{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T06:07:23Z","timestamp":1790143643527,"version":"4.0.1"},"reference-count":109,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2025,10,23]],"date-time":"2025-10-23T00:00:00Z","timestamp":1761177600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Life"],"abstract":"<jats:p>Background: Sexual dysfunction (SD) is a common yet under-recognized consequence of traumatic brain injury (TBI), with significant implications for physical health, psychological well-being, interpersonal relationships and social reintegration. Although TBI research has largely focused on cognitive, motor and behavioral outcomes, the impact of SD remains insufficiently addressed in both clinical practice and rehabilitation programs. Objectives: This review aims to synthesize current evidence on the prevalence, mechanisms and management of SD following TBI, while emphasizing the importance of gender-sensitive and multidisciplinary approaches to care. Methods: A narrative review was conducted by searching PubMed, Scopus and Web of Science for English-language articles published between 2000 and 2025 using combinations of the following keywords: traumatic brain injury, sexual dysfunction, neuroendocrine dysfunction, psychological sequelae and rehabilitation. Priority was given to peer-reviewed clinical studies, systematic reviews and expert consensus guidelines that addressed neurological, endocrine, cognitive, psychological and social aspects of SD in TBI survivors. Exclusion criteria included case reports with insufficient clinical detail and non-peer-reviewed sources. Articles were screened for relevance to both pathophysiological mechanisms and therapeutic strategies. Results: The etiology of post-TBI SD is multifactorial, involving direct neurological injury, hypothalamic\u2013pituitary dysfunction, emotional and cognitive impairments, as well as psychological challenges such as stigma and relationship strain. Men and women may present distinct symptom profiles; for instance, men more frequently report erectile dysfunction and hypogonadism, whereas women more commonly experience challenges with arousal, lubrication and psychological stress. Effective interventions include pharmacotherapy, hormone replacement therapy, psychotherapy and rehabilitative approaches designed to restore intimacy and quality of life. Optimal outcomes are achieved through multidisciplinary collaboration among neurology, endocrinology, psychiatry, psychology and rehabilitation medicine. Conclusions: Sexual dysfunction should be recognized as a critical component of TBI sequelae rather than a secondary concern. Routine screening, gender-sensitive assessment and the integration of individualized, multidisciplinary care pathways are essential to improving patient outcomes. Advancing clinical awareness and standardization in this area holds the potential to significantly enhance the holistic recovery and reintegration of TBI survivors.<\/jats:p>","DOI":"10.3390\/life15111659","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T00:47:36Z","timestamp":1761266856000},"page":"1659","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Sexual Dysfunction in Traumatic Brain Injury: A Narrative Review and Call for Multidisciplinary Framework"],"prefix":"10.3390","volume":"15","author":[{"given":"Ioannis","family":"Mavroudis","sequence":"first","affiliation":[{"name":"Department of Neuroscience, Leeds Teaching Hospitals, NHS Trust, Leeds LS1 3EX, UK"},{"name":"Faculty of Medicine, Leeds University, Leeds LS2 9JT, UK"},{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"},{"name":"Academy of Romanian Scientists, 050044 Bucharest, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5617-0346","authenticated-orcid":false,"given":"Foivos","family":"Petridis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7319-2045","authenticated-orcid":false,"given":"Dimitrios","family":"Kazis","sequence":"additional","affiliation":[{"name":"Third Department of Neurology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1962-7861","authenticated-orcid":false,"given":"Gabriel","family":"D\u0103sc\u0103lescu","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Ia\u0219i, Carol I Avenue, No. 20A, 700505 Ia\u0219i, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, Pacurari Street 11, 700511 