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Chapter 25. Sexual Dysfunction

Nathan D. Zasler, M.D.; Michael F. Martelli, Ph.D.
DOI: 10.1176/appi.books.9781585624201.682649

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Traumatic brain injury (TBI) may adversely affect the expression of sexuality and/or sexual functions because of a variety of different factors. A TBI may affect myriad aspects of functioning germane to sexual expression, including cognitive, emotional, behavioral, physical, and psychosocial functioning. The complexity of these factors, not only singly but also integrated into their influence on human behavior, presents clinical assessment and treatment challenges as well as methodological challenges for research (Sandel et al. 2007). Brain injury may produce sexual dysfunction at the genital level as well as adversely affect expression of sexuality at the nongenital level. Ultimately, the mediating factors in these functional alterations include disruption of neuroanatomical pathways or aberrations in neurophysiological function, or both, as a result of the TBI. To better comprehend the effect of brain injury on sexuality, one must first understand the basic neuroanatomical pathways and neurophysiological mechanisms that are involved in the mediation of sexual function.

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