All SCIs are different. How
SCIs 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 the changes in sexual function and how
to best deal with them.
There is little research on treating
sexual function in SCIs. For men who cannot achieve
an erection, the same treatments that are used for
erection problems (erectile dysfunction) may be used.
For information on the treatment of erection problems,
see the topic
A vibrating device can also help men obtain an
Always talk to a doctor familiar with SCIs before using
any medicines or assistive devices. You should discuss the location of your
injury, possible side effects, and any other medical conditions you have. You
also need to watch for
autonomic dysreflexia, a syndrome in which there is a
sudden onset of excessively high blood pressure. If not treated promptly and
correctly, it may lead to
stroke, and even death.
Women may have
problems being aroused and have little or no vaginal lubrication. You can
work with your partner to find areas of your body that react to stimulation. The medicine sildenafil (Viagra) can also help women become aroused. A
vibrating device may also help. Lack of lubrication can result in problems such
as vaginal tearing or pain during intercourse. If this is a problem, a
water-based lubricant such as Astroglide will help, but do not use oil-based
Both men and women can benefit from counseling,
talking with each other, and
sensual exercises. Your sex life will likely be
different after your SCI, but sexual intimacy is still possible and encouraged.
Your rehabilitation center may have a counselor or other health professional
who specializes in sexual health after an SCI. He or she may be able to help
you and your partner with these issues.
Men with SCIs usually have difficulty
fathering a child. Most men with SCIs have poor sperm quality and have trouble
ejaculating. To have children, men with SCIs can use
penile stimulation to obtain sperm for
assistive reproductive technologies.
Stimulation can be done with a vibrator (penile vibratory stimulation, or
PVS). Vibrators are available that are specially made to induce ejaculation in
men with SCIs. Vibrators can damage your skin. Use them carefully if you do not
have feeling in the penis. If PVS is not successful, rectal probe
electroejaculation (RPE) is an option. In this procedure, your doctor inserts
an electrical probe into the
rectum to stimulate ejaculation.
usually do not affect a woman's ability to have children. Most women have a brief pause in their
menstrual cycle after an SCI. But after their period
returns, they usually can have children. It is important for women who are
sexually active after an SCI to use effective birth control if they do not want
to get pregnant. Women with SCIs who want to get pregnant should be aware of
the special medical, psychological, and social issues involved in an SCI
pregnancy. And they should work with doctors who also understand these needs.
Common concerns and complications include:2
- Urinary tract infections (UTIs), which increase during
pregnancy in women with SCIs. Your urine should be tested frequently.
- Pressure sores. The additional weight of pregnancy
puts greater pressure on the skin and may increase the risk of pressure sores.
Be sure you perform skin exams regularly.
- Mobility devices. The weight gain of pregnancy may mean that you need to change the type of mobility device you use. You may also have to change your transfer technique.
- Lung function. Women with damage higher on the spinal cord may
experience reduced lung function.
Ventilator support may be needed.
- Autonomic dysreflexia. During labor, the symptoms of
this condition may be the same as seen in uterine contractions. Anesthesia
should be used during labor to prevent this serious condition.