Posts Tagged sexual dysfunction

[BLOG POST] 7 Most Embarrassing Depression Symptoms

Posted by Kostas Pantremenos in Depression on August 9, 2022

embarrassment and shame in having depression

Suffering from depression seems like a constant and unending struggle. Most of the time, this dangerous mental health condition has embarrassing or unwanted symptoms that you have to live with.

Apart from feelings of helplessness, hopelessness, emptiness, and worthlessness, you may start smelling awful because you haven’t taken a shower for a couple of days, or you don’t have the strength to get out of bed in the morning.

And this makes people think that you are lazy.

Most of the people around you might not notice these outward signs of depression because they are unaware of issues related to mental health problems.

As a result, they might end up labeling you unkindly.

Having worked at a psychiatrist’s office, I’ve heard numerous patients opening up about their embarrassing behaviors, symptoms, and traits of depression. If you are struggling with depression, it’s highly likely that you’ve experienced these issues.

You are not alone.

Knowing The Difference Between Feeling Sad and Having Depression

Most Embarrassing Symptoms

1 Gaining weight

For a number of people, weight gain is one of the most embarrassing symptoms of depression. According to the American Journal of Public Health, increased body mass index has been linked to suicidal thoughts among women. According to CDC, 43 percent of people with depression suffer from obesity. Also, depressed adults are at a higher risk of obesity. What’s the link?

Depressed individuals view eating as a way to fill the emptiness they feel inside. And the extra weight makes them feel awful about themselves. Some don’t want their family members and friends to see them because they are worried about being judged. Antidepressants should not be used to treat clinical depression as this might backfire and lead to serious side effects such as weight gain. It’s important for individuals to look for natural ways to promote health and wellbeing while maintain a healthy weight.

2 Not showering

If you are depressed, you might have a hard time taking a shower or bathing every day. You might prefer to stay indoors in your pajamas, especially if you are a remote worker. You’ll also find yourself skipping shaving or washing your hair. And this will make you look untidy.

3 Sexual dysfunction

One of the most common effects of depression among men and women is sexual dysfunction. Prescribing antidepressants to such patients can ruin their sex life. You’ll have low or no sex drive. And it will take longer than usual to achieve an orgasm, if you can climax at all. Depression has been linked to erectile dysfunction, which can be a source of embarrassment among men. Bedroom problems can make individuals feel inadequate.   

4 Brain fog

Do you find yourself forgetting what you promised your loved ones a few minutes or hours ago? Do you have trouble engaging and following conversations on EssayWritingLab? Do you find yourself confused most of the time? Brain fog is one of the biggest complaints among people suffering from depression. For some people, brain fog is quite embarrassing because they fear they might say the wrong things.

5 Snapping at your kids

Irritability and anger are subtle symptoms of depression. Research studies have shown that depressed people experience moments of anger. Most patients lose their temper and have a tendency of slamming the door, yelling and throwing things. They snap at their kids or their loved ones publicly and then feel ashamed.

6 Lack of dental hygiene

Depressed individuals can go for a long time without brushing their teeth. And this can be embarrassing. Since their gums pay the price, most of them smile less or, worse, don’t smile at all. When it gets so bad, depressed individuals give up on self-care entirely. Lack of dental hygiene not only allows bacteria to take over but also leads to the loss of teeth, which can be quite expensive to fix.

7 Inability to work full-time

The inability to stay focused and achieve the expected results can be one of the most embarrassing symptoms of depression.

This might start by showing up late to work or failing to attend key meetings. Depression can harm your ability to be creative and productive in the workplace. When they get promoted, individuals suffering from depression will have a hard time concentrating on the most important tasks, and they’ll miss their deadlines most of the time. Everything in the workplace can be exhausting. And this can lead to demotions and embarrassment in the workplace.

These Home Habits Helped Me Manage Severe Depression Symptoms

Coping with depression

Coping with depression and its symptoms can be overwhelming. It is especially difficult if you are struggling with feelings of shame, embarrassment, or guilt. No matter the cause, there are certain things that you can do to reduce embarrassment.

Know that people understand

Depression is a common mental condition that is affecting millions of people across the world. The high rate of depression means that people are going through similar experiences. We all experience depression differently. However, people will recognize how you are feeling and empathize with you. You might feel isolated when you are depressed. But it’s important to keep in mind that you are not alone.