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alin","family":"Ciobica","sequence":"additional","affiliation":[{"name":"Department of Biology, Faculty of Biology, \u201cAlexandru Ioan Cuza\u201d University of Ia\u0219i, Carol I Avenue, No. 20A, 700505 Ia\u0219i, Romania"},{"name":"\u201cIoan Haulica\u201d Institute, Apollonia University, Pacurari Street 11, 700511 Ia\u0219i, Romania"},{"name":"\u201cOlga Necrasov\u201d Center, Department of Biomedical Research, Romanian Academy, 700506 Ia\u0219i, Romania"},{"name":"Center of Biomedical Research, Romanian Academy, Bd. Carol I, No. 8, 700505 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ciprian","family":"Ilea","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorana Caterina","family":"Anton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emil","family":"Anton","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Medicine and Pharmacy \u201cGrigore T. Popa\u201d, 700115 Ia\u0219i, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,10,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"529","DOI":"10.1016\/j.purol.2019.08.002","article-title":"Dysfonctions sexuelles apr\u00e8s traumatisme cr\u00e2nien: Revue syst\u00e9matique de la litt\u00e9rature","volume":"29","author":"Robert","year":"2019","journal-title":"Progres En Urol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1186\/s13054-016-1318-1","article-title":"Chronic impact of traumatic brain injury on outcome and quality of life: A narrative review","volume":"20","author":"Stocchetti","year":"2016","journal-title":"Crit. Care"},{"key":"ref_3","first-page":"107","article-title":"Sexual dysfunction after traumatic brain injury","volume":"15","author":"Hibbard","year":"2000","journal-title":"NeuroRehabilitation"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1016\/S1474-4422(22)00309-X","article-title":"Traumatic brain injury: Progress and challenges in prevention, clinical care, and research","volume":"21","author":"Maas","year":"2022","journal-title":"Lancet Neurol."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"29","DOI":"10.4103\/1793-5482.131061","article-title":"Cognitive and sexual functions in patients with traumatic brain injury","volume":"9","author":"War","year":"2014","journal-title":"Asian J. Neurosurg."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1007\/s13760-025-02755-6","article-title":"Endocrine dysfunction post-traumatic brain injury: Challenges and therapeutic approaches","volume":"125","author":"Soltani","year":"2025","journal-title":"Acta Neurol. Belg."},{"key":"ref_7","first-page":"11","article-title":"Discussing Sexual Health after Traumatic Brain Injury: An Unmet Need!","volume":"14","author":"Russo","year":"2017","journal-title":"Innov. Clin. Neurosci."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"100473","DOI":"10.1016\/j.ijchp.2024.100473","article-title":"Understanding sexual distress related to sexual function (SDRSF): A preliminary framework based on a qualitative study with clinical sexologists","volume":"24","author":"Raposo","year":"2024","journal-title":"Int. J. Clin. Health Psychol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"61","DOI":"10.4103\/2321-3868.130189","article-title":"Sexuality following trauma injury: A literature review","volume":"2","author":"Connell","year":"2014","journal-title":"Burn. Trauma"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1042","DOI":"10.1136\/jnnp.2006.107193","article-title":"Neurological control of human sexual behaviour: Insights from lesion studies","volume":"78","author":"Baird","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e01389","DOI":"10.1002\/brb3.1389","article-title":"Neuroanatomy and function of human sexual behavior: A neglected or unknown issue?","volume":"9","author":"Cacciola","year":"2019","journal-title":"Brain Behav."},{"key":"ref_12","unstructured":"Kufe, D.W., Pollock, R.E., Weichselbaum, R.R., Bast, R.C., Gansler, T.S., Holland, J.F., and Frei, E. (2025, June 22). The Hypothalamic-Pituitary-Gonadal Axis, Holland-Frei Cancer Medicine, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK13386\/."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"bvab002","DOI":"10.1210\/jendso\/bvab002","article-title":"Sexual Dysfunction: A Neglected and Overlooked Issue in Adult GH Deficiency: The Management of AGHD Study","volume":"5","author":"Monzani","year":"2021","journal-title":"J. Endocr. Soc."