Trauma Disruption of Sexual Functioning in Veterans
Sexual functioning involves three stages: desire (attraction to others), arousal (physiological excitement), and orgasm (pleasure). Traumatic experiences can lead to impairment in all three of these stages, leading to decreased sexual satisfaction and increased stress during sexual encounters.
Trauma survivors may feel uninterested in initiating or engaging in sex due to fear and anxiety related to being touched. This stage of lack of interest is called hypoactive sexual desire disorder (HSDD) or low libido.
Traumatic events such as military combat, rape, abuse, or natural disasters often involve exposure to life-threatening situations that activate the 'fight-or-flight' response system. The sympathetic nervous system speeds up heart rate, blood pressure, and breathing while simultaneously slowing digestion and immune function. During sexual activity, this activation can interfere with physical sensations of pleasure and relaxation, resulting in difficulty achieving arousal or orgasm. These symptoms are characteristic of hypersexual disorder (HSX), where individuals have an excessive preoccupation with sexual thoughts, urges, and behaviors but fail to achieve orgasm.
Another way trauma affects sexuality is by reducing bonding and intimacy cues necessary for sexual attraction and synchrony between partners. People who have experienced trauma may feel numbness, distrust, or detachment from others, preventing them from feeling emotionally connected to their partner. They might also struggle with emotional regulation, making it difficult to share vulnerable feelings and experiences during sex. These factors can lead to sexual avoidance, dissatisfaction, or infidelity.
Veterans with PTSD may experience flashbacks, nightmares, or intrusive memories during sex, which can cause intense fear and anxiety. This can lead to sexual withdrawal and avoidance, further contributing to relational issues.
Some veterans may have trouble forming new relationships due to trust issues or a lack of social support, exacerbating their isolation and loneliness. These factors contribute to hypoactive sexual desire and relationship distress, leading to decreased quality of life.
Traumatic events can significantly impact veterans' ability to enjoy sex, form healthy relationships, and maintain their mental health. Therefore, treatment approaches must address these underlying factors through behavioral therapy, medications, and cognitive-behavioral therapy (CBT) to reduce symptoms of PTSD, depression, anxiety, and HSDD. This multi-modal approach helps restore sexual function and improve overall well-being. With proper care, veterans can learn to cope with past traumas and reclaim their lives in all areas, including intimacy and pleasure.
In what ways does trauma disrupt veterans' internal cues necessary for sexual arousal, bonding, and relational synchrony?
Traumatic experiences can lead to an increase in hypervigilance and heightened sensory processing, which may interfere with the ability of veterans to receive and interpret internal cues related to sexual arousal, bonding, and relational synchrony. This can result in decreased sexual desire and intimacy, difficulty regulating emotions during sex, and difficulties establishing and maintaining meaningful relationships.