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Brainstreams > Learn > Healing Brain > Sexual Health and Intimacy
HomeLearnHealing BrainSexual Health and Intimacy

Sexual Health and Intimacy

Sexual Health and IntimacyAdmin2017-11-20T19:18:00-08:00
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Sexuality is an important of us all, regardless of our age, gender, health and physical ability. Sexuality includes: biological, erotic, physical, emotional, social, or spiritual feelings and behaviours. It is the way people experience and express themselves as sexual beings.

Sexual health can include: sexual knowledge, sexual interest, sexual response, sexual activity, sexual relationships, fertility/contraception and how you feel about yourself.

After a brain injury, you or your partner may experience changes in your sexuality.

Below are a some examples of some common questions raised by the person living with a brain injury, or their partners and families.

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Click on a topic below to jump to that section:

  • Common Sexual Health Questions

  • Sexual Health Online Resources

  • Sexual Health and Relationships Tip Sheets

Common Sexual Health Questions

Click on the plus symbol beside a topic to learn more.

Why has my desire for sexual intimacy changed?

A decrease in the level of sexual interest is a common concern. The reasons for this are many and may include:

Physical changes such as:

  • Difficulty getting an erection, vaginal dryness
  • Loss of body movement
  • Loss of sensation
  • Spasticity
  • Pain
  • Fatigue
  • Difficulty communicating

Emotional / behavioural changes – that may affect the expression of sexuality such as:

  • Fear and anxiety
  • Depression
  • Changes in body image and self esteem
  • Behavioural disinhibition
  • Changes in role
  • Social isolation

Medical conditions such as:

  • Thyroid problems, vascular disease, diabetes, hormonal changes
  • Potential side effects of some medications

Some of these changes may be temporary and improve over time.  There may be some treatment options for you.  Discuss your concerns with your doctor or sexual health clinician.

Share your concerns and feelings with your partner. Talking with each other may help clarify misunderstandings as well as create chances to work on your intimate relationship.

My body does not move in the same way, what can I do?

You may have difficulty moving, balancing and positioning your body, legs, arms and hands for sexual activity. Pain and discomfort may also be a concern.

  • Be creative and stay open to new ideas
  • Stretching and range of motion exercises may help decrease spasticity
  • Taking anti-spasticity medication prior to sexual activity may help. Talk to your doctor about this.
  • A physiotherapist, occupational therapist or sexual health clinician can explore different positions and techniques with you and your partner
  • Try new positions, and explore using pillows and adaptive devices. The Sexual Device Manual gives ideas for positions and devices.

Do I still need to worry about birth control and sexually transmitted disease?

The short answer is “yes”

Try to avoid an unplanned/unwanted pregnancy

  • You may choose to change your method of contraception. Think about your ability to remember, hand function and physical ability. Discuss this with your doctor.
  • Everyone is vulnerable to STD’s and HIV infection. Always use condoms with casual partners and partners when you don’t know their sexual history
  • For information on contraception and safer sex practices contact:
    BC Options for Sexual Health at www.optbc.org or 1-800-SEX-SENSE (1-800-739-7367)

I find it much harder to meet new people, what can I do?

  • Pay attention to your appearance (clothing, hair, shaving) and personal hygiene
  • Join support groups, find ways to help others, volunteer, join a hobby or interest group or take a course. Attend a service club or church. The bottom line is, you need to get out of the house to meet people.
  • Get ideas from family and friends

I notice that I sometimes say things that upset people

  • We all have thoughts in our head that we don’t share with people around us. For example, if we see an attractive person walking down the street we don’t say, “I like your butt”. For some persons with a brain injury keeping these thoughts private is difficult.
  • In some cases after a brain injury, the person’s understanding of appropriate sexual behaviour can be affected. This can be very confusing and upsetting for the family.
  • Giving constructive feedback to the person may help
  • If the behaviour continues, you can try education, counselling, setting boundaries and medical help.
  • Getting feedback from others and being aware that you have trouble with this is the first step
  • If this is a problem you are experiencing as a brain injury survivor, you will have to work hard to watch what you say. A psychologist or occupational therapist can help you find ways to do this.

I find it difficult to feel sexual towards my partner when I am more of a parent to him/her during the day

  • Your partner may take on more of a care giving role after your brain injury.  It can be time consuming, physically tiring and emotionally draining.
  • Your partner may feel differently towards you emotionally
  • Having the help of a paid caregiver helps your partner focus on your relationship
  • Find simple ways to work on your relationship: Go on a weekly date, set aside an hour each day to focus on intimacy
  • If you need more help, consider counselling. A good therapist can help clarify concerns and increase communication between you and your partner

How can I maintain a healthy attitude towards sexual activity?

In your journey to sexual rediscovery it can be helpful to understand that life behaviours of a sexually healthy person include:

  • Appreciating one’s own body
  • Affirming one’s own sexual orientation and respecting others
  • Making informed choices
  • Identifying and living according to one’s values
  • Taking responsibility for one’s own behaviours
  • Enjoying and expressing one’s sexuality throughout life
    (Adapted from the Sexuality Information and Education Council of US)
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Online Resources

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Spinal Cord Injury BC

The Spinal Cord Injury of BC offers information on various aspects of relationships and sexual health.

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Heart and Stroke Foundation

The Heart and Stroke Foundation offers advice on both relationships and sex and intimacy.

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GF Strong

The GF Strong Rehabilitation centre shares information about its Sexual Health Rehabilitation Service.

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Sexual Health Tip Sheets

Click on the titles below to read each tip sheet from Sexual Health Rehab Service, GF Strong Rehab Centre:

  • Becoming More Interested in Sex

  • Body Image and Self-Esteem

  • Sexuality and Disability

  • Caregiving and Sex – A Complicated Mix

  • General Suggestions for Enjoying your Sexuality

  • Getting More Help with Sexual Concerns

  • Relationships and Disability

  • Sex and Disability – Managing Physical Changes

  • Sexuality and Intimacy after a Brain Injury

  • STD’s and Disability

  • Talking About Sex with a Partner

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In This Section

  • Alcohol and Substance Use
  • Caregivers Need Care Too
  • Managing Problem Behaviours
  • Sexual Health and Intimacy

The British Columbia Brain Injury Association
c/o Janelle Breese Biagioni
PO Box 37091 MILLSTREAM PO
Victoria, BC V9B 0E8

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