Why sexual health is important to your quality of life
People dealing with conditions like bipolar disorder experience specific issues around sexuality that can have a significant impact on their quality of life.9 Sexual interest can be increased in people with bipolar disorder. For example, a recent study found that females with bipolar disorder type 1 reported higher sexual interest when they were having manic symptoms.10 People with bipolar disorder have an increased tendency to high risk sexual behavior (such as unprotected sex or multiple partners) when they’re in the hypomanic or manic phase of their condition.11 The disinhibition associated with hypomania or mania may cause individuals to engage in risky behaviour that they would normally reject, raising the risk of consequences like sexually transmitted diseases, unwanted pregnancy or damages to their relationships. But, of course, there is another side to bipolar disorder sexuality: when you're in the depressive part of the cycle, you're not likely to have much sexual desire at all. Reduced sexual drive (libido) is a common feature of depression and can certainly reduce your quality of life. Also, antidepressant medications often have reduced libido as a side-effect.12
How you can take action
Protect your own sexual safety. There is limited research about the most helpful ways to increase the safety of sexual behaviour during a manic phase, and it’s not likely to be a big focus of most treatment programs for individuals with bipolar disorder. But research studies have shown that educational and psychological treatments can increase the sexual safety of individuals with bipolar disorder.17 These treatments increased knowledge of sexual risks, encouraged the use of condoms, increased the ability to stand firm when refusing risky sexual contact and helped in planning to keep oneself safe in risky situations.
When it comes to protecting your own sexual safety, research suggests that the key is to make sure that you seriously look at the risks of disinhibited sexual behaviour (remember, that’s sexual behavior that you wouldn’t normally take part in), speak openly with a therapist or trusted friend about your own history of risky sexuality when you are feeling manic or hypomanic, and plan ahead to keep yourself safe in risky situations (for example bring a friend who knows to look out for you, have condoms to keep sexual encounters safer). As well, mood stabilizing medications that balance your mood can reduce the manic or hypomanic disinhibition that adds to risky sexual behavior.
Finally, medications used for mood management can often have sexual side-effects: reduced libido or other sexual problems. If this happens for you, it's worth discussing the problem with your healthcare provider in order to try to find a medication with less effect on your sexuality. Talking to intimate partner(s) about the problem can also be helpful in openly coming up with possible solutions together.
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