Analyze your beliefs about depression

Nowadays, there’s a great deal of stigma surrounding anxiety, depression, and other mental issues. One of the best ways to eliminate feelings of embarrassment about your condition is by reconsidering your beliefs about mental health issues. Learning more about mental health conditions will open your eyes and help you discover some of the best treatments for this disorder.

Talk to someone

It’s quite difficult to open your heart and share with someone how you are feeling. It’s a sensitive issue that most people prefer keeping private. However, you don’t have to keep it a secret. It’s important for you to have a social support system that will protect you against various symptoms of depression. If you want to talk to someone, you should consider reaching out to a trained counselor who will offer you advice and accelerate your recovery process.

Conclusion

 To break the shame and stigma that comes with this health condition known as depression, we need to open up about these embarrassing symptoms.

Feeling guilty and embarrassed about your mental state is not uncommon. While it will take time, remind yourself that your thoughts and emotions are valid. Also, seek professional treatment whenever you can.

Author Bio:

Sherri Carrier is a professional writer at dissertation writing service and a member of several writing clubs in New York. She has been writing her own poems since she was a child. The young author gets inspiration from her favorite writers and people whom she loves.

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[ARTICLE] Risk of Erectile Dysfunction After Traumatic Brain Injury: A Nationwide Population-Based Cohort study in Taiwan – Full Text

Posted by Kostas Pantremenos in Disability and Sex, TBI on January 20, 2022

Abstract

Introduction:

In our study, we aimed to investigate the association between a traumatic brain injury (TBI) and subsequent erectile dysfunction (ED). This is a population-based study using the claims dataset from The National Health Insurance Research Database.

Methods:

We included 72,642 patients with TBI aged over 20 years, retrospectively, selected from the longitudinal health insurance database during 2000–2010, according to the ICD-9-CM. The control group consisted of 217,872 patients without TBI that were randomly chosen from the database at a ratio of 1:3, with age- and index year matched. Cox proportional hazards analysis was used to estimate the association between the TBI and subsequent ED.

Results:

After a 10-year follow-up, the incidence rate of ED was higher in the TBI patients when compared with the non-TBI control group (24.66 and 19.07 per 100,000, respectively). Patients with TBI had a higher risk of developing ED than the non-TBI cohort after the adjustment of the confounding factors, such as age, comorbidity, residence of urbanization and locations, seasons, level of care, and insured premiums (adjusted hazard ratio (HR) = 2.569, 95% CI [1.890, 3.492], p < .001).

Conclusion:

This is the first study using a comprehensive nationwide database to analyze the association of ED and TBI in the Asian population. After adjusted the confounding factors, patients with TBI have a significantly higher risk of developing ED, especially organic ED, than the general population. This finding might remind clinicians that it’s crucial in early identification and treatment of ED in post-TBI patients.

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Traumatic brain injury (TBI) is a worldwide public health problem defined as an insult to the brain from external mechanical force which may cause impairment of cognitive and physical functions, and psychological health problems. TBI could be classified as mild, moderate, or severe according to the initial Glasgow Coma Scale (GCS) score or the consciousness (Ghajar, 2000). The incidence of TBI is increasing throughout the world and has been associated with fatalities and long-term disabilities (Roozenbeek, Maas, & Menon, 2013; Stocchetti, 2014). Neuropsychological and neuropsychiatric disorders such as cognitive decline, sleep–wake cycle disturbances, depression, anxiety or posttraumatic stress disorders can also result in disabilities themselves and thus result in a major concern as being the cause of disabilities after TBI (Hibbard, Uysal, Kepler, Bogdany, & Silver, 1998; Moretti et al., 2012; Ouellet, Beaulieu-Bonneau, & Morin, 2015; Zaninotto et al., 2016). Among these problems, sexual dysfunctions and inappropriate sexual behaviors have been reported in the TBI patients that might contribute to an impaired quality of life, and disturbances to the patients with TBI and their caregivers (Ponsford, 2003; Ponsford, Downing, & Stolwyk, 2013; Sander et al., 2013; Turner, Schottle, Krueger, & Briken, 2015; War, Jamuna, & Arivazhagan, 2014).