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"102830","DOI":"10.1016\/j.bas.2024.102830","article-title":"Acute neuroendocrine changes after traumatic brain injury","volume":"4","author":"Stankovics","year":"2024","journal-title":"Brain Spine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s11920-017-0777-7","article-title":"Sexual Behavior Among Persons with Cognitive Impairments","volume":"19","author":"Thom","year":"2017","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"e2741","DOI":"10.32872\/cpe.v2i3.2741","article-title":"Cognitive-Behavioral and Emotion-Focused Couple Therapy: Similarities and Differences","volume":"2","author":"Bodenmann","year":"2020","journal-title":"Clin. Psychol. Eur."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"3063","DOI":"10.1089\/neu.2018.6171","article-title":"Sex Differences in Traumatic Brain Injury: What We Know and What We Should Know","volume":"36","author":"Gupte","year":"2019","journal-title":"J. Neurotrauma"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"8111022","DOI":"10.1155\/2022\/8111022","article-title":"Neurobiological Links between Stress, Brain Injury, and Disease","volume":"2022","author":"Guo","year":"2022","journal-title":"Oxidative Med. Cell. Longev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1097\/HTR.0000000000000188","article-title":"Persistent Hypogonadotropic Hypogonadism in Men After Severe Traumatic Brain Injury: Temporal Hormone Profiles and Outcome Prediction","volume":"31","author":"Barton","year":"2016","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"275","DOI":"10.1080\/09602010244000363","article-title":"Sexual changes associated with traumatic brain injury","volume":"13","author":"Ponsford","year":"2003","journal-title":"Neuropsychol. Rehabil."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"247479","DOI":"10.1155\/2015\/247479","article-title":"Sexual Functioning, Desire, and Satisfaction in Women with TBI and Healthy Controls","volume":"2015","author":"Strizzi","year":"2015","journal-title":"Behav. Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Duncan, K.A. (2020). Estrogen Formation and Inactivation Following TBI: What we Know and Where we Could go. Front. Endocrinol., 11.","DOI":"10.3389\/fendo.2020.00345"},{"key":"ref_23","first-page":"427","article-title":"The benefits and risks of testosterone replacement therapy: A review","volume":"5","author":"Bassil","year":"2009","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1016\/j.eururo.2015.03.031","article-title":"Phosphodiesterase 5 inhibitors for the treatment of erectile dysfunction: A trade-off network meta-analysis","volume":"68","author":"Chen","year":"2015","journal-title":"Eur. Urol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1016\/j.biopsych.2021.09.024","article-title":"Mental Health Consequences of Traumatic Brain Injury","volume":"91","author":"Howlett","year":"2021","journal-title":"Biol. Psychiatry"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Lavoie, S., Sechrist, S., Quach, N., Ehsanian, R., Duong, T., Gotlib, I.H., and Isaac, L. (2017). Depression in Men and Women One Year Following Traumatic Brain Injury (TBI): A TBI Model Systems Study. Front. Psychol., 8.","DOI":"10.3389\/fpsyg.2017.00634"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1097\/HTR.0b013e3182114efd","article-title":"Association of depressive symptoms with functional outcome after traumatic brain injury","volume":"27","author":"Hudak","year":"2012","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_28","first-page":"21","article-title":"Anxiety and sexual dysfunction","volume":"49","author":"Kaplan","year":"1988","journal-title":"J. Clin. Psychiatry"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Torregrossa, W., Raciti, L., Rifici, C., Rizzo, G., Raciti, G., Casella, C., Naro, A., and Calabr\u00f2, R.S. (2023). Behavioral and Psychiatric Symptoms in Patients with Severe Traumatic Brain Injury: A Comprehensive Overview. Biomedicines, 11.","DOI":"10.3390\/biomedicines11051449"},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"M\u00fcller, S.M., and Antons, S. (2023). Decision making and executive functions in problematic pornography use. