ПРОГНОСТИЧНІ ЧИННИКИ СЕКСУАЛЬНИХ ДИСФУНКЦІЙ У ВІЙСЬКОВИХ ТА ВЕТЕРАНІВ

Svyatoslava Fedorets

doi:10.31732/2663-2209-2024-74-345-352

Authors

Svyatoslava Fedorets KROK University https://orcid.org/0000-0002-2343-7550

DOI:

https://doi.org/10.31732/2663-2209-2024-74-345-352

Keywords:

veterans, military personnel, depression, erectile dysfunction, decreased sex drive, post-traumatic stress disorder, mental disorders, rehabilitation, couple relationship, sexual dysfunction, sexual rehabilitation, anxiety

Abstract

The article highlights the peculiarities of sexual dysfunctions in military personnel and veterans and their prognostic factors. In particular, foreign studies of previous years are analysed, attention is focused on the unresolved parts of the general research problem, and the problematic areas of existing research results are emphasised. In addition, the author focuses on the unevenness of research among men and women involved in military affairs, as well as the lack of data on differences in their sexual health. The main groups of precursors of deterioration in sexual functioning are identified, which were conditionally divided into two groups of ‘inorganic’ and ‘organic’ factors. An in-depth review of the specifics of inorganic precursors of sexual dysfunctions is carried out. Among them are psychological factors, social influences, relationship problems, and mental health disorders of a non-organic nature. Separate clusters of post-traumatic stress disorder are considered and their uneven impact on possible sexual dysfunctions is noted. Attention is focused on such changes as emotional numbness, avoidance, obsessive symptoms, chronic autonomic arousal and their connection with sexual problems in veterans and military personnel. The relationship between various precursors of sexual problems and typical sexual dysfunctions to which they mostly lead is indicated. Some differences in the way the same predictors of sexual dysfunction can affect the sexual functioning of male and female veterans are highlighted. Important associated factors of sexual dysfunction, such as depression, anxiety disorders, antidepressant medication, etc. are considered. Some organic precursors and their impact on the deterioration of sexual functioning are noted. The importance of psychoeducation among veteran families as a way of early prevention of sexual dysfunctions is also emphasised. In addition, the importance of raising awareness among professionals in helping professions about possible deterioration in the sexual functioning of military personnel and veterans is highlighted.

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Author Biography

Svyatoslava Fedorets, KROK University

Postgraduate student, "KROK" University, Kyiv, Ukraine

References

Aksaray G, Yelken B, Kaptanoglu C, et al. Sexuality in women with obsessive compulsive disorder. J Sex Marital Ther 2001; 27: 273–277

Badour C.L., Gros D.F., Szafranski D.D., Acierno R. Problems in sexual functioning among male OEF/OIF veterans seeking treatment for posttraumatic stress. Compr. Psychiatry. 2015;58:74–81. doi: 10.1016/j.comppsych.2014.12.012.

Basson R, Gilks T. Women's sexual dysfunction associated with psychiatric disorders and their treatment. Womens Health (Lond). 2018 Jan-Dec;14:1745506518762664. doi: 10.1177/1745506518762664. PMID: 29649948; PMCID: PMC5900810.

Bentsen I.L., Giraldi A.G., Kristensen E., Andersen H.S. Systematic Review of Sexual Dysfunction Among Veterans with Post-Traumatic Stress Disorder. Sex. Med. Rev. 2015;3:78–87. doi: 10.1002/smrj.47.

Bhalla A., Allen E., Renshaw K., Kenny J., Litz B. Emotional numbing symptoms partially mediate the association between exposure to potentially morally injurious experiences and sexual anxiety for male service members. J. Trauma. Dissociation. 2018;19:417–430. doi: 10.1080/15299732.2018.1451976.

Bodinger L, Hermesh H, Aizenberg D, et al. Sexual function and behavior in social phobia. J Clin Psychiatry 2002; 63: 874–879.

Bradford A, Meston CM. The impact of anxiety on sexual arousal in women. Behav Res Ther 2006; 44: 1067–1077.

Breyer BN, Fang SC, Seal KH, Ranganathan G, Marx BP, Keane TM, Rosen RC. Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort. J Trauma Stress. 2016 Jun;29(3):229-36.