Erectile dysfunction (ED), or the inability to attain or maintain a penile erection sufficient for successful vaginal intercourse, is a common sexual dysfunction that affects mainly men aged 40 or older (Shamloul & Ghanem, 2013). Previous studies reported that 26%–29% of males had experienced ED aged ≧40 (Hwang, Tsai, Lin, Chiang, & Chang, 2010; Rhoden, Teloken, Sogari, & Vargas Souto, 2002). Diabetes mellitus, hypertension, obesity, limited physical exercise, and lower urinary tract symptoms have been linked to the development of erectile dysfunction (Chaudhary et al., 2016; Clavijo, Miner, & Rajfer, 2014; Kaya, Sikka, & Gur, 2015; Leoni, Fukushima, Rocha, Maifrino, & Rodrigues, 2014; Maiorino, Bellastella, & Esposito, 2015; Phe & Roupret, 2012). Some neurological disorders are frequently associated with ED, including multiple sclerosis, temporal lobe epilepsy, Parkinson’s disease, stroke, Alzheimer’s disease, and spinal cord injury (Shamloul & Ghanem, 2013; Siddiqui et al., 2012). Previous studies have reported that TBI results in problems and disturbances such as inappropriate sexual behaviors and overall sexual dysfunctions in patients after TBI (Hanks, Sander, Millis, Hammond, & Maestas, 2013; Sander, Maestas, Pappadis, Hammond, & Hanks, 2016). Several physical factors such as hypogonadism (Cuesta et al., 2016) and prophylactic antiepileptic drugs (Yang & Wang, 2016) could attribute organic ED, in addition to neuropsychological and neuropsychiatric disorders (Farre, Fora, & Lasheras, 2004; Shamloul & Ghanem, 2013; Yafi et al., 2016). The association between TBI and ED was not studied specifically. This study aimed to clarify the association between TBI and ED in a nationwide, population-based, matched cohort study.

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[Abstract] Sexual dysfunction after traumatic brain injury

Posted by Kostas Pantremenos in Disability and Sex, TBI on January 16, 2022

Abstract

Objective: The frequency of self reported sexual difficulties was examined in a group of 322 individuals with traumatic brain injury (TBI) ($N = 193$ men; 129 women) and contrasted with reports of sexual difficulties in 264 individuals without disability (152 men; 112 women) residing in the community. Physiological, physical, and body images problems impacting sexual functioning were examined individually and then summed into a sexual dysfunction score. Mood, quality of life, health status and presence of an endocrine disorder were examined as predictors of sexual difficulties post TBI.

Study design: In this retrospective study, data about sexual difficulties were analyzed separately for men and women with TBI and without disability. ANOVAs with post hoc analysis for continuous variables, chi-square analyses for categorical variables, and ANCOVAs for predictors of sexual difficulties were utilized.

Results: When contrasted to individuals without disability, individuals with TBI reported more frequent (1) physiological difficulties influencing their energy for sex, sex drive, ability to initiate sexual activities and achieve orgasm; (2) physical difficulties influencing body positioning, body movement and sensation, and (3) body image difficulties influencing feelings of attractive and comfort with having a partner view one’s body during sexual activity. Additional gender specific TBI findings were observed. In comparison to gender matched groups without disability, men with TBI reported less frequent involvement in sexual activity and relationships, and more frequent difficulties in sustaining an erection; women with TBI reported more frequent difficulties in sexual arousal, pain with sex, masturbation and vaginal lubrication. While groups differed in core demographic variables, age was the only demographic variable that was related to reports of sexual difficulties in individuals with TBI and men without disability. Age at onset and severity of injury were negatively related to reports of sexual difficulties in individuals with TBI. In men with TBI and without disability, the most sensitive predictor of sexual dysfunction was level of depression. For women without disability, an endocrine disorder was the most sensitive predictor of sexual dysfunction. For women with TBI, an endocrine disorder and level depression combined were the most sensitive predictors of sexual difficulties.

Conclusion: Individuals post TBI report frequent physiological, physical and body images difficulties which negatively impact sexual activity and interest. For men post TBI, predictors of sexual difficulties included age at interview, age at injury, and having milder injuries, however, depression was the most sensitive predictor of sexual dysfunctions. For women post TBI, predictors of their sexual difficulties included age at injury and having milder injuries, however, depression and an endocrine disorder combined were the most sensitive predictors of sexual dysfunction. Implications of this study include the need for broad-based assessment of sexual dysfunction, and the implementation of treatment studies to enhance sexual functioning post TBI.

