– Changes in Sexual Behaviour

Brain injury can affect an individual’s sex drive and the desire for sex (libido) may increase or decrease. This can be due to the area and extent of the brain damage. In the case of loss of interest, it can be due to physical and psychological factors such as depression, feeling unattractive, constant tiredness and fear of rejection. A normal or increased sex drive when coupled with a lack of awareness and insensitivity to others can result in demanding and unsatisfying sexual relationships. These factors when combined with impulsive and disinhibited behaviour can lead to sexual remarks or advances that will cause offence. Where there is a strong sexual need without the ability to find a sexual partner, considerable frustration is likely to be experienced.

A second problem relates to the sex act itself. It is fairly common for men with a brain injury not to be able to obtain or sustain an erection. This can lead to feelings of frustration and inadequacy. Impotency can be the result of brain damage but, as with decreased sex drive, psychological factors can play a big part. For example, loss of confidence may affect physical performance and anxiety surrounding the difficulty can make matters worse.

Other factors may contribute to difficulties with either lovemaking or the desire for sex, such as loss of sensation or physical problems. This might make the physical act of lovemaking painful, awkward or unsatisfying. Another problem for both men and women is difficulty achieving orgasm – experiencing it too soon or less intensely. Certain medications may affect the ability to achieve orgasm and again anxiety and depression may also play a significant part in this.

Not everyone has sexual problems following a brain injury but for those who do the changes in sexuality can be very distressing.