Why You Shouldn’t Discount Sex After a Spinal Cord Injury

A spinal cord injury (SCI) is a life-altering event for both the SCI survivor and their loved ones. There are a lot of adjustments that need to be made to daily routines, such as using the bathroom, getting around the house, and even going to bed.

One major concern that SCI survivors (and their significant others) have is how their injury will affect their intimacy and sexual function. Some people discount the mere possibility of sex after a spinal cord injury entirely. They think that a lack of motor control eliminates any chance they have at maintaining a state of sexual wellbeing.

While an SCI is highly likely to impact sexual function, sex after a spinal cord injury is still possible, and can be important for maintaining intimacy between SCI survivors and their significant others.

Why shouldn’t you discount the possibility of sex after a spinal cord injury? Here are a few things to know about spinal cord injury sexual function:

Sex After a Spinal Cord Injury: Not All SCIs Are Equal

Not all spinal cord injuries are the same. Depending on the location of the injury and whether it is “complete” or “incomplete,” SCI survivors may have differing levels of motor and sensory impairment. For example, a person with a cervical spinal cord injury may suffer from quadriplegia (the inability to move any limbs) or even respiratory issues that require the use of an assisted breathing apparatus.

Meanwhile, a lumbar spinal cord injury survivor might experience weakness and numbness in the hips, groin, and legs or full paralysis of their legs (paraplegia), but will usually retain full control over their arms. In the case of some incomplete lumbar spinal cord injuries, the injured person may even be able to walk limited distances with braces or other assisted walking devices.

So, having a spinal cord injury may affect your sexual wellbeing to different degrees depending on the level of the injury and its “completeness.” However, even with a severely limiting type of injury, intimacy is still possible.

Sex After a Spinal Cord Injury: Erections in Men

Many men might think that spinal cord injury sexual function is impossible—that they won’t be able to become erect when they need/want to. However, there are studies that prove otherwise. While an SCI can affect the survivor’s ability to achieve an erection, many men with spinal cord injuries can achieve erections.

There are two primary means of triggering an erection in men:

  1. Psychogenic Triggers. Sexual thoughts or visual/auditory stimuli that trigger erotic thoughts; and
  2. Reflex Triggers. Direct, contact-based stimuli to an erogenous zone on the male body (typically the phallus).

What may be of interest to many men is that while many spinal cord injuries may prevent psychogenic triggers from causing an erection, reflex triggers will frequently work. According to information cited by the Christopher & Dana Reeve Foundation, the reason for this is that “The nerves that control a man’s ability to have a reflex erection are located in the sacral area (S2-S4) of the spinal cord. Most paralyzed men are able to have a reflex erection with physical stimulation unless the S2-S4 pathway is damaged.”

Furthermore, many men who have sex after a spinal cord injury may still be able to impregnate a woman and even achieve orgasm. As noted by the Christopher & Dana Reeve Foundation article:

“Researchers report that ejaculation occurs in up to 70 percent of men with incomplete lower-level injuries, and in as many as 17 of men with complete lower-level injuries. Ejaculation occurs in about 30 percent of men with incomplete upper-level injuries and almost never in men with complete injuries… A study of 45 men with SCI and 6 able-bodied controls demonstrated that 79 percent of the men with incomplete lesions and 28 percent of those with complete injuries achieved orgasm in the laboratory setting.”

In fact, for men, achieving ejaculation helped lessen certain SCI symptoms. As the foundation article notes, “ejaculation has been reported to decrease spasticity for up to 24-hours.” Spasticity, or spastic hypertonia, is a condition that may cause muscular stiffness or uncontrollable leg movement in SCI survivors.

Sex After a Spinal Cord Injury: Reproductive Function in Women

SCIs can affect a woman’s sexual wellbeing and reproductive urges just as severely as they do a man’s. In fact, it is not uncommon for a woman to experience interruptions in their menstrual cycle following a spinal cord injury. This may lead some women to wonder if they’ll be able to be sexually active after a SCI.

However, it is possible for many women with a spinal cord injury to have sex, achieve orgasm, and to become pregnant. As noted in a Craig Hospital article on the subject:

“The clitoris, located on the minor labia, is the female counterpart to the penis because it is capable of erection, and its stimulation can lead to orgasm. However, orgasm is not essential for fertilization to take place – you can get pregnant without having an orgasm.

Normally, your vagina will become moist to make intercourse easier. This is called lubrication. Your breasts will also become more sensitive and your nipples will become erect. After a spinal cord injury, your vagina may lubricate less and some women find it takes longer to have lubrication occur.”

While the loss of sensation in the groin may impede lubrication and orgasm, there are ways for female SCI survivors to achieve it. Tiffiny Carlson, a SCI survivor herself, provides advice for women with spinal cord injuries on how to experiment to discover new methods of achieving orgasm in a guest blog for spinalcord.com:

“if you communicate about what feels good and discover where your new erogenous zones are (scars, the face, neck, the line on body where injury stops/begins) physical orgasms from new areas can be achieved.

Also, try experimenting with good and bad touch and try to touch using different body parts (like the tongue or toes) to touch your partner. And sex in the shower can especially feel good because of the enhanced temps and sensation variations.”

The Craig Hospital article seconds this advice, stating that “People who approach sex with an open mind and a willingness to experiment to find out what works and doesn’t work after their injury tend to have the most success and reported satisfaction.” So, taking the time to explore alternative erogenous zones can be the key to successful sex after a spinal cord injury.

A spinal cord injury doesn’t have to be the end of your sexual wellbeing—it can be the start of a new chapter instead.

If you have any questions about sexual function after a spinal cord injury, be sure to check out our guide, Bladder, Bowel, and Sexual Functions After a Spinal Cord Injury at the link below:

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Topics: Spinal Cord Injury

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