Do Your PTSD Symptoms Affect Your Sexual Health?
“The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma. People who have survived atrocities often tell their stories in a highly emotional, contradictory, and fragmented manner that undermines their credibility and thereby serves the twin imperatives of truth-telling and secrecy. When the truth is finally recognized, survivors can begin their recovery. But far too often, secrecy prevails, and the story of the traumatic event surfaces not as a verbal narrative but as a symptom.”
― Judith Lewis Herman, 1992
The following blog is based on a presentation to the Association for Psychological Science Conference, 2025.
How do we address sexual dysfunction and its relationship to traumatic experiences? How do we find the words, the narrative, to help us address the pain and transform our experiences?
In a recent presentation at the Association for Psychological Science Conference, I addressed just how specific PTSD symptoms can predict various forms of sexual dysfunction. By peeling away the layers of shame and secrecy and directly addressing the pain, we can restore sexual health and mental health.
So why don’t we see more studies about these complex relationships between PTSD and sexual health in clinical research and literature? It became my mission to explore how we can disrupt the cycle of traumatic events that may have occurred years ago, in order to restore sexual health. Consequently, our lab at Fielding Graduate University conducted a study asking the question: “What is the relationship between the specific type of PTSD symptom or symptom cluster and the type of sexual dysfunction?”
We believed that if trauma causes sexual problems, certain PTSD symptoms would be linked to specific types of sexual difficulties, depending on the stage of the sexual response cycle. For example, avoidance-related PTSD symptoms may predict low sexual desire, while intrusion and cognitive-affective symptoms (emotions and thoughts) may be associated with sexual arousal dysfunction.
Trauma, PTSD, and Sexual Health: A Complex Relationship
Childhood trauma affects up to nearly half of all children, and about one in five people in the general population experience potentially traumatic events. Among military populations, PTSD is particularly prevalent, affecting 13% of active-duty personnel and 7% of veterans.
In the broader U.S. population, lifetime rates of PTSD range from 6% to 9%. Additionally, about one-third of those with PTSD develop chronic physical illnesses or somatic disorders.
Sexual dysfunction is also widespread, reported by 43% of women and 31% of men. Research shows that specific PTSD symptoms—especially those related to emotional numbing, avoidance, and negative mood—are closely linked to difficulties across the sexual response cycle, including issues with desire, arousal, and orgasm. These connections are particularly well-documented in veterans.
A growing body of research highlights that not all PTSD symptoms affect sexual health in the same way. Understanding which symptoms are linked to specific sexual problems can help inform more targeted and effective interventions, both in clinical treatment and scientific research.
Methodology
In our research, 517 adults in the U.S. were recruited to participate in an anonymous online survey. Our demographics were equally divided between males and females, with a majority identifying as white.
We looked at the data step-by-step to see if PTSD symptoms could explain sexual problems beyond simple personal details such as age. In the first step, we included demographic information. In the second step, we added PTSD symptom clusters to see if they improved our ability to predict specific types of sexual dysfunction. We only reported results where adding PTSD symptoms significantly improved the prediction.
Our study found clear links between PTSD symptoms and sexual dysfunction in both women and men. As expected, individuals with more PTSD symptoms were more likely to experience challenges with sexual desire and satisfaction.
Among women, higher levels of avoidance and cognitive/affective PTSD symptoms—and lower levels of intrusion and hyperarousal—were associated with lower sexual desire and greater dissatisfaction. Interestingly, women with fewer avoidance symptoms reported less lubrication, suggesting a complex relationship between PTSD symptom patterns and sexual functioning.
For men, PTSD symptoms were linked to lower sexual satisfaction and functioning, especially problems like premature ejaculation. Men who struggled with negative thoughts and emotions related to trauma were more likely to feel dissatisfied and experience overall sexual difficulties. Feeling constantly on edge (hyperarousal) also increased the chances of premature ejaculation. Surprisingly, men who avoided thinking about or confronting their trauma actually reported fewer sexual problems, suggesting that how someone copes with PTSD can affect their sex life in different ways.
Summary
In short, we discovered that only certain PTSD symptoms were linked to specific sexual difficulties, not universally. Generally, the more PTSD symptoms someone experienced, the more likely they were to struggle with sexual satisfaction or function. For women, the most significant impact lay in sexual desire, but the pattern was unexpected: fewer trauma-related flashbacks and stress responses actually predicted lower desire and greater dissatisfaction. For men, it was surprising that premature ejaculation was the only sexual issue strongly associated with PTSD symptoms — something that definitely warrants further investigation.
Our hypotheses were partly supported: specific PTSD symptoms were linked to specific sexual difficulties in both men and women. While the results suggest that trauma can affect sexual functioning in different ways depending on the symptom type and the person’s sex, some findings, like why certain symptoms didn’t affect arousal, remain unclear. Still, this research highlights how trauma may shape sexual response through distinct biological and psychological pathways and underscores the importance of considering these differences in both research and treatment.
At Kimberly Keiser & Associates, our providers ground clinical practice in research. If you have a history of childhood abuse and neglect and current difficulties with sexual functioning and posttraumatic stress symptoms, our providers are here to support you on your healing journey.