This is a part of the Hot Topic podcast series from the Model Systems Knowledge Translation Center on Sexuality and Intimacy After Burn Injury. Dr. Karen Kowalske, researcher, discusses how physical factors interfere with sexuality after burn injury.

Karen Kowalske, M.D.

Co-Principal Investigator

North Texas Burn Rehabilitation Model System

Following a burn injury there are a number of physical factors that interfere with sexuality. The most obvious one is the skin. The skin is fragile, it’s prone to tearing, and so any intimacy can result in tearing of the skin. So we strongly recommend making sure the skin is nice and moist before any intimacy to make sure that you don’t have skin tearing.

Some of that requires communication, there may be one body part that’s a little more tender or a little more fragile that you might want to avoid, particularly when initially getting back into sexuality. The second component is that grafted skin…

For those with grafted skin, the area that’s skin grafted usually doesn’t have normal sensation. So you might not be able to feel touch and, or touch may be uncomfortable. So understanding that that area may feel differently is something to communicate with your partner.

The physical components include contracture, so a contracture is when a limb doesn’t move normally. So, any individual with contracture might have difficulty with positioning or finding a comfortable way to have any sort of sexual activity including intercourse.

The physiologic function all can be changed following a burn injury. There are a couple of components. One is there are some hormonal changes when the body is stressed, so particularly for men they may not have a normal testosterone level which may interfere with sexual drive and sexual performance, so that’s something to discuss with your physician if it’s an issue., to bring up whether you might need some of your hormonal labs checked. For women, if their estrogen level is low they may have vaginal dryness which can interfere with sexual activity and may require lubricants.

The physiologic components can include side effects from medications. So antidepressant medication specifically can interfere both with sexual desire and sexual performance.

Within the classes of antidepressants there are many medication options, so if an individual is having side effects from their medication, we don’t want them to just stop it and say I’m not ever taking medicine again. You need to talk to your doctor and find out if there’s another medication that you could use because depression interferes with sexual desire and sexual performance.

So we don’t want someone to just stop their medications so we want to try to find a medication that doesn’t have side effects for an individual so that they can enjoy normal sexual activity and function.

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