Spinal cord injuries (SCI) can lead to changes in a person’s sexual health. Depending on the severity of the injury and its location on the spine, it can lead to a loss of motor function, the inability to perceive touch or respond to stimuli, and/or the decline or absence of sexual response reflexes.
Men with SCI may experience erectile dysfunction (ED), problems with ejaculation, and orgasmic dysfunction. Women, on the other hand, may find they have decreased vaginal sensation and lubrication as well as orgasmic dysfunction with SCI. Both men and women with SCI can also experience the side effects of fatigue, pain, depression, or a change in one’s self-image.
These changes in sexual functioning can be very traumatic and emotional for individuals with SCI, so it is not unusual for people to feel a sense of loss and grief after their injury. However, people with SCI can and do engage in sexual relationships and experience sexual intimacy with others. The following are some of the ways in which a person with SCI can nurture their sexuality.
Communicate for success.
Open communication with a partner is key for anyone who is in a sexual relationship, and this is still true for people with SCI. People with SCI should discuss foreplay, touching, stimulation, best sexual positions for mobility and comfort, achieving and maintaining an erection, facilitating vaginal lubrication, and/or bladder and bowel management with a partner to set the stage for a more successful sexual experience.
Masturbate to (re)discover pleasure.
Masturbation is a great way to discover what feels good during sex. SCI can cause a decrease or loss of sensation in the body below the level of injury. Nevertheless, the genitals may still respond to stimulation, particularly vibratory stimulation. Modified, hands-free vibrators are available for people with limited mobility.
Additionally, it can be worthwhile to explore stimulating other erogenous zones during masturbation, as these areas may become more sensitive after SCI. The scalp, neck, lips, ears, nipples, and arms may become especially responsive to pleasurable touch for people with SCI.
Use sex aids.
In addition to vibrators, other sex aids, devices, medications, or products may help facilitate more comfortable, enjoyable sex for individuals with SCI. For men experiencing ED, oral ED medications, vacuum erection devices, intracavernous injections, or stimulating the head of the penis with a vibrator may help. Women who need additional vaginal lubrication can use personal lubricants. Lastly, specialty furniture and lifts exist to help people with limited mobility position themselves more comfortably during sex.
Abramson, C. E., McBride, K. E., Konnyu, K. J., & Elliott, S. L. (2008). Sexual health outcome measures for individuals with a spinal cord injury: a systematic review. Spinal cord, 46(5), 320-324. https://doi.org/10.1038/sj.sc.3102136
Agency for Clinical Innovation. (2017, March). Sexuality following spinal cord injury. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/349051/Spinal-sexuality-guideline-160317.pdf
Alexander, M., Hicks, T., Aisen, M., & Klebine, P. (2015). Sexuality & Sexual Functioning After Spinal Cord Injury. Model Systems Knowledge Translation Center. https://msktc.org/sci/factsheets/sexuality