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1191297"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1080\/02699050600744137","article-title":"Challenges associated with the definition and assessment of inappropriate sexual behaviour amongst individuals with an acquired neurological impairment","volume":"20","author":"Johnson","year":"2006","journal-title":"Brain Inj."},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Bj\u00f8rge, H., Kvaal, K., and Ulstein, I. (2019). The effect of psychosocial support on caregivers\u2019 perceived criticism and emotional over-involvement of persons with dementia: An assessor-blinded randomized controlled trial. BMC Health Serv. Res., 19.","DOI":"10.1186\/s12913-019-4551-x"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"464","DOI":"10.1016\/j.sxmr.2018.11.005","article-title":"Testosterone Replacement Therapy for Sexual Symptoms","volume":"7","author":"Rastrelli","year":"2019","journal-title":"Sex. Med. Rev."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1093\/bmb\/57.1.81","article-title":"Depression and sexual dysfunction","volume":"57","author":"Baldwin","year":"2001","journal-title":"Br. Med. Bull."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1080\/09602011.2015.1136222","article-title":"Relationships between risky sexual behaviour, dysexecutive problems, and mental health in the years following interdisciplinary TBI rehabilitation","volume":"28","author":"Moreno","year":"2018","journal-title":"Neuropsychol. Rehabil."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Bown, D., Belli, A., Qureshi, K., Davies, D., Toman, E., and Upthegrove, R. (2019). Post-traumatic stress disorder and self-reported outcomes after traumatic brain injury in victims of assault. PLoS ONE, 14.","DOI":"10.1371\/journal.pone.0211684"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1097\/MOU.0000000000000442","article-title":"Testosterone therapy improves erectile function and libido in hypogonadal men","volume":"27","author":"Rizk","year":"2017","journal-title":"Curr. Opin. Urol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5489\/cuaj.11291","article-title":"Synergetic effect of testosterone and phophodiesterase-5 inhibitors in hypogonadal men with erectile dysfunction: A systematic review","volume":"6","author":"Alhathal","year":"2012","journal-title":"Can. Urol. Assoc. J."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Kundakovic, M., and Rocks, D. (2022). Sex hormone fluctuation and increased female risk for depression and anxiety disorders: From clinical evidence to molecular mechanisms. Front. Neuroendocr., 66.","DOI":"10.1016\/j.yfrne.2022.101010"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1186\/s43045-022-00206-z","article-title":"Sexual dysfunction and quality of life in female patients with major depression disorder","volume":"29","author":"Eissa","year":"2022","journal-title":"Middle East Curr. Psychiatry"},{"key":"ref_41","doi-asserted-by":"crossref","unstructured":"Mestre-Bach, G., Blycker, G.R., and Potenza, M.N. (2022). Behavioral Therapies for Treating Female Sexual Dysfunctions: A State-of-the-Art Review. J. Clin. Med., 11.","DOI":"10.3390\/jcm11102794"},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Mollayeva, T., Mollayeva, S., Pacheco, N., and Colantonio, A. (2021). Systematic Review of Sex and Gender Effects in Traumatic Brain Injury: Equity in Clinical and Functional Outcomes. Front. Neurol., 12.","DOI":"10.3389\/fneur.2021.678971"},{"key":"ref_43","first-page":"678971","article-title":"Mild traumatic brain injury\/concussion and female sexuality, a scoping review of the literature","volume":"7","author":"Tiffany","year":"2020","journal-title":"Inj. Epidemiol."},{"key":"ref_44","first-page":"CD013071","article-title":"Testosterone replacement in men with sexual dysfunction","volume":"2024","author":"Lee","year":"2024","journal-title":"Cochrane Database Syst. Rev."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"591","DOI":"10.21037\/tau.2020.01.13","article-title":"Do testosterone supplements enhance response to phosphodiesterase 5 inhibitors in men with erectile dysfunction and hypogonadism: A systematic review and meta-analysis","volume":"9","author":"Zhu","year":"2020","journal-title":"Transl. Androl. Urol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Xie, C., Hu, J., Cheng, Y., and Yao, Z. (2022). Researches on cognitive sequelae of burn injury: Current status and advances. Front. Neurosci., 16.","DOI":"10.3389\/fnins.2022.1026152"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Liu, X., Feng, Z., Galling, B., Qi, N., Zhu, X.