Brain Injury and Sexual Issues in Grand Rapids, Michigan

A brain injury can change the way a person in Grand Rapids experiences and expresses their sexuality. Changes may include:

  • Reduced sex drive (low libido)
  • Difficulties with sexual functioning (such as erectile problems)
  • Behaving sexually at inappropriate times

Talking about sex after a brain injury can feel uncomfortable, but open conversation is important for the person with the injury, their partner, and family members. In West Michigan, support is available through local healthcare systems such as Spectrum Health, Trinity Health Grand Rapids, Metro Health, Mercy Health, and community resources like the Kent County Health Department.

Understanding Brain Injury and Sexual Changes

What Is Acquired Brain Injury (ABI)?

Acquired brain injury (ABI) refers to any type of brain damage that occurs after birth. Causes can include:

  • Infection
  • Disease
  • Lack of oxygen
  • A blow to the head (such as a fall on ice during Michigan winters or a car accident on I-196 or US-131)

What Is Traumatic Brain Injury (TBI)?

Traumatic brain injury (TBI) is a type of ABI usually caused by a direct injury to the head, for example:

  • Motor vehicle crashes
  • Falls on snow or ice (especially common during Grand Rapids’ long, icy winters)
  • Sports injuries
  • Assaults

TBI can cause changes in:

  • Thinking and memory
  • Behavior and emotions
  • Movement and body function

The more severe the injury, the more significant the symptoms and loss of function tend to be.

Common Sexual Changes After Brain Injury

Sexual functioning and arousal involve several areas of the brain. When these areas are damaged, a person may experience difficulties with sex, even if their body is physically capable.

Changes in Libido (Sex Drive)

After a traumatic head injury:

  • About half of people experience a reduced sex drive.
  • The remainder may have increased libido or no change at all.

Both decreased and increased sexual interest are common and are medical issues, not character flaws.

Erectile Problems

Among men with brain injury:

  • 40–60% experience temporary or permanent erectile problems (impotence).
  • This can be due to damage in the brain, nerve pathways, blood flow, medications, or emotional factors like anxiety and depression.

Difficulty Reaching Orgasm

Up to 40% of men and women report problems having an orgasm after a brain injury. This can include:

  • Taking much longer to reach orgasm
  • Weaker or less satisfying orgasms
  • Inability to reach orgasm at all

Reduced Frequency of Sex

After a brain injury, couples often have sex less often. Common reasons include:

  • Physical disability or fatigue
  • Depression or anxiety
  • Relationship strain or break-up
  • Pain from other injuries
  • Sexual difficulties (erectile problems, low libido, difficulty with arousal)

Other Factors That Affect Sexual Function After Brain Injury

In Grand Rapids, people recovering from a brain injury may also be dealing with other health and life stressors that affect sexuality. These can include:

Emotional Health

  • Depression
  • Anxiety
  • Stress (including financial stress, job loss, or role changes in the family)

These issues are common after TBI and can significantly reduce sex drive and enjoyment of sex.

Medications

Some medications commonly used after brain injury can lower libido or affect sexual function, such as:

  • Antidepressants
  • Anti-anxiety medications
  • Seizure medications
  • Blood pressure medications
  • Pain medications (especially opioids)

Never stop medication on your own. Talk with a doctor in Grand Rapids (for example, a neurologist at Spectrum Health or Metro Health) about possible alternatives or dose adjustments.

Associated Injuries

If the brain injury occurred in a serious accident, there may also be:

  • Spinal cord injuries
  • Pelvic injuries
  • Chronic pain
  • Mobility limitations

These can directly affect sexual functioning and sexual positions.

Relationship Changes

Brain injury can change:

  • Personality and mood
  • Roles in the relationship (for example, one partner becoming a caregiver)
  • Communication patterns

Relationship tension or emotional distance often leads to less sexual activity.

Prior Sexual Difficulties

Any sexual problems that existed before the brain injury—such as erectile dysfunction, low desire, or pain with sex—may worsen after the injury.