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[Abstract + Similar articles] Interventions for Sexual Dysfunction Following Stroke

Posted by Kostas Pantremenos in Disability and Sex, REHABILITATION on July 6, 2020

Abstract

Background: Sexual dysfunction following stroke is common but often is poorly managed. As awareness of sexual dysfunction following stroke increases as an important issue, a clearer evidence base for interventions for sexual dysfunction is needed to optimise management.

Objectives: To evaluate the effectiveness of interventions to reduce sexual dysfunction following stroke, and to assess adverse events associated with interventions for sexual dysfunction following stroke.

Search methods: We conducted the search on 27 November 2019. We searched the Cochrane Central Register of Controlled Trials (CENTRAL; from June 2014), in the Cochrane Library; MEDLINE (from 1950); Embase (from 1980); the Cumulative Index to Nursing and Allied Health Literature (CINAHL; from 1982); the Allied and Complementary Medicine Database (AMED; from 1985); PsycINFO (from 1806); the Physiotherapy Evidence Database (PEDro; from 1999); and 10 additional bibliographic databases and ongoing trial registers.

Selection criteria: We included randomised controlled trials (RCTs) that compared pharmacological treatments, mechanical devices, or complementary medicine interventions versus placebo. We also included other non-pharmacological interventions (such as education or therapy), which were compared against usual care or different forms of intervention (such as different intensities) for treating sexual dysfunction in stroke survivors.

Data collection and analysis: Two review authors independently selected eligible studies, extracted data, and assessed study quality. We determined the risk of bias for each study and performed a ‘best evidence’ synthesis using the GRADE approach.

Main results: We identified three RCTs with a total of 212 participants. We noted significant heterogeneity in interventions (one pharmacological, one physiotherapy-based, and one psycho-educational), and all RCTs were small and of ‘low’ or ‘very low’ quality. Based on these RCTs, data are insufficient to provide any reliable indication of benefit or risk to guide clinical practice in terms of the use of sertraline, specific pelvic floor muscle training, or individualised sexual rehabilitation.

Authors’ conclusions: Use of sertraline to treat premature ejaculation needs to be tested in further RCTs. The lack of benefit with structured sexual rehabilitation and pelvic floor physiotherapy should not be interpreted as proof of ineffectiveness. Well-designed, randomised, double-blinded, placebo-controlled trials of long-term duration are needed to determine the effectiveness of various types of interventions for sexual dysfunction. It should be noted, however, that it may not be possible to double-blind trials of complex interventions.

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[ARTICLE] Sexuality: A Neglected Discussion in Chronic Traumatic Brain Injury – issuu

Posted by Kostas Pantremenos in Cognitive Rehabilitation, Disability and Sex, TBI on February 24, 2020

By Kathryn Farris, OTR/L • Marisa King, PT, DPT • Monique R. Pappadis, MEd, PhD • Angelle M. Sander, PhD

Sexual dysfunction is a problem for 25% to 50% of persons with
traumatic brain injury (TBI) at one or more years post-injury
(Downing, Stolwyk, and Ponsford, 2013; Sander et al., 2012).
Dysfunction can occur at the stages of desire (Downing et al., 2013;
Sander et al., 2012; Strizzi et al., 2015), arousal (Sander et al., 2012;
Strizzi et al., 2015), and orgasm (Downing et al., 2013; Sander et
al., 2012; Strizzi et al., 2015). Sexual dysfunction after TBI can result
from damage to parts of the brain involved in regulating sexual
function, including the frontal lobe, temporal lobe, and subcortical
structures (Sandel, Delmonico, and Kotch, 2007). TBI-related
disruption of neurotransmitters and the neuroendocrine system also
impact sexual function (Behan et al., 2008).
TBI-related changes in physical, cognitive, emotional, behavioral,
and social functioning can impact sexuality. Physical changes
include spasticity, hemiparesis, balance/vestibular dysfunction, and
impaired sensation (Gervasio and Griffith, 1999). Cognitive deficits
can also negatively impact sexual function (Aloni and Katz, 2003).
For example, impaired attention and concentration can affect a
person’s ability to stay focused during a sexual encounter or become
aroused. Impaired initiation and planning can affect relationship
building and frequency of sexual activity. Reduced abstract thinking
and cognitive flexibility can limit ability to fantasize, impacting sexual
arousal. Memory impairments can result in an excessive demand for
sexual activity that can be distressing to partners. Impaired social
communication can result in decreased empathy, reduced ability to
read and respond to non-verbal behavior in others, and problems
perceiving emotions (Zupan et al., 2014).
Depression and anxiety, which occur frequently post-TBI (Osborn,
Mathias, and Fairweather-Schmidt, 2014, 2016), can inhibit
sexual desire and arousal. While hypersexuality is not as common
as hyposexuality after TBI (Simpson, Sabaz, and Daher, 2013),
disinhibition and impulsivity contribute to decreased self-monitoring
of sexual behavior in some people (Bezeau, Bogod, and Mateer,
2004). TBI can negatively impact social relationships, leading
to marital dissatisfaction and/or reduced relationship quality
(Hammond et al., Davis et al., 2011; Kreutzer et al., 2007). Reduced
social participation or social isolation is common following TBI and
contributes to sexual dysfunction (Sander et al., 2013).
Medication side effects also contribute to sexual problems. Many
drugs used to facilitate sleep and reduce cognitive and emotional
changes after TBI can have negative side effects on sexual
function (Aloni and Katz, 2003; Moreno et al., 2015) Examples
include anticonvulsants, selective serotonin reuptake inhibitors,
serotonin antagonist and reuptake inhibitors, dopamine agonists,
acetylcholinesterase inhibitors, stimulants, and baclofen.

