When soldiers return from war, we can see the obvious scars of combat. But there are injuries and effects that can be much harder to notice. The wars in Iraq and Afghanistan have resulted in over 50,000 combat-related injuries. In the same time, over 175,000 service members have been diagnosed with post-traumatic stress disorder and over 327,000 suffered traumatic brain injury.

Injuries, both physical and mental, can have a broad impact on all areas of a returning soldier’s life. We are slowly coming to terms with effects like PTSD, depression, and suicide. But what about fertility? A survey of veterans of Operation Enduring Freedom and Operation Iraqi Freedom showed 13.8% of men reported an experience with infertility after serving. Let’s examine how combat-related injuries might cause infertility in men.

Physical Injury

Around 75% of injuries in modern warfare are from explosives. Blast injuries, as with an improvised explosive device, typically involve shrapnel penetrating the lower extremities — the legs and groin. These injuries can often include serious harm to the external genitals. Almost 2,000 service members suffered debilitating injury to the groin or genitals between 2000 and 2013.

Scar tissue in the testicles or other damage to the sperm cells can stop sperm production. Similarly, damage to the ducts and tubes that transport sperm can prevent otherwise healthy sperm from moving properly, as can injury to the penis. Surgery may be a treatment option in some cases, depending on the extent of the damage.

Mental Trauma

Far more servicemen suffer mental trauma than receive physical injury. This includes PTSD but also traumatic brain injury, a physical condition that can have long-lasting mental effects.

Post-traumatic stress disorder has received a lot research, and its effects on fertility are better understood today as a result. A Veterans Affairs study conducted in 2015 reported that male veterans with PTSD were four times more likely to experience erectile dysfunction. Many who suffer from PTSD self-medicate with alcohol, and treatment for the disorder can include antidepressants. Both alcohol and certain medications can have their own impact on fertility.

Traumatic brain injury (TBI) is also being taken more and more seriously by the medical community. Where “concussions” were once thought to be serious but short-term conditions, today we recognize that TBI can actually be life-threatening and life-altering. The sexual side-effects of TBI include:

  • Changes in sexual desire, such as either a decrease or a significant increase, as well as an inability to control sexual behavior.
  • Difficulty becoming sexually aroused or maintaining an erection.
  • Difficulty reaching orgasm.
  • Decreased sperm production, possibly due to damage to the areas of the brain that affect the production of sex hormones.

After returning from war, service members want to get back to as normal a life as possible. For many, that includes starting a family. Unfortunately, infertility can be a painful reminder of everything they went through. If you are a veteran facing fertility problems, be sure to talk to your doctor about possible male infertility treatment options, and if needed ask about the best resources for support during this time. If you want more information about improving fertility or tips for conceiving, follow us on Facebook and Twitter, or sign up for our newsletter below.

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