How PTSD can affect your sex life (how to deal and how to heal)

By Maya Khamala

Post-traumatic stress disorder, more commonly known as PTSD, is a common mental health condition that can develop after someone experiences trauma. The trauma in question may take the form of a war, a natural disaster, an accident, a sexual assault, domestic abuse, or any number of other threatening life events. Although PTSD symptoms often start within 3 months of a trauma, in some cases, it can be years before they rise to the surface. And while many people tend to recover in a matter of months, some can experience symptoms for many years. Women suffer from PTSD and its cousin, complex PTSD at much higher rates than men, the latter being a common reaction among people who’ve endured long-term trauma, such as growing up in a physically and/or psychologically abusive household.

The reality is that recovering from trauma (sexual or otherwise) is almost never a predictable process. PTSD can significantly affect both physical and mental health–including a person’s sex life.

The sex drive dive 

Since PTSD symptoms are often in direct conflict with pleasure, intimacy, trust, and feeling safe, it's unsurprising that regardless of the cause of someone’s trauma, 90% of women with PTSD report a reduced sex drive—individuals with PTSD are three times more likely to suffer from asexual dysfunction. The arousal that occurs with sexual activity can actually serve to enhance (involuntary) reactions like fear, self-hate, and revulsion. In addition to a lower libido, women with PTSD are more likely to experience insufficient lubrication and painful intercourse too.

When triggered, a person with PTSD might shut down and reject a partner without being able to explain. If this sounds like you, you’ve likely felt shame, fear, insecurity, or anger around the notion that you’re disappointing your partner. Some people in this situation may even force themselves to have sex when they really don’t want to. Not good for anyone.

The post-sex blues 

Patti Feuereisen, a psychologist who has worked with sex abuse survivors for 30+ years told Huffpost that many survivors will dissociate (tune out) during an assault, and this feeling can hang around long after the abuse is over. Dissociation is one of the more common symptoms of PTSD, and it tends to make it challenging for sexual assault survivors to feel connected to themselves, their bodies, their partners, or the world at large. For many survivors, simply being present during sex can be emotionally painful and triggering, even if their partner is supportive, respectful, and wonderful in every way. 

Postcoital dysphoria, AKA post-sex blues, are feelings of intense sadness, upheaval or anger that occur after sex—even when it was consensual, pleasurable, intimate—and sometimes even after masturbation. Symptoms include anxiety, depression, feelings of emptiness, melancholy, or crying. Research suggests that postcoital dysphoria is strongly connected with a history of sexual assault. According to sex therapist Stefani Threadgill, because memories of trauma are stored in parts of the brain associated with survival, they can be more easily triggered during a sexual encounter. 

46% of women have reported experiencing postcoital dysphoria at least once in their life. And a history of childhood sexual abuse is the most important predictor, while a history of physical abuse, emotional abuse, and sexual assault in adulthood also show up as risk factors. Additionally, new research shows that men with a history of childhood sexual abuse also experience postcoital dysphoria at higher rates.

Getting past it

If you’re dealing with a reduced sex drive or post-sex blues as the result of PTSD, it does not mean you’re broken or damaged beyond repair. It simply means you're human—and you can heal.

Experts agree that practicing self-care, both in and out of the bedroom, is key to overcoming the sexual dysfunctions associated with PTSD, even if it means stopping mid-caress and simply doing whatever the moment calls for—whatever will make you feel good in that moment: drink a cup of tea, perhaps, or stare deeply into your pet's eyes, or work toward remapping the experience. Remapping or reframing a traumatic experience into a positive one can be extraordinarily empowering. One way to do this is by practicing intentional intimacy for about 20 minutes—with a partner or by yourself, according to Feuereisen. This takes the form of setting aside time in to fuel connection, whether sexual, emotional, physical or spiritual—with a partner or with yourself. Said connection can be forged verbally, non-verbally, physically, sexually, non-sexually or some combination of these—it's all up to you. That's the point, after all.

Additionally, discussing with a partner how PTSD can deflate your sexual desire—rarely, sometimes, or often—opens the door to real understanding and a deeper bond, which in turn increases the likelihood of more consistent and natural sexual arousal. Certainly, if you struggle to enjoy sex due to symptoms of PTSD, you deserve a partner who can love and help you through it.

Last, though certainly not least, there is never shame in seeking help from a mental health professional if you feel it may help you navigate the complexities of your unique experiences with sex and PTSD. 

One love.


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