Self-Esteem and Body Image

People may feel less confident or attractive after a brain injury because of:

  • Scars
  • Weight changes
  • Cognitive or speech difficulties
  • Needing help with daily tasks

This can make them less likely to feel sexual or initiate intimacy.

Other Medical Conditions

Common conditions in Michigan adults that can affect sexual function include:

  • Diabetes
  • Hypertension (high blood pressure)
  • Heart disease
  • Obesity

These conditions can reduce libido, impair blood flow, and interfere with arousal and orgasm.

Talking With Professionals in Grand Rapids

Seek Professional Advice

If your specialists do not bring up sexual issues after a brain injury, you are allowed to ask. Sexual health is a normal and important part of recovery.

Local professionals who can help include:

  • Your primary care provider or family doctor
  • Neurologists at Spectrum Health, Trinity Health Grand Rapids, Metro Health, or Mercy Health
  • Rehabilitation specialists (physiatrists)
  • Psychologists, counselors, or sex therapists experienced with brain injury
  • Urologists (for erectile and ejaculation issues)
  • Gynecologists (for pain, lubrication, and orgasm issues)

You can also contact:

  • Kent County Health Department – for sexual health resources and referrals
  • Grand Rapids Public Health and community clinics – for confidential sexual health services

Before Resuming Sex: Talk With Your Doctor

Before becoming sexually active again after a brain injury, speak with your healthcare provider. They can help you understand:

  • When it is medically safe to resume sexual activity
  • How your medications and other conditions might affect sex
  • Any precautions you should take (for example, with heart conditions or seizures)

General Tips for Resuming Sex

  • Talk about expectations and feelings.
    Open, honest communication can help couples navigate changes. Discuss fears, desires, and what feels different since the injury.

  • Take it slow.
    Fatigue is common after TBI. Plan sexual activity for times of day when energy is highest and avoid putting pressure on yourselves to “perform” like before.

  • Focus on pleasure, not performance.
    Shift the goal from “perfect sex” or orgasm to shared pleasure, closeness, and comfort.

  • Be flexible about what sex means.
    If penis-in-vagina intercourse is not possible or is difficult, explore other forms of intimacy, such as:

    • Kissing and cuddling
    • Touching and massage
    • Oral sex
    • Mutual masturbation
    • Using lubricants or sex toys as recommended by your provider

Grand Rapids couples may find it helpful to work with a sex therapist or relationship counselor familiar with neurological conditions.

Strengthening Romance and Intimacy

Even when sexual function changes, emotional closeness and romance can grow stronger.

Ways to Boost Romance

  • Offer regular affection: holding hands, hugging, kissing
  • Express appreciation and give genuine compliments
  • Plan simple dates around Grand Rapids, such as:
    • A walk along the Grand River or through Riverside Park (weather permitting)
    • Visiting the Frederik Meijer Gardens & Sculpture Park
    • Enjoying a quiet meal at home or a favorite local restaurant
  • Celebrate special occasions like birthdays, anniversaries, and recovery milestones

Feeling emotionally connected often improves sexual interest and satisfaction over time.

Treating Sexual Problems After Brain Injury

Address Emotional Health

If depression, anxiety, or stress are present, ask about:

  • Counseling or psychotherapy (individual or couples)
  • Support groups for brain injury survivors and caregivers in West Michigan
  • Medication for mood disorders, if appropriate

Mental health treatment can significantly improve libido and enjoyment of sex.

Medication Review

If you suspect your reduced libido or sexual difficulty is medication-related:

  • Talk to your doctor about alternatives
  • Ask if any doses can be reduced safely
  • Never change or stop medications on your own

Erectile Problems: Treatment Options

Treatment for erectile problems after brain injury may include:

  • Counseling or sex therapy – to address anxiety, relationship issues, or past trauma
  • Medications – such as phosphodiesterase-5 inhibitors (e.g., sildenafil), if medically appropriate
  • Vacuum erection devices
  • Hormone evaluation if low testosterone or other imbalances are suspected

Urologists in Grand Rapids (through Spectrum Health, Trinity Health, or independent practices) can provide evaluation and treatment.

