Sexuality in neurologic disability: An overview

Sexuality concerns commonly arise in individuals with both acquired and congenital neurologic disabilities. As health care professionals it is critical to have an understanding of the potential consequences of neurologic impairment on sexuality as well as sexual function. Psychologic, latrogenic, and secondary medical issues must all be taken into consideration when addressing the primary sexuality concerns. An understanding of normal neuroanatomy and neurophysiology is critical if one is to propose interventional strategies in this patient population. Basic concepts regarding sexual functioning in specific neurologic conditions including spinal cord injury, cerebral vascular accidents, traumatic brain injury, peripheral neuropathies and multiple sclerosis will be reviewed. The General Rehabilitation Assessment Sexuality Profile will be reviewed as it pertains to the sexual history, sexual physical exam, and clinical sexual diagnostic testing. Lastly, treatment options for both genital and nongenital sexual dysfunction in neurologic disability will be examined.