Neurovegetative and Psychogenic Sexual Health Disorders in Military Personnel with Combat-Related Trauma
DOI:
https://doi.org/10.32782/2077-6594/2026.3/07Keywords:
combat trauma, erectile dysfunction, posttraumatic stress disorder, International index of erectile function-15Abstract
Purpose: to determine the characteristics of erectile dysfunction in men with combat trauma compared to the course of erectile dysfunction accompanied by post-traumatic stress disorder. Materials and Methods. The work was based on the results of a survey of 298 men injured as a result of combat operations, using the International Index of Erectile Function-15 questionnaires and the DSM-5 disease classifier for diagnosing post-traumatic stress disorder. The study group was divided into two: men without PTSD (group 1), men with PTSD (group 2). Each group was divided into two subgroups: subgroup 1.1 – men aged 20–39 years without PTSD, subgroup 1.2 – men aged 40–53 years without PTSD, subgroup 2.1 – men aged 20–39 years with PTSD, subgroup 2.2 – men aged 40–53 years with PTSD. Results. It was found that the total score on the IIEF-15 scale in subgroup 1.1 was 20.43, which corresponds to a moderate form of ED, and in subgroup 2.1 this score was 17.21, i.e. it was 1.2 times lower, but also corresponded to a moderate form of ED. In subgroup 1.2 the average score was 17.75, which was 1.3 times higher than in subgroup 2.2. Only in men of subgroup 2.2 who suffered as a result of hostilities and were diagnosed with PTSD the total score was 13.96±0.15, which corresponded to a moderate form of severity. Conclusions. The study demonstrated that veterans with combat-related PTSD demonstrated a significantly higher prevalence of sexual difficulties in all functional domains compared with combatants with combat trauma but without PTSD. The total score on the IIEF-15 was lowest among men aged 40–53 years with combat trauma and comorbid PTSD (subgroup 2.2).
References
Burnett AL, Nehra A, Breau RH, Culkin DJ, Faraday MM, Hakim LS, Heidelbaugh J, Khera M, McVary KT, Miner MM, Nelson CJ, Sadeghi-Nejad H, Seftel AD, Shindel AW. Erectile Dysfunction: AUA Guideline. J Urol. 2018;200(3):633-641. https://doi.org/10.1016/j.juro.2018.05.004.
Protuđer M, Stevanović A, Letica-Crepulja M. Sexual Dysfunctions among Veterans with and without PTSD. Healthcare. 2023;11(13):1861. https://doi.org/10.3390/healthcare11131861
Shridharani AN, Brant WO. The treatment of erectile dysfunction in patients with neurogenic disease. Transl Androl Urol. 2016;5(1):88-101. https://doi.org/10.3978/j.issn.2223-4683.2016.01.07
Birowo P, Deswanto IA, Rasyid N. Epidemiology of erectile dysfunction: A cross-sectional web-based survey conducted in an Indonesian national referral hospital [version 1; peer review: 2 approved with reservations]. F1000Research. 2019;8:817. https://doi.org/10.12688/f1000research.18930.1
Bentsen IL, Giraldi AG, Kristensen E, Andersen HS. Systematic Review of Sexual Dysfunction Among Veterans with Post-Traumatic Stress Disorder. Sex. Med. Rev. 2015;3:78–87. https://doi.org/10.1002/smrj.47
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;8:432. https://doi.org/10.3390/jcm8040432
Tran JK, Dunckel G, Teng EJ. Sexual dysfunction in veterans with post-traumatic stress disorder. J. Sex. Med. 2015;12:847-855. https://doi.org/10.1111/jsm.12823
Yehuda R, Lehrner A, Rosenbaum TY. PTSD and Sexual Dysfunction in Men and Women. J. Sex. Med. 2015;12:1107-1119. https://doi.org/10.1111/jsm.12856
Blevins CA, Weathers FW, Davis MT, Witte TK, Domino JL. The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL‑5): Development and Initial Psychometric Evaluation. J Trauma Stress. 2015;28(6):489-498. https://doi.org/10.1002/jts.22059
Sveen J, Bondjers K, Willebrand M. Psychometric properties of the PTSD Checklist for DSM-5: a pilot study. Eur J Psychotraumatol. 2016;7:30165. https://doi.org/10.3402/ejpt.v7.30165
Горшков ОО, Баранов ІІ, Домініченко ЯЛ. Особливості клінічної діагностики посттравматичного стресового розладу з психотичними симптомами. Український медичний часопис. 2024;4(162). doi:10.32471/umj.1680-3051.162.254487