Memory, Planning, and Sexual Activity

Some people with brain injury have trouble:

  • Remembering to use contraception
  • Initiating sex
  • Paying attention to their partner’s pleasure

Contraception After Brain Injury

Prior methods may no longer be practical. For example:

  • A woman with memory issues may forget to take a daily birth control pill.

Options to discuss with a healthcare provider include:

  • Long-acting reversible contraception (LARC), such as:
    • Intrauterine devices (IUDs)
    • Contraceptive implants
  • Contraceptive injections
  • Condoms (with reminders or partner support)

Ask your primary care provider, OB/GYN, or a local clinic (including Kent County Health Department or Grand Rapids community health centers) about the best contraception for your situation.

Aids to Support Arousal

Some couples find it helpful to use:

  • Erotic videos or audio
  • Erotic literature or magazines
  • Sensate-focus exercises (guided touch exercises often recommended by sex therapists)

These can help stimulate arousal and shift focus from anxiety to sensation and connection.

Inappropriate Sexual Behavior After Brain Injury

Sometimes, a person with a brain injury may:

  • Masturbate in public
  • Make sexual comments at inappropriate times
  • Touch others inappropriately

This behavior usually stems from brain changes, not intentional disrespect. It can still be very distressing for family members and caregivers.

How Family and Caregivers Can Respond

  • Stay as calm as possible.
    Showing extreme shock or anger can make the person feel ashamed or confused about their sexuality.

  • Clearly state the behavior is not appropriate.
    For example: “It’s okay to masturbate, but it needs to be done in private, in your bedroom.”

  • Offer an appropriate alternative.
    Gently redirect the person to a private space or a different activity.

  • Be prepared to repeat instructions.
    Memory and impulse control may be affected. Consistent, patient responses are crucial.

Work as a Team

Discuss these issues with:

  • The person’s therapists (occupational therapist, psychologist, speech therapist)
  • Rehabilitation specialists
  • Other support staff or caregivers

Try to develop a consistent plan for:

  • What language everyone uses to correct behavior
  • Where private sexual behavior is allowed
  • What consequences or redirections are used

Set firm but respectful boundaries and help the person find safe, appropriate ways to express their sexuality.

Local Resources in Grand Rapids, Michigan

If you or a loved one in Grand Rapids is dealing with brain injury and sexual issues, consider:

Medical and Rehabilitation Services

  • Spectrum Health – Neurology, Rehabilitation, Urology, Behavioral Health
  • Trinity Health Grand Rapids – Brain injury rehabilitation and counseling
  • Metro Health – University of Michigan Health – Neurology and rehab services
  • Mercy Health – Primary care, neurology, and specialty services

Public Health and Community Support

  • Kent County Health Department – Sexual health services, contraception, STI testing, and referrals
  • Grand Rapids Public Health and community clinics – Low-cost or sliding-scale care
  • Local brain injury support groups and rehabilitation programs in West Michigan

Ask your doctor or hospital social worker for up-to-date contact information and referrals.

Key Points

  • Acquired brain injury (ABI) can result from infection, disease, lack of oxygen, or a blow to the head.
  • Traumatic brain injury (TBI) is usually caused by a direct injury to the head, such as a car accident or fall on ice.
  • The more severe the brain injury, the more significant the changes in thinking, behavior, and sexual function are likely to be.
  • Sexual changes after brain injury can include reduced or increased libido, erectile problems, difficulty with orgasm, and inappropriate sexual behavior.
  • Emotional health, medications, other injuries, relationship changes, and chronic conditions like diabetes or high blood pressure can all contribute to sexual problems.
  • Open communication, medical evaluation, counseling, and support from Grand Rapids healthcare resources can help individuals and couples adapt and find satisfying ways to express their sexuality after brain injury.