my partner of 4 1/2 years sustained a concussion 16 months ago. he has post concussion syndrome and is still very affected by symptons. he is 41 and this was his 6th concussion. he is not working and is not sure what type of work he can do now. he takes wellbutrin and ritalin (as needed). he tested negative for a testerone imbalance. he sees a therapist, rests a lot, eats well and exercises daily. we've been in couples therapy for 4 months.

despite slowly getting better in most areas of his life (memory, motor function, fatigue), he's lost his desire for sex and it hasn't come back at all. while he is fully functional physically and able to feel emotions (again), including romantic love, he does not desire sexual contact. even something as basic as a hand massage never takes him beyond the immediate touch on his hand. we've tried to get the ball rolling in a number of ways, but he's just not into it.

is this something that can return? i'd love to hear anyone's personal experience with this side of the injury.

we are not married and do not have kids. i love him but and at a crossroads in terms of the future.

thank you.

Hi and welcome to NT.

I'll give my thoughts and my experience as a male that has experienced sexual dysfunction with a TBI. Keep in mind your partner’s injury and mine are different, he had a series of concussions while mine was a one-time TBI that was classified moderate to severe.

My issue with resuming sex after my injury included the inability to have an erection. In addition to a skull fracture I also sustained an open book pelvic fracture. Either in conjunction with the pelvic trauma or the repair surgery there was some collateral damage to the “boys”. There was loss of libido in addition to the ED. Tests showed low testosterone; now I use a testosterone supplement which helps with libido, and Levitra is helpful on the performance side.

So regarding your question, "can it return", my experience suggests that it can. One area to consider is his medications. Wellbutrin can cause loss of libido. You mentioned his testosterone "balance"; consider that the testosterone range for men is pretty wide, if he is on the low end of the "normal" range that could contribute to lowered libido also. Is he physically able to have an erection? If not, or if it’s difficult to maintain or weak, this could translate in to lowered interest in sex. ED medications can be helpful here.

I’m guessing this is part of the couple’s therapy? Since the romantic love part seems to be there I’d suggest as next steps a visit to a urologist for a full testosterone test, prostate check, and a discussion about ED medication. The urologist will likely have free samples of Levitra, Cialis, and probably Viagra.

Best to you both.

I googled side effects for wellbutrin and found this on the second link:

Less serious side effects may include:

headache or migraine, dizziness, tremors (shaking);
sleep problems (insomnia),



loss of interest in sex;




nausea, vomiting, constipation, dry mouth;
appetite changes, weight loss or gain; or
mild itching or skin rash, increased sweating.

(spacing added for emphasis)

Thanks for asking about this - it happens more often than a lot of people realize.

One of the things that can affect libido is also autonomic nervous system dysfunction -- when your system is constantly stuck in "fight or flight" mode. Slow breathing exercises as well as some forms of meditation can help balance that out. There could also be endocrine/hormonal issues as a result of the TBIs

Also 16 months is not very long, in terms of TBI recovery. I recommend that you don't base your future together only on this factor -- follow up with a number of things and keep at it, and also have patience. It's good if your relationship has more to keep it together than sex.

thanks for your replies. he's been on wellbutrin for years (before the accident where he walked into a sign post crossing the street) so he doesn't feel it's part of the problem. he didn't have sexual side effects from it before. and yes, he is able to get an erection. masturbating is not pleasurable for him, though. and he says he's not able to fantasize anymore.

i mentioned the urologist visit but he feels overwhelmed by going to another doctor. plus the cost. the initial testoterone test was only partially covered by his basic insurance. it was given by his gp. would. urologist redo the test? why a prostate exam.

and obviously, sex isn't everything but it is important to me.

thank you again-

Peppersandeggs,

You never mentioned how he sustained either concussion, and if they were already covered by his insurance, other than that one time about his partial coverage of a test.

Could you elaborate on that?

Reason for asking: any injury already receiving insurance coverage should continue receiving coverage for these mentioned studies as 'sequelae' - or complications from medications and the injuries, no matter the length from injury.

