Orgasm, lubrication, erection, fantasy, desire: these are all sexual functions that are controlled by the central nervous system. And neurosexuality wishes to remind us of this.
This emerging conceptual framework for study and practice focuses on the relationship between the brain and sexuality. Because when we are interested in the physiology of sexuality, it is clear that the most powerful sexual organ is not between our legs… but between our two ears!
The hypothalamus, as the hormone control center, controls sexual desire, lubrication and erection. The amygdala allows us to feel certain emotions such as pleasure. The orbitofrontal cortex participates in the decision-making process and therefore in the initiation of sexual activity. The cerebellum acts on the modulation of the motor response. The parietal lobes are related to the sensory awareness of the body.
For Jhon Alexander Moreno, researcher and associate professor in the Department of Psychology at the University of Montreal, neurosexuality is a global framework that supports the inclusion of sexual rehabilitation in the care of people with neurological disorders.
“Since there is a correlation between different parts of the brain and various dimensions of sexual response, this means that a person with brain damage may also likely be struggling with sexual disturbances,” says the neuropsychologist.
Sexual health at risk
Sexual problems related to neurological disorders – such as dementia, epilepsy, stroke, amyotrophic lateral sclerosis, brain damage caused by traumatic brain injury (TBI) – can come in many forms: decreased desire sex, difficulty reaching orgasm and fantasizing, change in body image, erectile dysfunction, depression associated with low sexual energy, appearance of risky sexual behavior.
“Generally, a TBI can be accompanied by symptoms of hyposexuality such as a loss of libido. In some more exceptional cases, a TBI can cause an exacerbation of sexual desire and lead, for example, to hypersexuality, that is to say a compulsion, an impossibility of controlling one’s behavior, an uncontrollable need to approach strangers for erotic purposes. In both cases, the entourage of these people reports no longer recognizing their loved one, as if the person before no longer existed, ”underlines Jhon Alexander Moreno.
As a new field of study and practice, neurosexuality thus invites health professionals to integrate sexuality into the clinical evaluation of these individuals.
“Sexual health is part of general health, so it must be counted among all the other dimensions of rehabilitation, such as mobility, social participation, cognition and emotions,” says the researcher. These aspects are affected by neurological disorders, but also play a role in sexuality. And the results of my research have shown that it is not automatic to associate brain damage with sexuality, for which the concept of neurosexuality exists and would benefit from being better known.
Inform and standardize
For Jhon Alexander Moreno, it is necessary to evaluate sexuality through a process and a clinical examination that normalizes it. According to him, people who have suffered a brain injury are asking questions about their sexuality and are asking for a more proactive approach on the part of the workers.
“First and foremost, healthcare personnel need to be aware of these potential consequences,” he says. Then, we must inform people with brain damage and their partners, in addition to making them feel that they are in the right place to discuss it. It is important to have a positive and respectful approach to sexuality and to de-stigmatize sexual issues.”
Once the questions have been asked and the problems targeted, care then becomes multimodal, specifies the researcher. It can be pharmacological, motor and hormonal, but also relational, behavioral and communicational.
“The multidisciplinary nature of neurosexuality is essential to grasping the complexities of sexual behavior and to helping people in our care to have sexual and relational experiences that are sources of pleasure and fulfillment,” summarizes Jhon Alexander Moreno.