Yehuda R, Hoge CW, McFarlane AC, Vermetten E, Lanius RA, Nievergelt CM, Hobfoll SE, Koenen KC, Neylan TC, Hyman SE. Post-traumatic stress disorder. Nat Rev Dis Primers. 2015;1:15057. https://doi.org/10.1038/nrdp.2015.57
Carmassi C, Dell’Oste V, Pedrinelli V, Barberi FM, Rossi R, Bertelloni CA, Dell’Osso L. Is Sexual Dysfunction in Young Adult Survivors to the L’Aquila Earthquake Related to Post-traumatic Stress Disorder? A Gender Perspective. J. Sex. Med. 2020;17(9):1770–1778. https://doi.org/10.1016/j.jsxm.2020.05.016
Judkins JL, Moore BA, Collette TL, Hale WJ, Peterson AL. Morissette SB. Incidence Rates of Posttraumatic Stress Disorder Over a 17-Year Period in Active Duty Military Service Members. J. Trauma. Stress, 2020;33: 994-1006. https://doi.org/10.1002/jts.22558
Sexton MB, Anderson RE, Bennett DC, Thomas EJ, Broman RB, Richards SKH. Military Sexual Trauma Survivor Preferences for Provider Gender and Associations With Mental Health Evaluation Attendance. Behav Ther (NYNY). 2020;43(1):6-14. https://commons.und.edu/psych-fac/29
Bird ER, Piccirillo M, Garcia N, Blais R, Campbell S. Relationship Between Posttraumatic Stress Disorder and Sexual Difficulties: A Systematic Review of Veterans and Military Personnel. J. Sex. Med. 2021;18:1398-1426. https://doi.org/10.1016/j.jsxm.2021.05.011
Rozanov V, Frančišković T, Marinić I, Macarenco M, Letica-Crepulja M, et al. Mental Health Consequences of War Conflicts. In: Javed A., Fountoulakis K.N., editors. Advances in Psychiatry. 1st ed. Volume 4. Springer International Publishing AG; Cham, Switzerland. 2019:281-304. https://doi.org/10.1007/978-3-319-70554-5_17
Hackett G, Krychman M, Baldwin D, Bennett N, El-Zawahry A, Graziottin A, et al. Coronary Heart Disease, Diabetes, and Sexuality in Men. J. Sex. Med. 2016;13(6):887-904. https://doi.org/10.1016/j.jsxm.2016.01.023
Rosen RC, Cappelleri JC, Gendrano N. The International Index of Erectile Function (IIEF): a state-of-the-science review. International Journal of Impotence Research. 2002;14:226-244. https://doi.org/10.1038/sj.ijir.3900857
Neijenhuijs KI, Holtmaat K, Aaronson NK, Holzner B, Terwee CB, Cuijpers P, Verdonck-de Leeuw IM. The International Index of Erectile Function (IIEF)-A Systematic Review of Measurement Properties. J Sex Med. 2019;16(7):1078-1091. https://doi.org/10.1016/j.jsxm.2019.04.010
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders: DSM-5. 5th ed., American Psychiatric Publishing, 2013.
Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, Schnurr PP. The PTSD Checklist for DSM-5 (PCL-5). National Center for PTSD. 2023. Available online: https://www.ptsd.va.gov/professional/assessment/adult-sr/ptsd-checklist.asp.
Badour CL, Gros DF, Szafranski DD, Acierno R. Problems in sexual functioning among male OEF/OIF veterans seeking treatment for posttraumatic stress. Compr. Psychiatry. 2015;58:74–81. https://doi.org/10.1016/j.comppsych.2014.12.012
Bećirović E, Avdibegović E, Softić R, Mirković Hajdukov M. Sexual Dysfunctions in Bosnian War Veterans. Psychiatr Danub. 2019;31(Suppl 5):839-846. https://hrcak.srce.hr/file/390848
Letica-Crepulja M, Grahovac-Juretić T, Katalinić S, Lesica T, Rončević-Gržeta I, Frančišković T. Posttraumatic Stress Disorder and Comorbid Sexual Dysfunctions. Psychiatr Danub. 2017;29(2):221-225. https://doi.org/10.24869/psyd.2017.221
National Institute for Clinical Excellence (NICE) Post-Traumatic Stress Disorder. The Management of PTSD in Adults and Children in Primary and Secondary Care. National Clinical Practice Guideline Number 116. [(accessed on 12 April 2023)]. Available online: https://www.nice.org.uk/guidance/ng116
VA/DOD Clinical Practice Guideline for the Management of Posttraumatic Stress Disorder and Acute Stress Disorder. US Department of Veterans Affairs [(accessed on 10 April 2023)]; Available online: https://www.healthquality.va.gov/guidelines/mh/ptsd/
Lang AJ, Hamblen JL, Holtzheimer P, Kelly U, Norman SB, Riggs D, Schnurr PP, Wiechers I. A clinician’s guide to the 2023 VA/DoD Clinical Practice Guideline for Management of Posttraumatic Stress Disorder and Acute Stress Disorder. J Trauma Stress. 2024;37(1):19-34. https://doi.org/10.1002/jts.23013