It only takes having his Practitioner tying them into the injury, which any practitioner with any cognition to TBI and those medications could see very easily.... including your couples therapist making a new recommendation to the Physician. Or, get a new Physician to address them, AS such..... actually see someone who is experienced with TBI /PCS.

Lightrail, Brokebrilliant, and Owl are right there for it..........

Our conditions and medications all tie into this problem no matter which sex we are, the brain injury and the medications are detrimental to our desires and abilities........

Best Wishes.............

concussion,

he walked into a horizontal street sign while crossing the street. it hit him right above the eyebrow. he was knocked out and was immediately severly affected. we went to the er... he had an mri (normal). he was seen by neurologists, a neuropsychologist is in charge of his meds right now (he did an extensive evaluation of him). he tried abilify but did not like it.

he was technically working when this happened and recieved disability/workman's comp until last may. he returned to work briefly but has stopped working and is just using his orginal insurance, which is very basic and living off savings.

Hate to say this-but as a female (2 yrs after tbi) I'm not terribly interested. I love my hubby and I will participate and of course it's enjoyable...but I could just about care less.

I experienced this for a long time after my concussion. I found that royal jelly and carnitine boost my libido incredibly well and they also have several other benefits.

Hi,

I actually think this is an important discussion and hope others contribute their own experiences.

Next month will be the 6th anniversary of my new life with MTBI and still experience sexual problems. As a female (now 44) I can give you my perspective and some links for you to check out that I hope offer some help. Side note - if his injury was covered by workers comp, he can re-open the case if it was closed. A visit to an attorney might be very beneficial for his medical/financial future.

50 - 60% of TBI patients experience some form of sexual difficulties post-injury. While this can be an embarrassing issue to discuss, we are not alone. Whether you’re on either side of this equation it is frustrating. Part of being a whole person includes our sexual health and when it’s compromised we feel incomplete. At least I do

You mention your partner is physically capable, but not interested. Why? What is the root issue? Determining the root issue helps determine who to see for help: neuropsychiatrist, neuropsychologist, endocrinologist, sex therapist, etc.

FIRST - Is he interested in finding a solution? If he has no desire then it's difficult to work out the solution. If yes, he needs to ask himself questions like: Do I feel sexual desire and/or arousal? Is any particular part of sex too overwhelming for my senses to handle? Is any part of sex enjoyable? Can I reach orgasm? Sex, like light or sound, can be too overwhelming to the senses – just like light or sound. Experimenting together can be beneficial, but can also be frustrating to both partners. My last boyfriend found it frustrating and a "blow to his manhood" that I could not reach orgasm. Lack of communication doomed my relationship so be gentle with each other.

There are many reasons and solutions, but he needs to know the underlying reason why there is no interest. The brain is the biochemical "manager" of sexual function, barring a physical issue. The reason for sexual issues can range from the physical location of the brain injury, psychosocial, emotional, to biochemical disruption in the neurotransmitters that are responsible for sexual desire.

The frontal lobes play an important role in sex. From your description he hit his left frontal and/or temporal lobe. My accident caused my head (frontal & temporal lobes) to hit the steering wheel then the left side hit the driver’s side window – double whammy of external bruises, but MRI negative just the same. Personally, I believe the injury location has much to do with the dysfunction. However, we can be regionally limited to experts or research studies that can help.

My 6 years of experience says this is a dynamic process that evolves over time with or without medication. I found meds can help, but make you feel like a guinea pig trying to find the right med's or combo. My story evolution: No sexual desire at all; sexual desire returned, but physical sensation was too overwhelming so I avoided sex altogether; sensitivity lessened, sex became enjoyable, but now I can’t reach orgasm. Since I can’t reach orgasm - sex is frustrating and leaves me aching with a hole inside physically and emotionally. Having no current partner I decided not to try the medical solutions since a lack of desire is rather beneficial when you’re single. Lol A silver lining!

I wish you both the best!

~Kristy

Links:

http://www.stanleyducharme.com/resou...bin_injury.htm



This has a lot of information to read:
http://www.betterhealth.vic.gov.au/b..._sexual_issues

http://www.brainline.org/content/200...g_pageall.html