Erbes CR, Meis LA, Polusny MA, Compton JS, Wadsworth SM. An examination of PTSD symptoms and relationship functioning in U.S. soldiers of the Iraq war over time. Journal of Traumatic Stress. 2012;25:187–190. doi:10.1002/jts.21689.

Eriksson M.A., Rask E., Johnson O., Carlström K., Ahrén B., Eliasson M., Boman K., Söderberg S. Sex-related differences in the associations between hyperleptinemia, insulin resistance and dysfibrinolysis. Blood Coagul Fibrinolysis. 2008;19:625–632.

Cameron RP, Mona LR, Syme ML, Cordes CC, Fraley SS, Chen SS, Lemos L. Sexuality among wounded veterans of Operation Enduring Freedom (OEF), Operation Iraqi Freedom (OIF), and Operation New Dawn (OND): Implications for rehabilitation psychologists. Rehabilitation Psychology. 2011;56:289–301. doi:10.1037/a0025513.

Clayton AH, Gommoll C, Chen D, Nunez R, Mathews M. Sexual dysfunction during treatment of major depressive disorder with vilazodone, citalopram, or placebo: results from a phase IV clinical trial. Int Clin Psychopharmacol. 2015 Jul;30(4):216-23

Cohen BE, Maguen S, Bertenthal D, Shi Y, Jacoby V, Seal KH. Reproductive and other health outcomes in Iraq and Afghanistan women veterans using VA health care: Association with mental health diagnoses. Women’s Health Issues. 2012;22:461–471. doi:10.1016/j.whi.2012.06.005.

Cook J.M., Riggs D.S., Thompson R., Coyne J.C., Sheikh J.I. Posttraumatic stress disorder and current relationship functioning among World War II ex-prisoners of war. J. Fam. Psychol. 2004;18:36–45. doi: 10.1037/0893-3200.18.1.36.

Cyranowski JM, Bromberger J, Youk A, Matthews K, Kravitz HM, Powell LH. Lifetime depression history and sexual function in women at midlife. Arch. Sex. Behav. 2004;33:539–548. doi: 10.1023/B:ASEB.0000044738.84813.3b.

Filippi S, Marini M, Vannelli GB, et al. Effects of hypoxia on endothelin-1 sensitivity in the corpus cavernosum. Mol Hum Reprod. 2003;9:765-774.

Foy C.G., Newman J.C., Berlowitz D.R., Russell L.P., Kimmel P.L., Wadley V.G., Thomas H.N., Lerner A.J., Riley W.T., SPRINT Study Research Group Blood Pressure, Sexual Activity, and Erectile Function in Hypertensive Men: Baseline Findings from the Systolic Blood Pressure Intervention Trial (SPRINT) J. Sex. Med. 2019;16:235–247. doi: 10.1016/j.jsxm.2018.12.007.

Frohlich P, Meston C. Sexual functioning and self-reported depressive symptoms among college women. J Sex Res. 2002;39:321–325.

Hackett G., Krychman M., Baldwin D., Bennett N., El-Zawahry A., Graziottin A., Lukasiewicz M., McVary K., Sato Y., Incrocci L. Coronary Heart Disease, Diabetes, and Sexuality in Men. J. Sex. Med. 2016;13:887–904. doi: 10.1016/j.jsxm.2016.01.023.

Howard M. D. Escaping the pain: Examining the use of sexually compulsive behavior to avoid the traumatic memories of combat. Sexual Addiction & Compulsivity. 2007;14((2)):77–94.

Huang SY, Hung JH, Hu LY, Huang MW, Lee SC, Shen CC. Risk of sexually transmitted infections following depressive disorder: A nationwide population-based cohort study. Medicine (Baltimore). 2018 Oct;97(43):e12539. doi: 10.1097/MD.0000000000012539. PMID: 30412060; PMCID: PMC6221703.

Kimura M, Murata Y, Shimoda K, Robinson RG. Sexual dysfunction following stroke. Compr Psychiatry. (2001) 42:217–22. 10.1053/comp.2001.23141

Khandker M, Brady SS, Vitonis AF, et al. The influence of depression and anxiety on risk of adult onset vulvodynia. J Womens Health 2011; 20: 1445–1451.

Lambert J.E., Engh R., Hasbun A., Holzer J. Impact of posttraumatic stress disorder on the relationship quality and psychological distress of intimate partners: A meta-analytic review. J. Fam. Psychol. 2012;26:729–737. doi: 10.1037/a0029341.