[…]

Continue —> https://issuu.com/braininjuryprofessional/docs/bip_december_2019/26

 

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[Abstract + References] Changes in sexual functioning following traumatic brain injury: An overview on a neglected issue

Posted by Kostas Pantremenos in Caregivers, Disability and Sex, TBI on October 13, 2018

Highlights

  • Sexuality has a significant impact on interpersonal relationships and psychological well-being.
  • Up to 50% of patients with moderate to severe TBI report sexual problems.
  • Sexual disorders in TBI are closely dependent on the damaged brain area.
  • TBI patients and their caregivers should be provided with information useful to achieve a better sexual health.

Abstract

Traumatic brain injury (TBI) is any damage to the skull and/or the brain and its frameworks due to an external force. Following TBI, patients may report cognitive, physiological and psychosocial changes with a devastating impact on important aspects of the patient’s life, such as sexual functioning. Although sexual dysfunction (SD) occurs at a significantly greater frequency in individuals with TBI, it is not commonly assessed in the clinical setting and little information is available on this crucial aspect of patients’ quality of life. As the number of people with TBI is on the rise, there is a need for better management of TBI problems, including SD, by providing information to patients and their caregivers to achieve sexual health, with a consequent increase in their quality of life. Discussing and treating sexual problems in TBI patients enters the framework of a holistic approach. The purpose of this narrative review is provide clinicians with information concerning changes in sexual functioning and relationships in individuals with TBI, for a better management of patient’s functional outcomes and quality of life.

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via Changes in sexual functioning following traumatic brain injury: An overview on a neglected issue – Journal of Clinical Neuroscience

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[WEB SITE] Neurosexuality Needs to Be Better Addressed in Patients with Neurodisabilities

Posted by Kostas Pantremenos in Caregivers, Disability and Sex on February 24, 2018

Summary: Experts raise awareness of neurosexuality challenges faced by patients with neurodisabilities, including members of the LGBTQIA+ community, and provide guidance for healthcare providers and caregivers.

For people with brain disorders, whether from injury or disease, rehabilitation is a complex process. Neurosexuality is an emerging area of study and practice that focuses on the relationships between brain and sexual function in individuals with and without neurological disorders. Experts on the subject, reporting in NeuroRehabilitation, discuss how sexuality can affect neurorehabilitation in patients suffering from a range of conditions, from stroke and spinal cord injuries to sexual behavior in patients with dementia.

Research addressing the relationship between sexuality and the brain has a long history in neurological and behavioral sciences. This increased awareness has led to a better understanding within the scientific community regarding the importance of sexuality as a health outcome to promote the quality of life of individuals with neurodisabilities.

“This thematic issue of NeuroRehabilitation emphasizes that neurosexuality care should be driven by a transdisciplinary approach to appraise the evidence base of the potential negative consequences of different neurodisabilities on sexuality and to build upon sound treatment strategies to address these complexities,” explained guest editors Alexander Moreno, PhD, Caron Gan, RN, MScN, RP, AAMFT, and Nathan D. Zasler, MD.

