specializing in post-traumatic stress disorder.