Leeners B, Hengartner MP, Rössler W, et al. The role of psychopathological and personality covariates in orgasmic difficulties: a prospective longitudinal evaluation in a cohort of women from age 30 to 50. J Sex Med 2014; 11: 2928–2937.

Letica-Crepulja M, Stevanović A, Protuđer M, Popović B, Salopek-Žiha D, Vondraček S. Predictors of Sexual Dysfunction in Veterans with Post-Traumatic Stress Disorder. J Clin Med. 2019 Mar 29;8(4):432. doi: 10.3390/jcm8040432.

Letourneau EJ, Resnick HS, Kilpatrick DG, Saunders BE, Best CL. Comorbidity of sexual problems and posttraumatic stress disorder in female crime victims. Behavior Therapy. 1996;27:321–336. doi:10.1016/S0005-7894(96)80020-7.

Lorenz TA, Harte CB, Hamilton LD, et al. Evidence for a curvilinear relationship between sympathetic nervous system activation and women’s physiological sexual arousal. Psychophysiology 2012;49:111–117. doi: 10.1111/j.1469-8986.2011.01285.x.

Lunelli R.P., Irigoyen M.C., Goldmeier S. Hypertension as a risk factor for female sexual dysfunction: Cross-sectional study. Rev. Bras. Enferm. 2018;71:2477–2482. doi: 10.1590/0034-7167-2017-0259.

Malavige L.S., Levy J.C. Erectile dysfunction in diabetes mellitus. J. Sex. Med. 2009;6:1232–1247. doi: 10.1111/j.1743-6109.2008.01168.x.

Mazzaferro KE, Murray PJ, Ness RB, Bass DC, Tyus N, Cook RL. Depression, stress, and social support as predictors of high-risk sexual behaviors and STIS in young women. Journal of Adolescent Health. 2006;39(4):601–603.

McCall-Hosenfeld JS, Liebschutz JM, Spiro A, Seaver MR. Sexual assault in the military and its impact on sexual satisfaction in women veterans: A proposed model. Journal of Women’s Health. 2009;18:901–909. doi:10.1089/jwh.2008.0987.

Montejo A.L., Montejo L., Baldwin D.S. The impact of severe mental disorders and psychotropic medications on sexual health and its implications for clinical management. World Psychiatry. 2018;17:3–11. doi: 10.1002/wps.20509.

Pereira M.G., Pereira D., Pedras S. PTSD, psychological morbidity and marital dissatisfaction in colonial war veterans. J. Ment. Health. 2019;19:1–8. doi: 10.1080/09638237.2018.1487532.

Phé V., Rouprêt M. Erectile dysfunction and diabetes: A review of the current evidence-based medicine and a synthesis of the main available therapies. Diabetes Metab. 2012;38:1–13. doi: 10.1016/j.diabet.2011.09.003.

Phillips RL, Slaughter JR. Depression and sexual desire. Am Fam Physician. 2000;62:782–786.

Rees PM, Fowler CJ, Maas CP. Sexual function in men and women with neurological disorders. Lancet. 2007;369:512–525. doi: 10.1016/S0140-6736(07)60238-4.

Rosen RC, Lane RM, Menza M. Effects of SSRIs on sexual function: A critical review. Journal of Clinical Psychopharmacology. 1999;19:67–85. doi:10.1038/sj.ijir.3900472.

Seth P, Raiji PT, DiClemente RJ, Wingood GM, Rose E. Psychological distress as a correlate of a biologically confirmed STI, risky sexual practices, self-efficacy and communication with male sex partners in African-American female adolescents. Psychology, Health & Medicine. 2009;14(3):291–300.

Taft C.T., Watkins L.E., Stafford J., Street A.E., Monson C.M. Posttraumatic stress disorder and intimate relationship problems: A meta-analysis. J. Consult. Clin. Psychol. 2011;79:22–33. doi: 10.1037/a0022196.

Vasterling JJ, Proctor SP, Amoroso P, Kane R, Heeren T, White RF. Neuropsychological outcomes of army personnel following deployment to the Iraq war. Journal of the American Medical Association. 2006;296:519–529. doi:10.1001/jama.296.5.519.

Yehuda R., Lehrner A., Rosenbaum T.Y. PTSD and Sexual Dysfunction in Men and Women. J. Sex. Med. 2015;12:1107–1119. doi: 10.1111/jsm.12856.