Post-traumatic stress disorder (PTSD) is a mental health condition that can affect people who have seen or experienced a traumatic event. Some symptoms include nightmares, flashbacks, and/or uncontrollable thoughts about the event, as well as serious anxiety or significant changes in a person’s mood or temperament. Individuals with PTSD may have intense distress or extreme reactions to things that remind them of the traumatic event. These symptoms may develop soon after the event has taken place or years later.

Such symptoms are distressing on their own, but they may be compounded by the negative impact they can have on a person’s sexual function. The following are some of the ways in which PTSD might affect a person’s sexuality.

Lower frequency of sexual activity.

Research indicates that people with PTSD tend to have less frequent sexual activity (including masturbation) than other individuals. Sexual activity, whether alone or with a partner, requires some degree of vulnerability, which can be very unappealing to someone who has experienced a traumatic event. A person who has severe anxiety because of their PTSD may not be as comfortable putting themselves in vulnerable or sexually arousing situations, or they may find that sexual encounters are a trigger for their PTSD symptoms. Therefore, these individuals might choose to avoid sexual activity or engage in it less often.

Reduced sexual desire.

Many studies of individuals with PTSD have shown that they also experience diminished sexual desire. One theory that experts have proposed to explain this phenomenon is that fear and desire utilize the same hormonal and neurological networks in the body. If the body senses a threat, whether legitimate or not, these networks are activated to direct the body’s response. Healthy sexual desire and functioning require the temporary suppression of fear, which is why PTSD patients may experience lower sexual desire than their healthy counterparts. Another possibility is that many medications for mental health conditions, (such as SSRI antidepressants,) reduce sexual desire and arousal.

Difficulty with trust and intimacy in relationships.

Changes in a person’s mood or temperament brought on by PTSD may make it more difficult for them to trust others or maintain close interpersonal relationships. Since some amount of trust and intimacy is necessary to engage in sexual activity with a partner, this dynamic could affect the quality of a person’s sex life and their sexual satisfaction.

Increased incidence of sexual dysfunction.

Finally, PTSD can contribute to an increased risk of sexual dysfunctions such as orgasmic dysfunction in men and women, and erectile dysfunction (ED) in men. A person’s orgasmic and erectile function rely on physical and psychological factors. When a person is anxious or experiencing poor mental health, it is usually more difficult for them to reach orgasm or maintain an erection. Additionally, drugs prescribed for mental health conditions can hinder orgasmic and erectile function.

Compulsive sexual behavior.

Experiencing trauma, particularly early in life, may predispose a person to compulsive sexual behavior. According to one study on the topic, there are several factors that are common side effects of trauma that could contribute to the development of compulsive sexual behavior. A few of these factors are self-criticism, impulsivity, sensation-seeking, and internalizing depression and anxiety symptoms. Compulsive sexual behavior can become a way that people cope with negative emotions, which may affect more individuals with PTSD.

Treatment.

Fortunately, there are health care providers and resources that can help individuals cope with PTSD symptoms. A psychotherapist could use exposure therapy to treat an individual with PTSD. Exposure therapy involves identifying the triggers that set off PTSD symptoms and facing these triggers in a safe, productive way to reduce their impact over time. Certain medications can help PTSD symptoms, but one should keep in mind that these medications might hamper sexual response. If this is the case, patients should speak to their health care providers about changing their medication. Lastly, support groups exist for people with PTSD and may go a long way toward helping individuals cope with their symptoms and connect with others who have had similar experiences.

Resources:

• Cosgrove, D.J., Gordon, Z., Bernie, J.E., Hami, S., Montoya, D., Stein, M.B., & Monga, M. (2002). Sexual dysfunction in combat veterans with post-traumatic stress disorder. Urology, 60(5), 881–884. DOI: https://doi.org/10.1016/s0090-4295(02)01899-x
  
  
• Efrati, Y., & Gola, M. (2019). The effect of early life trauma on compulsive sexual behavior among members of a 12-step group. The journal of sexual medicine, 16(6), 803-811. DOI: https://doi.org/10.1016/j.jsxm.2019.03.272
  
  
• Mayo Clinic. (2018, July 6). Post-traumatic stress disorder (PTSD). https://www.mayoclinic.org/diseases-conditions/post-traumatic-stress-disorder/symptoms-causes/syc-20355967
  
  
• Schnurr, P.P., Lunney, C.A., Forshay, E., Thurston, V.L., Chow, B.K., Resick, P.A., & Foa, E.B. (2009). Sexual function outcomes in women treated for posttraumatic stress disorder. Journal of Women's Health, 18(10), 1549-1557. DOI: 10.1089=jwh.2008.1165
  
  
• Yehuda, R., Lehrner, A.M.Y., & Rosenbaum, T.Y. (2015). PTSD and sexual dysfunction in men and women. The Journal of Sexual Medicine, 12(5), 1107-1119. DOI: https://doi.org/10.1111/jsm.12856