The research literature supports the relationship between various forms of trauma, PTSD, and sexual dysfunctions. An estimated 20% to 48% of children are exposed to trauma in the form of childhood abuse and neglect; and exposure to potentially traumatic events occurs in around 18% of the general population. A further contributing factor to developing PTSD is military trauma, with Veterans in the general population and military personnel on active duty having prevalence rates of PTSD of 7% and 13% respectively.

Sexual dysfunctions affect 31% of men, including issues like premature ejaculation, erectile dysfunction, and delayed ejaculation. In women, 43% experience challenges such as low sexual desire, arousal disorder, difficulty reaching orgasm, or painful intercourse. Given the high occurrence of traumatic experiences—in childhood and adulthood—it’s not surprising that sexual dysfunctions go hand in hand with PTSD. As often observed in clinical practice, some individuals experience specific symptoms of PTSD along with specific difficulties with sexual functioning across the sexual response cycle (e.g., desire, arousal, orgasm). Research in this area is still developing, but ongoing studies aim to better understand these connections. The goal is to fill the gaps and improve treatment for people with a history of trauma and sexual dysfunction.

Clinicians often observe that patients do not see their current symptoms as part of a more comprehensive picture of PTSD and are often focused on the specific symptoms of sexual dysfunction. However, most symptoms of sexual dysfunction are not about sex at all.

Below are the PTSD symptom clusters.

Intrusion:

Involuntary and distressing memories of the traumatic event
Nightmares or flashbacks
Emotional distress when exposed to reminders of the trauma

Avoidance:

Avoidance of thoughts, feelings, or conversations about the trauma
Avoidance of places, activities, or people associated with the trauma
Avoidance of reminders of the trauma, such as objects or smells

Negative Alterations in Cognition (thinking) and Mood:

Persistent negative beliefs about oneself, the world, or the future
Distorted memories of the traumatic event
Difficulty concentrating or making decisions
Loss of interest in activities previously enjoyed

Hyperarousal:

Irritability or outbursts of anger
Difficulty sleeping
Hypervigilance (excessive alertness)
Startle response

Research has shown that the impacts of childhood sexual abuse on adult sexual functioning have a unique set of trauma symptoms that play a role in symptoms of sexual dysfunction. Research has found that 81% of study participants with a history of childhood sexual abuse reported challenges with sex. Specifically, these challenges were associated with PTSD symptoms of depression and hyperarousal. Other PTSD symptoms included dissociative amnesia, visual intrusions, and physical responses when the trauma was remembered. PTSD often involves physiological reactions to childhood sexual abuse and trauma which may lead to sleep issues, difficulty concentrating, and anhedonia (lack of interest, enjoyment, or pleasure in life’s experiences). Dissociative symptoms and altered state of consciousness have also been found to be linked to a history of childhood sexual abuse. Additionally, other research has shown that adult women who were sexually assaulted reported sexual dysfunction and and were diagnosed with PTSD and/or depressive symptoms, with an impairment in all areas of sexual response, with most impairment with arousal and lubrication.

If you have symptoms of sexual dysfunction, it may be helpful to consider if you also experience symptoms of PTSD to better understand a possible relationship between trauma you have experienced and your current sexual functioning.