title: Sexual Health in Male and Female Iraq and Afghanistan U. S. War Veterans With and Without PTSD: Findings From the VALOR Cohort.
abstract: We sought to determine whether posttraumatic stress disorder (PTSD) was associated with sexual health in returned warzone-deployed veterans from the recent Iraq and Afghanistan conflicts. We studied 1,581 males and females from the Veterans After-Discharge Longitudinal Registry, a gender-balanced U.S. Department of Veterans Affairs registry of health care-seeking veterans with and without PTSD. Approximately one quarter (25.1%) of males (n = 198) and 12.7% of females (n = 101) had a sexual dysfunction diagnosis and/or prescription treatment for sexual dysfunction. Both genders were more likely to have a sexual dysfunction diagnosis and/or prescription treatment if they had PTSD compared with those without PTSD (male: 27.3% vs. 21.1%, p = .054; female: 14.9% vs. 9.4%, p = .022). Among the 1,557 subjects analyzed here, males with PTSD had similar levels of sexual activity compared to those without PTSD (71.2% vs. 75.4%, p = .22), whereas females with PTSD were less likely to be sexually active compared to females without PTSD (58.7% vs. 72.1%, p < .001). Participants with PTSD were also less likely to report sex-life satisfaction (male: 27.6% vs. 46.0%, p < .001; female: 23.0% vs. 45.7%, p < .001) compared with those without PTSD. Although PTSD was not associated with sexual dysfunction after adjusting for confounding factors, it was significantly negatively associated with sex-life satisfaction in female veterans with a prevalence ratio of .71, 95% confidence interval [.57, .90].
authors.affiliation: Department of Urology, University of California San Francisco, San Francisco, California, USA.
authors.forename: Benjamin N
authors.initials: BN
authors.lastname: Breyer
authors.affiliation: Division of Epidemiology, New England Research Institutes, Watertown, Massachusetts, USA.
authors.forename: Shona C
authors.initials: SC
authors.lastname: Fang
authors.affiliation: Departments of Medicine and Psychiatry, University of California, San Francisco, Veterans Administration Medical Center, San Francisco, California, USA.
authors.forename: Karen H
authors.initials: KH
authors.lastname: Seal
authors.affiliation: Division of Epidemiology, New England Research Institutes, Watertown, Massachusetts, USA.
authors.forename: Gayatri
authors.initials: G
authors.lastname: Ranganathan
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Brian P
authors.initials: BP
authors.lastname: Marx
authors.affiliation: VA Boston Healthcare System, Boston, Massachusetts, USA.|Department of Psychiatry, Boston University School of Medicine, Boston, Massachusetts, USA.|National Center for PTSD, VA Boston Healthcare System, Boston, Massachusetts, USA.
authors.forename: Terence M
authors.initials: TM
authors.lastname: Keane
authors.affiliation: Division of Epidemiology, New England Research Institutes, Watertown, Massachusetts, USA.
authors.forename: Raymond C
authors.initials: RC
authors.lastname: Rosen
mesh_terms: D000328:Adult; D055826:Afghan Campaign 2001-; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D005260:Female; D006801:Humans; D054542:Iraq War, 2003-2011; D008297:Male; D008875:Middle Aged; D012042:Registries; D057566:Self Report; D017678:Sex Distribution; D012725:Sexual Behavior / Q000706:statistics & numerical data*; D012735:Sexual Dysfunction, Physiological / Q000453:epidemiology*; D000074384:Sexual Health / Q000706:statistics & numerical data*; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology* / Q000523:psychology; D014481:United States / Q000453:epidemiology; D014493:United States Department of Veterans Affairs; D014728:Veterans / Q000706:statistics & numerical data*; D058014:Veterans Health