-Q., Xiao, L., and Wang, G. (2023). Gender specific sexual dysfunction in patients with depression. Front. Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1194228"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"167","DOI":"10.2147\/NDT.S10389","article-title":"Cognitive behavioral therapy for the treatment of post-traumatic stress disorder: A review","volume":"7","author":"Kar","year":"2011","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"104050","DOI":"10.1016\/j.nsa.2024.104050","article-title":"Psychoneuroendocrine profiles of unmedicated men with major depressive disorder and associations to treatment effects and sexual side-effects","volume":"3","author":"Jensen","year":"2024","journal-title":"Neurosci. Appl."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"403","DOI":"10.2147\/ciia.2006.1.4.403","article-title":"Sildenafil in the treatment of erectile dysfunction: An overview of the clinical evidence","volume":"1","author":"Hatzimouratidis","year":"2006","journal-title":"Clin. Interv. Aging"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"259","DOI":"10.1016\/S0377-1237(07)80150-X","article-title":"Psychiatric Effects of Traumatic Brain Injury","volume":"63","author":"Sudarsanan","year":"2007","journal-title":"Med. J. Armed Forces India"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Nakao, M., Shirotsuki, K., and Sugaya, N. (2021). Cognitive\u2013behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. Biopsychosoc. Med., 15.","DOI":"10.1186\/s13030-021-00219-w"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"395","DOI":"10.1097\/HTR.0000000000000981","article-title":"INTIMASY-TBI Guideline: Optimization of INTIMAcy, SexualitY, and Relationships Among Adults with Traumatic Brain Injury","volume":"39","author":"Patsakos","year":"2024","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2739","DOI":"10.1080\/09638288.2020.1715494","article-title":"Sexuality in the context of physical rehabilitation as perceived by occupational therapists","volume":"43","author":"Lepage","year":"2020","journal-title":"Disabil. Rehabil."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1111\/jsm.12810","article-title":"Sexual health care for people with physical disabilities","volume":"12","author":"Rowen","year":"2015","journal-title":"J. Sex. Med."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jocn.2018.09.030","article-title":"Changes in sexual functioning following traumatic brain injury: An overview on a neglected issue","volume":"58","author":"Latella","year":"2018","journal-title":"J. Clin. Neurosci."},{"key":"ref_57","first-page":"400","article-title":"Relationship between guideline adherence and outcomes in severe traumatic brain injury","volume":"105","author":"Dheansa","year":"2023","journal-title":"Ind. Mark. Manag."},{"key":"ref_58","first-page":"e77851","article-title":"Association of Sexual Health and Mental Health in Erectile Dysfunction: Expert Opinion from the Indian Context","volume":"17","author":"Vasan","year":"2025","journal-title":"Cureus"},{"key":"ref_59","doi-asserted-by":"crossref","unstructured":"Eggenberger, L., Ehlert, U., and Walther, A. (2023). New directions in male-tailored psychotherapy for depression. Front. Psychol., 14.","DOI":"10.3389\/fpsyg.2023.1146078"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"E1","DOI":"10.1097\/HTR.0000000000000652","article-title":"Understanding Traumatic Brain Injury in Females: A State-of-the-Art Summary and Future Directions","volume":"36","author":"Valera","year":"2021","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1007\/s11065-023-09625-z","article-title":"Combined Cognitive and Psychological Interventions Improve Meaningful Outcomes after Acquired Brain Injury: A Systematic Review and Meta-Analysis","volume":"34","author":"Davies","year":"2023","journal-title":"Neuropsychol. Rev."