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Brain & Nervous System Health Center

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Living With a Spinal Cord Injury - Intimacy and Fertility

All spinal cord injuries are different. How they affect intimacy and sexual function-and how people will react to the change-varies. Because of this, you need to make your own observations and evaluate your experiences to understand your changes in sexual function and how to best deal with them.

After a spinal cord injury (SCI), how you look and what you are able to do changes. An SCI may also affect how your sexual organs work. These changes often result in frustration, anger, and disappointment, all of which can strain a relationship. People with SCIs may wonder if they will be able to maintain the relationship they are in or develop new ones.

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But being intimate means more than just having sex. Your interests, ideas, and behavior play a greater role in defining you than your appearance or your ability to have sex. A relationship depends on many things, including shared interests, how you deal with personal likes and dislikes, and how you treat each other.

The most important thing in a relationship is how well you communicate. Talk to your partner. Be honest about how the SCI has affected your sexual function and how you feel about it. Always keep in mind that people with SCIs can have relationships and marry, have an active sex life, and have children.

Desire and sexual arousal

Usually, men and women are sexually aroused through two pathways: direct stimulation of the genitals or other erotic area or through thinking, hearing, or seeing something sexually arousing. In men, this usually causes an erection, and in women it causes lubrication of the vagina and swelling of the clitoris. An SCI can affect either of these pathways and may change a person's physical response to arousal. Most people remain interested in sexual activity after an SCI, although the level of interest may decrease.

Many men with an SCI resume sexual activity within about 1 year of the injury. Men who are able to have an erection may find that the erection isn't rigid enough or doesn't last long enough for sexual activity. Some have retrograde ejaculation, in which semen goes into the bladder instead of out through the penis.

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