An important contribution to this issue advocates for changing the culture of neurodisability through language and sensitivity of providers in order to create a safe place for lesbian, gay, bisexual, transgender, queer, intersex, asexual, and people with other sexual orientations and forms of gender expression (LGBTQIA+). “The particular needs of LGBTQIA+ individuals living with a neurological disorder are neglected in clinical practice and research. The invisibility of LGBTQIA+ individuals with neurological disorders reflects the historical exclusion of marginalized identities and creates disparities of access to healthcare,” explained Alexander Moreno, PhD, Faculty of Human Sciences, Department of Sexology, Université du Québec à Montréal (UQÀM) and the Center for Interdisciplinary Research in Rehabilitation of Greater Montreal, Ari Laoch, MS, Virginia Commonwealth University, and Nathan D. Zasler, MD, Concussion Care Centre of Virginia, Ltd. and Tree of Life Services, Inc. (VA).

The invisibility of LGBTQIA+ individuals with neurological disorders translates into diminished quality of care or inappropriate care, lack of recognition of all family configurations, exclusion of family caregivers, and violations of human rights (e.g., the right to be treated with dignity). Shedding light on the diversity of individuals with neurological disorders has the potential to improve healthcare by helping rehabilitation professionals to be sensitive to the particular needs of LGBTQIA+ individuals. In addition, the results of this study help promote the inclusion of sexual and gender diversity in the curricula of future practitioners and delineate future directions for research. Most importantly, the current study provides concrete clinical recommendations aiming to orient healthcare professionals wanting to improve their practice.

The authors surveyed the literature concerning neurological disorders affecting LGBTQIA+ individuals. They found that the relative neglect of LGBTQIA+ individuals with neurological disorders in clinical practice and research is striking. Healthcare professionals working with individuals with neurological disorders have the responsibility to create safer spaces in their clinical practice, including the use of inclusive language, the modification of admission forms to reflect diverse realities, the inclusion of sexual orientation and gender identity in their institutional policies, and participate in continuing education to challenge misconceptions, stereotypes, and negative attitudes. The authors provide 20 recommendations to guide clinicians, researchers, and policy professionals about the care of the LGBTQIA+ community.

Moreno, Laoch, and Zasler emphasized that “being part of a positive change in the rehabilitation of LGBTQIA+ people with neurodisabilities is part of our obligation as healthcare providers who are self-reflective, critical, and willing to improve the quality of the services provided in an ethical framework.”

Additional contributions to the issue cover a variety of important topics.

Sexual Health After Pediatric Acquired Brain Injury (ABI)

The authors reviewed over 2000 studies and found that literature about sexuality in children and adolescents with ABI has mainly addressed physical issues (e.g., precocious puberty), with positive sexual health needing further development in topics such as body image, sexual orientation, and social competence including flirting, dating, and romance.

Sexual health after traumatic brain injury (TBI) in younger and older adults Sexual problems were more likely for older (average mid-40s) patients with TBI than for younger (average 30s) patients. Older patients showed lower sexual desire and suffered more from anxiety and depression. Younger patients did not exhibit these symptoms to the same degree, suggesting that clinicians should be aware of age differences when treating their patients.

Stroke and Sexual Functioning

A literature review of post-stroke sexual functioning describes how various dysfunctions are related to stroke location, laterality, and physical and psychological changes. Three programs are presented to address post-stroke rehabilitation.

Multiple Sclerosis (MS) and Sexual Dysfunction

For patients with MS, assessment and treatment of sexual dysfunctions are described, including sexual assessment tools especially for MS. The authors also explore related topics including relationships, fertility, pregnancy, and parenting issues. They emphasize that, like other neurological disorders, there is a need for more collaboration among providers in addressing sexual concerns in MS.

How perceptions of sexuality in individuals with amyotrophic lateral sclerosis (ALS) can affect care

Surveys of both patients with ALS, also known as Lou Gehrig’s disease, and ALS care providers revealed uncomfortable feelings when the subject of sexuality was raised. The authors call for more education among ALS specialists in sexuality and a policy change that guarantees the inclusion of sexuality in their guidelines.

Sexual Concerns After Spinal Cord Injury (SCI)

SCI can impact sexual response, male infertility and its treatments, as well as pregnancy issues. The authors emphasize the importance of providing education and specific sexual recommendations based on the individual’s remaining sexual potential, and to include their partners, when available. They also present basic and advanced treatments for sexual dysfunctions and discuss other challenges in the management of sexual dysfunction of individuals with SCI.