},{"key":"ref_62","first-page":"69","article-title":"Sexuality after traumatic brain injury: A critical review","volume":"32","author":"Moreno","year":"2013","journal-title":"NeuroRehabilitation"},{"key":"ref_63","first-page":"e77087","article-title":"Partnering with Patients to Improve a Multidisciplinary Sexual Dysfunction Program: A Survey of Patient Experience at a Single Institution","volume":"17","author":"Iftekhar","year":"2025","journal-title":"Cureus"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"6","DOI":"10.5334\/ijic.6473","article-title":"A Systematic Review of Interventions that Use Multidisciplinary Team Meetings to Manage Multimorbidity in Primary Care","volume":"22","author":"Greenfield","year":"2022","journal-title":"Int. J. Integr. Care"},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"898","DOI":"10.1016\/j.fertnstert.2014.02.025","article-title":"Effects of hormone therapy on cognition and mood","volume":"101","author":"Fischer","year":"2014","journal-title":"Fertil. Steril."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"10732748241236327","DOI":"10.1177\/10732748241236327","article-title":"The Effects of Patient-Centered Communication on Patient Engagement, Health-Related Quality of Life, Service Quality Perception and Patient Satisfaction in Patients with Cancer: A Cross-Sectional Study in T\u00fcrkiye","volume":"31","year":"2024","journal-title":"Cancer Control"},{"key":"ref_67","unstructured":"National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Health Care Services, Board on Health Sciences Policy, Committee on Accelerating Progress in Traumatic Brain Injury Research and Care, Matney, C., Bowman, K., and Berwick, D. (2025, June 22). Traumatic Brain Injury: A Roadmap for Accelerating Progress, Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK580075\/."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"S262","DOI":"10.4103\/indianjpsychiatry.indianjpsychiatry_612_23","article-title":"Promoting sexual well-being","volume":"66","author":"Rao","year":"2024","journal-title":"Indian J. Psychiatry"},{"key":"ref_69","doi-asserted-by":"crossref","unstructured":"Duncan, K.A., and Garijo-Garde, S. (2021). Sex, Genes, and Traumatic Brain Injury (TBI): A Call for a Gender Inclusive Approach to the Study of TBI in the Lab. Front. Neurosci., 15.","DOI":"10.3389\/fnins.2021.681599"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1007\/s11920-996-0006-2","article-title":"Prevalence and risk factors of sexual dysfunction in men and women","volume":"2","author":"Rosen","year":"2000","journal-title":"Curr. Psychiatry Rep."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1016\/S0166-2236(00)01821-X","article-title":"Brain damage, sex hormones and recovery: A new role for progesterone and estrogen?","volume":"24","author":"Stein","year":"2001","journal-title":"Trends Neurosci."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"714","DOI":"10.1007\/s12028-022-01672-3","article-title":"Endocrine Dysfunction After Traumatic Brain Injury: An Ignored Clinical Syndrome?","volume":"39","author":"Mahajan","year":"2023","journal-title":"Neurocrit. Care"},{"key":"ref_73","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1186\/s41016-019-0173-8","article-title":"Sex differences in traumatic brain injury: A multi-dimensional exploration in genes, hormones, cells, individuals, and society","volume":"5","author":"Ma","year":"2019","journal-title":"Chin. Neurosurg. J."},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"287","DOI":"10.31887\/DCNS.2011.13.2\/tmcallister","article-title":"Neurobiological consequences of traumatic brain injury","volume":"13","author":"McAllister","year":"2011","journal-title":"Dialog-Clin. Neurosci."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"e12590","DOI":"10.1111\/jne.12590","article-title":"Emerging insights into hypothalamic-pituitary-gonadal axis regulation and interaction with stress signalling","volume":"30","author":"Kauffman","year":"2018","journal-title":"J. Neuroendocr."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"908","DOI":"10.1590\/S0004-27302009000800003","article-title":"Hypogonadism after traumatic brain injury","volume":"53","author":"Hohl","year":"2009","journal-title":"Arq. Bras. Endocrinol. Metabol."