Marital separation rates can be as high as 78 percent among people with TBI, Moreno said.
The research also showed that people with TBI commonly experience thinking problems, depression, anxiety and changes in body image. Some of their medications -- such as blood-pressure drugs, antidepressants, stimulants and anticonvulsants -- can lower sex drive and cause other physical and mental problems. Some develop personality changes, such as reduced social skills and trouble knowing what is inappropriate to say or do with others, the study found.
Yet experts said sexual issues associated with TBI don't get much attention from physicians and rehabilitation professionals.
"It's not something that's really dealt with acutely or soon afterwards," said Kenneth Podell, co-director of the Methodist Concussion Center in Houston. "When the patient goes home, the focus is still on primary things. Then, as people are settling into their routine, that's where [the problems] seem to be popping up."
The sexual problems that people with TBI experience are so intertwined with the complex psychological and social aftereffects of the injury that patients need a more holistic approach to rehabilitation, Moreno said.
"Yet most places don't have a multi-disciplinary approach to TBI; Methodist [Concussion Center] does not have it," Podell said. "You find [multi-disciplinary teams] in certain rehabilitation hospitals or centers, and yet even then you're getting a neurologist, a psychologist, a speech pathologist -- but you don't necessarily have a sex therapist."
Podell said most studies reviewed in the research included only those with moderate an
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