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Brain Injury and Sex

Sex drive, or libido, is an indvidual’s desire to engage in sexual activity. It allows us to express ourselves sexually and/or be intimate with our partners. After a traumatic brain injury, an individual can experience changes in sexual behavior. These may include: 

  • Reduced libido or increased libido  
  • Decreased arousal  
  • Erectile problems for men 
  • Inability to climax or reach orgasm 
  • Inappropriate sexual behavior (i.e., masterbating in front of people) 
  • Reproductive changes (i.e., irregular menstrual cycles for women, decreased sperm production for men) 

Other factors may also play a role in an individual’s sexual problems. These include: 

Factor  Description 
Depression, anxiety, or stress   These conditions can reduce sex drive. 
Medications  Some medications, such as antidepressants, can reduce libido. 
Relationship problems  A couple with relationship problems are less likely to have sex. 
Prior sexual difficulties  A brain injury can worsen any prior sexual problems that an individual had before the injury.  
Reduced confidence  An individual with a brain injury may feel less confident or attractive, which makes them less likely to feel sexual or engage in sexual activity. 
Other associated injuries  Any other injuries acquired from the accident (i.e., spinal cord injury) can affect an individual’s sexual functioning. 
Other illnesses  Other illnesses that an individual may have (i.e., diabetes, high blood pressure) can reduce sexual drive  


General strategies that an individual with TBI can utilize to help with sexual problems are: 

  • Talk to a doctor or health professional who you feel comfortable talking with about your sexual problems  
  • Consider sex therapy, psychotherapy, or counseling to help with emotional issues related to your sexual problems 
  • Discuss with your partner to plan sexual activities during the time of day when you’re feeling less tired  
  • Talk with your partner about different positions to try to prevent any pain or balance issues 
  • Limit distractions in the environment where sexual activity is taking place so you can focus more on sex 
  • Use sexual aids to help with sexual arousal (i.e., watch erotic videos or look at erotic pictures)  



For more TBI Glossary Terms, click here.

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