},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"379","DOI":"10.1089\/neu.2024.0114","article-title":"Identifying Growth Hormone Deficiency in Brain-Injured Patients: The Quality of Life Scale-99","volume":"42","author":"Barnard","year":"2025","journal-title":"J. Neurotrauma"},{"key":"ref_78","doi-asserted-by":"crossref","unstructured":"Gasco, V., Cambria, V., Bioletto, F., Ghigo, E., and Grottoli, S. (2021). Traumatic Brain Injury as Frequent Cause of Hypopituitarism and Growth Hormone Deficiency: Epidemiology, Diagnosis, and Treatment. Front. Endocrinol., 12.","DOI":"10.3389\/fendo.2021.634415"},{"key":"ref_79","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1007\/s10143-024-03088-3","article-title":"Acute and chronic hypopituitarism following traumatic brain injury: A systematic review and meta-analysis","volume":"47","author":"Aljboor","year":"2024","journal-title":"Neurosurg. Rev."},{"key":"ref_80","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1210\/clinem\/dgad484","article-title":"Effect of Testosterone Replacement Therapy on Sexual Function and Hypogonadal Symptoms in Men with Hypogonadism","volume":"109","author":"Pencina","year":"2023","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1097\/JCP.0b013e31819c76e9","article-title":"Sexual Dysfunction, Depression, and the Impact of Antidepressants","volume":"29","author":"Kennedy","year":"2009","journal-title":"J. Clin. Psychopharmacol."},{"key":"ref_82","doi-asserted-by":"crossref","unstructured":"Indirli, R., Lanzi, V., Arosio, M., Mantovani, G., and Ferrante, E. (2023). The association of hypogonadism with depression and its treatments. Front. Endocrinol., 14.","DOI":"10.3389\/fendo.2023.1198437"},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"177","DOI":"10.1038\/s41443-020-00405-4","article-title":"Erectile dysfunction in patients with anxiety disorders: A systematic review","volume":"34","author":"Velurajah","year":"2021","journal-title":"Int. J. Impot. Res."},{"key":"ref_84","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1097\/HTR.0b013e31828b4f7b","article-title":"Factors associated with sexuality following traumatic brain injury","volume":"28","author":"Ponsford","year":"2013","journal-title":"J. Head Trauma Rehabil."},{"key":"ref_85","doi-asserted-by":"crossref","unstructured":"Buono, V.L., Corallo, F., Bonanno, L., Quartarone, A., and De Cola, M.C. (2023). Body Image and Emotional Status in Patients with Acquired Brain Injury. J. Clin. Med., 12.","DOI":"10.3390\/jcm12124070"},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1007\/s11940-002-0004-6","article-title":"Cognitive Impairment Following Traumatic Brain Injury","volume":"4","author":"Arciniegas","year":"2002","journal-title":"Curr. Treat. Options Neurol."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"194","DOI":"10.1038\/ijir.2013.4","article-title":"Depression is correlated with the psychological and physical aspects of sexual dysfunction in men","volume":"25","author":"Pastuszak","year":"2013","journal-title":"Int. J. Impot. Res."},{"key":"ref_88","doi-asserted-by":"crossref","first-page":"CNC18","DOI":"10.2217\/cnc-2016-0012","article-title":"The partner\u2019s experience of traumatic brain injury and its recovery","volume":"1","year":"2016","journal-title":"Concussion"},{"key":"ref_89","doi-asserted-by":"crossref","unstructured":"Unadkat, P., Rebeiz, T., Ajmal, E., De Souza, V., Xia, A., Jinu, J., Powell, K., and Li, C. (2025). Neurobiological Mechanisms Underlying Psychological Dysfunction After Brain Injuries. Cells, 14.","DOI":"10.3390\/cells14020074"},{"key":"ref_90","doi-asserted-by":"crossref","unstructured":"Salvio, G., Martino, M., Giancola, G., Arnaldi, G., and Balercia, G. (2021). Hypothalamic\u2013Pituitary Diseases and Erectile Dysfunction. J. Clin. Med., 10.","DOI":"10.3390\/jcm10122551"},{"key":"ref_91","doi-asserted-by":"crossref","unstructured":"Arcos-Romero, A.I., and Calvillo, C. (2023). Sexual Health and Psychological Well-Being of Women: A Systematic Review. Healthcare, 11.","DOI":"10.20944\/preprints202309.1963.v1"},{"key":"ref_92","first-page":"281","article-title":"Treating male sexual dysfunction after traumatic brain injury: Two case reports","volume":"38","author":"Simpson","year":"2016","journal-title":"NeuroRehabilitation"},{"key":"ref_93","doi-asserted-by":"crossref","unstructured":"Shen, Y., Jiang, L., Lai, J., Hu, J., Liang, F., Zhang, X., and Ma, F. (2025). Correction: A comprehensive review of rehabilitation approaches for traumatic brain injury: Efficacy and outcomes. Front. Neurol., 16.","DOI":"10.3389\/fneur.2025.1651979"},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1016\/j.maturitas.2003.10.005","article-title":"Sexual function, menopause and hormone