Studying Intimacy And Sexuality In Clients With Dementia

Obtaining consent to study individuals with cognitive impairment is a controversial topic. In the environment of a residential care facility, the authors propose a multi-step approach involving authorized representatives (e.g., family caregivers), professional caregivers working in the facility, a pre-consent phase, a consent presentation phase, and a final consent before data collection. Their reflections and suggestions illuminate the ethical challenges involved in the study of sexuality and intimacy in individuals with severe cognitive impairment.

In summary, the guest editors write, “We hope that this thematic issue provides an impetus for rehabilitation and other health professionals, students in the health sciences, and researchers to develop their competence and awareness of the importance of sexual neurorehabilitation in persons with neurodisabilities.”

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via Neurosexuality Needs to Be Better Addressed in Patients with Neurodisabilities – SexualDiversity.Org

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[ARTICLE] Effectiveness of a structured sexual rehabilitation programme following stroke: A randomized controlled trial – Full Text

Posted by Kostas Pantremenos in Disability and Sex, REHABILITATION on March 29, 2017

Abstract

Background: Sexual activity is an integral part of life; it is important to address sexual health after stroke, but this is often poorly done.

Objective: To assess the effectiveness of a structured sexual rehabilitation programme compared with written information alone regarding sexual and psychological functioning (anxiety, depression, stress), functional independence and quality of life in an Australian stroke cohort.

Methods: A total of 68 participants were randomized to a structured sexual rehabilitation programme (treatment group; n = 35) or to written information alone (control group; n = 33). Outcome measures included: Sexual Functioning Questionnaire Short Form; Depression, Anxiety Stress Scale; Functional Independence Measure, and Stroke and Aphasia Quality of Life Scale-39 Generic. Assessments were performed at baseline, 6 weeks and 6 months after the intervention. Participant’s preferences regarding how they would like to receive information, who from, and how frequently, were collected at baseline.

Results: There was no difference between groups for any outcome measures. Half of the participants (51%) wished to receive information and were divided equally into preferring written information vs face-to-face counselling, with the majority (54%) preferring information after discharge from an inpatient setting.

Conclusion: Provision of written information alone appears to be as effective as a 30-min individualized sexual rehabilitation programme in an inpatient setting. Further research is needed regarding longer term outcomes and outpatient settings.

Stroke is a leading cause of death and disability (1). Sexual dysfunction is common after stroke, and has multifactorial causes: damage to the brain (causing decline in sexual desire/interest and coital frequency for both sexes, decline in vaginal lubrication and orgasm in females, and in erection and ejaculation in males, and physical changes, such as hemiplegia with resulting impairment of mobility) together with medical issues, such as medications and premorbid medical conditions (diabetes, hypertension, cardiac issues) and psychological factors (fear of new stroke, loss of self-esteem, role/relationship changes) are major contributors (2–5).

Sexuality is a broad concept and may be experienced and expressed in a variety of ways; including thoughts, fantasies, desires, beliefs, attitudes, values, behaviours, practices, roles, and relationships (6). Sexual activity is an integral part of life and the importance of addressing sexual health after stroke is well accepted (7). Despite this, it is common for sexuality to be poorly addressed, not just in stroke, but also in other neurological conditions, such as spina bifida (8) and spinal cord injury (9). The 2012 Australian National Stroke Audit Rehabilitation Services Report (10), which included 2,789 post-stroke patients across 111 Australian public and private hospitals, showed that only 17% of patients received information on sexuality. This is despite the opportunities provided through the staffing complement in rehabilitation settings. In practice, allied healthcare providers could have a primary or secondary role in sexual rehabilitation; they could be the sole providers of intervention or provide further intervention in their specific areas of expertise, such as physiotherapy training to optimize mobility in bed for sexual positioning, nursing education for catheter management, and dyspraxia training with speech therapy for sexual activities such as kissing. In addition, although current guidelines recommend the assessment and management of post-stroke sexual dysfunction (7), it is unclear what types of intervention (timing, content, intensity, setting) should be provided and how effective they are. The only intervention study currently available in the literature that addresses the impact of intervention on sexual activity following stroke suggests that a sexual rehabilitation intervention programme prior to hospital discharge increased sexual satisfaction and frequency of sexual activity one month post-discharge, but did not promote sexual knowledge (11). This study was conducted with culturally homogenous 40–49-year-old Korean couples and had significant methodological limitations (generalizability, pre-post design, and short follow-up). Patient’s preferences relating to sexual counselling, such as the timing of such counselling, also varied, creating further challenges for optimization of care (12, 13). Some studies show that most participants feel overwhelmed in the early adjustment period and that the best time to address sexual adjustment issues is towards the end of an acute rehabilitation hospitalization or shortly after discharge. In a pilot randomized controlled trial (RCT) conducted in 2014, the feasibility and importance of providing sexual rehabilitation following stroke was demonstrated; however, the “pilot” nature of the study did not allow for conclusive findings to be drawn (14).

