Prevalence, correlates, mechanisms, and treatment of sexual health problems after traumatic brain injury: A scoping review

Sexuality is an important domain affected by traumatic brain injury (TBI). A scoping review was conducted to identify the evidence base derived from quantitative studies investigating sexual health issues after TBI. A systematic search of 4 electronic databases found 1833 citations published as of the end of 2010, of which 24 met the inclusion/ exclusion criteria. Only 2 treatment studies were identified (a single case treating premature ejaculation and a case series treating sexual dysfunction induced by selective serotonin reuptake inhibitors); both were rated poorly for methodological quality. Fourteen studies reported the prevalence of sexual dysfunction (drive, arousal, orgasm), with rates generally ranging between 10% and 50%. One study reported about the knowledge of safer sex and another reported about the agency use of a sex education program for adults with TBI. Six studies reported mechanisms underpinning sexual function/dysfunction: 2 found that reduction in sexual cognition may be linked to reduced sex drive; 2 reported intact penile function among men in a vegetative state; and 2 reported the duration of amenorrhea and female fertility rates after TBI. Overall, most studies were from a single center, few were controlled, and all observational studies were cross-sectional, meaning that the course of sexual dysfunction after TBI is unknown. Given the frequency and complexity of sexual health issues after TBI, more high quality studies are needed.