replacement therapy (HRT)","volume":"48","author":"Caba","year":"2004","journal-title":"Maturitas"},{"key":"ref_95","doi-asserted-by":"crossref","unstructured":"Kaltsas, A., Dimitriadis, F., Zachariou, A., Sofikitis, N., and Chrisofos, M. (2025). Phosphodiesterase Type 5 Inhibitors in Male Reproduction: Molecular Mechanisms and Clinical Implications for Fertility Management. Cells, 14.","DOI":"10.3390\/cells14020120"},{"key":"ref_96","doi-asserted-by":"crossref","first-page":"1629","DOI":"10.1007\/s13311-023-01430-z","article-title":"Phosphodiesterase-5 (PDE-5) Inhibitors as Therapy for Cerebrovascular Dysfunction in Chronic Traumatic Brain Injury","volume":"20","author":"Kalyani","year":"2023","journal-title":"Neurotherapeutics"},{"key":"ref_97","doi-asserted-by":"crossref","first-page":"1827","DOI":"10.1111\/j.1743-6109.2011.02306.x","article-title":"Sex therapy and combined (sex and medical) therapy","volume":"8","author":"Althof","year":"2011","journal-title":"J. Sex. Med."},{"key":"ref_98","doi-asserted-by":"crossref","first-page":"qfad033","DOI":"10.1093\/sexmed\/qfad033","article-title":"Mindfulness in sex therapy and intimate relationships: A feasibility and randomized controlled pilot study in a cross-diagnostic group","volume":"11","author":"Krieger","year":"2023","journal-title":"Sex. Med."},{"key":"ref_99","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1310\/sci2301-49","article-title":"A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework","volume":"23","author":"Elliott","year":"2017","journal-title":"Top. Spinal Cord Inj. Rehabil."},{"key":"ref_100","doi-asserted-by":"crossref","first-page":"732","DOI":"10.1080\/09638288.2016.1271026","article-title":"Training rehabilitation teams in sexual health care: A description and evaluation of a multidisciplinary intervention","volume":"40","author":"Pieters","year":"2017","journal-title":"Disabil. Rehabil."},{"key":"ref_101","doi-asserted-by":"crossref","unstructured":"Bogaert, E., and Roels, R. (2025). Sexual health in patient care: Shortcomings in medical training and experienced barriers in sexual history taking. BMC Med. Educ., 25.","DOI":"10.1186\/s12909-025-06850-3"},{"key":"ref_102","doi-asserted-by":"crossref","unstructured":"Torregrossa, W., Torrisi, M., De Luca, R., Casella, C., Rifici, C., Bonanno, M., and Calabr\u00f2, R.S. (2023). Neuropsychological Assessment in Patients with Traumatic Brain Injury: A Comprehensive Review with Clinical Recommendations. Biomedicines, 11.","DOI":"10.3390\/biomedicines11071991"},{"key":"ref_103","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.aju.2013.07.007","article-title":"Psychological and interpersonal dimensions of sexual function and dysfunction","volume":"11","author":"Assalian","year":"2013","journal-title":"Arab. J. Urol."},{"key":"ref_104","doi-asserted-by":"crossref","first-page":"475","DOI":"10.1007\/s11934-008-0081-5","article-title":"Sexual dysfunction in women: What can urologists contribute?","volume":"9","author":"Goldstein","year":"2008","journal-title":"Curr. Urol. Rep."},{"key":"ref_105","unstructured":"Leslie, S.W., and Sooriyamoorthy, T. (2025, June 22). Erectile Dysfunction, StatPearls [Internet], Available online: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK562253\/."},{"key":"ref_106","doi-asserted-by":"crossref","first-page":"1080","DOI":"10.3171\/2017.10.JNS17352","article-title":"Estimating the global incidence of traumatic brain injury","volume":"130","author":"Dewan","year":"2019","journal-title":"J. Neurosurg."},{"key":"ref_107","unstructured":"WHO (2006). Defining Sexual Health\u2014Report of a Technical Consultation on Sexual Health 28\u201331 January 2002, Geneva, World Health Organization."},{"key":"ref_108","doi-asserted-by":"crossref","first-page":"S373","DOI":"10.21037\/tau.2018.04.12","article-title":"Spinal cord injury and male infertility\u2014A review of current literature, knowledge gaps, and future research","volume":"7","author":"Anderson","year":"2018","journal-title":"Transl. Androl. Urol."},{"key":"ref_109","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1016\/j.yfrne.2018.03.006","article-title":"Sex-related responses after traumatic brain injury: Considerations for preclinical modeling","volume":"50","author":"Braun","year":"2018","journal-title":"Front. 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