A Critique of “Sexual Dysfunction in Male Iraq and Afghanistan War Veterans: Association with Posttraumatic Stress Disorder and Other Combat-Related Mental Health Disorders: A Population-Based Cohort Study” (Breyer et al)
The emphasis on sex and the body that is embedded in our culture often leads to the degradation of this act into a merely organic event, disregarding its psychological aspects. Males are especially called to be sexually potent to an almost surreal level; nevertheless, this can be especially difficult to control while having a mental disease. “Sexual Dysfunction in Male Iraq and Afghanistan War Veterans: Association with Posttraumatic Stress Disorder and Other Combat-Related Mental Health Disorders: A Population-Based Cohort Study” (Breyer et al), published in The Journal of Sexual Medicine tries to address these characteristics in a scientific way. Published mainly for the scientific community, it intends to explore the prevalence and correlates of this condition among war veterans. While it is a very interesting article and does focus on mental conditions, the explored options for treatment are pharmacological; it would have been interesting had they studied the effects of psychotherapeutic treatment as well.
In the study, the medical data of 405,275 war veterans from Iraq and Afghanistan was used to find correlations between erectile dysfunction and Posttraumatic Stress Disorder (PTSD), in particular, as there had already been found a relation between sexual dysfunction and PTSD in women. The researchers found that, after adjusting for the population, these war veterans were more than three times more likely to suffer from erectile dysfunction than their peers; furthermore, pharmacological treatment augmented this prevalence.
This article was written primarily for the scientific community, while there are also great social implications. Its publication in a scientific journal, technical vocabulary and display of advanced information such as the results of the statistical test are evidence that this article is not for the layperson. Meanwhile, it would also be interesting if armies around the world, and the U.S. one in particular, could pay attention to this study, as it shows that war greatly impacts the population, including their mental and sexual states.
The fact that a drug that worsens a complicated medical condition is used to combat another mental malady with which it has great correlation was the most important part of this study. “Returned veterans with mental health diagnoses, particularly PTSD, had an increased risk of receiving a sexual dysfunction diagnosis, being prescribed medication for sexual dysfunction, and utilizing specialty urological services” (Breyer et al 81). The iatrogenic effects that PTSD medication can have on its sufferers should be paid attention to and remedied as soon as possible. With the emphasis on sex and sexual performance that is so important in contemporary times, it would be excellent if a drug could be found that did not diminish these aspects. The stress that war veterans were under and the change from peace to war and back should be handled with great psychological care. Adding additional stresses should be kept to a minimum.
Therefore, one of the flaws of the article is that, while it does asses a mental condition, the treatments that it studies are biological. While it is true that introducing chemicals into your nervous system that are foreign to it can frequently cause sexual problems, the effects of psychotherapy should have also been researched. There could be positive effects against erectile dysfunction through the psychotherapeutic treatment of PTSD.
In conclusion, the article highlights an often-forgotten part of sexual activity: the mind. While sexual prowess is usually measured with numbers, there are also many psychological factors at play during a sexual relationship. Concretely, a relationship between PTSD and erectile dysfunction was found in war veterans; furthermore, those patients who were taking medicine to treat the former condition found that it aggravated the latter. It would be interesting to study the effects that the treatment of PTSD through psychotherapy could have on erectile dysfunction. Humans are very complicated and cannot be reduced to their biological body: many psychological factors affect it and should also be taken into account.
Breyer Benjamin N., et al. “Sexual Dysfunction in Male Iraq and Afghanistan War Veterans: Association with Posttraumatic Stress Disorder and Other Combat-Related Mental Health Disorders: A Population-Based Cohort Study”. The Journal of Sexual Medicine 11.1 (2014): 75-83. Web. 12 Feb. 2014.