The primary aim of this RCT was to assess the effectiveness of a comprehensive structured sexual rehabilitation programme compared with written information alone, on sexual and psychological (anxiety, depression, stress) function, and on functional independence and quality of life in an Australian stroke cohort. Building on the previous pilot RCT, to our knowledge this will be the first adequately powered RCT in this area. The findings will provide evidence that may lead to improved care.

Continue —> Journal of Rehabilitation Medicine – Effectiveness of a structured sexual rehabilitation programme following stroke: A randomized controlled trial – HTML

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[Abstract] A Multicenter Study of Sexual Functioning in Spouses/Partners of Persons With Traumatic Brain Injury.

Posted by Kostas Pantremenos in Disability and Sex, REHABILITATION, TBI on February 2, 2016

Abstract

Objective

To investigate sexual functioning and its predictors in spouses/partners of persons with traumatic brain injury (TBI).

Design

Inception cohort survey.

Setting

Community.

Participants

70 persons with complicated mild to severe TBI admitted to one of six participating TBI Model Systems inpatient rehabilitation units and their spouses/partners who were both living in the community and assessed 1 year after injury.

Interventions

Not applicable.

Main Outcome Measures

Derogatis Interview for Sexual Functioning Self-Report (DISF-SR); Global Sexual Satisfaction Index (GSSI).

Results

20% of spouses/partners of persons with TBI reported sexual dysfunction and 44% reported dissatisfaction with sexual functioning. 62% of spouses/partners reported a decrease in sexual activity during the year post-injury, 34% reported a decrease in sexual drive or desire, and 34% indicated that sexuality was less important in comparison to pre-injury. The sexual functioning of spouses/partners of persons with TBI was highly associated with the sexual functioning of the person with TBI. Age of spouse/partner and sexual functioning in persons with the TBI were significant predictors of spouses/partner’s sexual functioning, even after controlling for gender of partner and the physical, cognitive, participation, and sexual functioning of the person with injury.

Conclusions and Implications

Greater sexual dysfunction in spouses/partners was associated with older age and with poorer sexual functioning in the person with injury. Rehabilitation professionals should provide education on the potential impact of TBI on sexual functioning for both persons with TBI and their spouses/partners and integrate the assessment of sexual functioning into their clinical assessment, making appropriate referrals for therapy.

Keywords:

Traumatic brain injury, Sexual dysfunction, Spouses, Sexual partners

List of abbreviations:

DISF (Derogatis Interview for Sexual Functioning), DISF-SR (Derogatis Interview for Sexual Functioning Self-Report), DSM-IV (Diagnostic and Statistical Manual of Mental Disorders IV), FIMTM (functional independence measure), GCS (Glasgow Coma Scale), GSSI (Global Sexual Satisfaction Index), PART-O (Participation Assessment with Recombined Tools – Objective), TBI (Traumatic Brain Injury), TBIMS(Traumatic Brain Injury Model Systems)

Source: A Multicenter Study of Sexual Functioning in Spouses/Partners of Persons With Traumatic Brain Injury – Archives of Physical Medicine and Rehabilitation

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[WEB SITE] Sex and Sexuality | Stroke.org

Posted by Kostas Pantremenos in Disability and Sex on June 9, 2015

 

Talking about sex is hard for many people in general. Surviving a stroke and experiencing sexual dysfunction can add to the uneasiness of the subject. Part of getting back into a normal routine and life involves resuming a healthy sex life. The need to love and be loved, and to have the physical and mental release sex provides, is important.

more —>  Sex and Sexuality | Stroke.org.

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