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Study at one VAMC finds high rate of sexual dysfunction among new Veterans

November 10, 2015

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Returning Veterans experience relatively high rates of sexual dysfunction, according to a study at one VA post-deployment clinic. (Photo for illustrative purposes only. ©iStock/andresr)

Returning Veterans experience relatively high rates of sexual dysfunction, according to a study at one VA post-deployment clinic. (Photo for illustrative purposes only. ©iStock/andresr)

In a study of 247 Veterans who had served recently in Iraq or Afghanistan, almost 18 percent screened positive for sexual functioning difficulties. Factors that were linked with self-reported sexual dysfunction included depression, posttraumatic stress disorder, female sex, and a higher service connection rating.

The study came out online Nov. 2, 2015, in the journal Sexual Medicine. It was conducted at the post-deployment health clinic at the Michael E. DeBakey VA Medical Center in Houston.

"Sexual dysfunction is as prevalent as other conditions we think of as being related to military service, such as posttraumatic stress disorder and traumatic brain injury," said study coauthor Dr. Drew Helmer in a news release from the publisher. "Recent combat Veterans are often at a stage of life when sexual health is critical for establishing and sustaining relationships and starting families. We should make it easy for all Veterans to discuss sexual health concerns with their health care providers and receive effective care."

Helmer, a researcher and primary care physician, directs the War-Related Illness and Injury Study Center in East Orange, N.J., one of three such centers funded by VA. He is also an associate professor at Rutgers University-NJ Medical School and the author of the 2014 book Sex after Service: A Guide for Military Service Members, Veterans, and the People Who Love Them.

He collaborated on the study with researchers from the Houston VA, Baylor College of Medicine, and the University of Texas.

Study based on self-report screening measure

The study was based on results from a questionnaire called the Arizona Sexual Experience Scale, which is used for screening at VA post-deployment clinics. Patients rate themselves on factors such as arousal, sex drive, vaginal or erectile function, and orgasm satisfaction.

Nearly one in five of the Veterans whose data was included in the study scored positive for sexual dysfunction. Previous estimates of sexual health concerns among returning Veterans have varied widely, from around 5 to 25 percent, due to differing study methods.

One limitation of the new study was that the respondents may have under-reported military sexual trauma and minority sexual status. So the researchers can't say whether these issues were in fact linked to sexual dysfunction in the study sample. By the same token, the rate of PTSD among the Veterans in the study—56 percent—was based on initial clinic screenings, and the actual rate, determined in follow-up exams, may be far lower. That too could affect the associations seen in the study.

Also, the researchers did not have enough data on the Veterans' medications—for example, how long they were on them—to tease out whether this could have been partly responsible for the high rate of sexual dysfunction.

The study authors say more research is needed to understand how Veterans' sexual health problems relate to events before, during, or after military service. Helmer added in an interview: "We know from our clinical experience how important sexual health is to our Veteran patients. We hope that our findings and future research efforts help them find solutions in partnership with their health care providers."



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