Spinal cord injury often causes sexual problems, but people with spinal cord injuries can in fact have satisfying sex lives.

About Sexuality after a Spinal Cord Injury

In the first months following a spinal cord injury, it is natural for victims to be focused on physical and psychological recovery and rehabilitation. However, coming to terms with sexuality after spinal cord injury is an important step toward making a healthy adjustment to your new life. Sexual expression is a fundamental part of being human and an important component of our identity as men and women.

After spinal cord injury, people have a choice to be sexually active or not. As such, it’s important that you have information about sexuality and the emotional support to make that decision.

Human sexuality is complicated; it encompasses not only sexual drive and desire, but also

  • interpersonal relations
  • intimacy
  • self understanding
  • self-understanding about body image, and
  • sexual function and behaviors.

For many, the possibility that disabled people might have sex seems questionable. As a result of this lack of knowledge, paralyzed individuals are often assumed to be non-sexual.

Spinal cord injuries does affect a person’s sexuality, but it does not need to end it

Yet while a spinal cord injury does affect a person’s sexuality, it does not need to end it. Sexual expression is a natural and vital part of human life, whether or not a person can walk. Despite the changes in physical function, the emotional aspects of sexuality continue to be as important for disabled people as for anybody else.

There’s no doubt that spinal cord injuries give rise to multiple comorbidities that not only affect a SCI victim’s physical and psychological functions but also cause detrimental psychological consequences and sexual dysfunction. The extent of sexual dysfunction is influenced by the severity of the neurologic lesion (where the spinal cord injury occurred), the presence of bladder and bowel problems, pain, and spasticity, and by difficulties with interpersonal and social relationships. Impaired sensitivity of the genitals contributed to the lower popularity of non-coital sexual activity in women.  In addition, issues with muscle movement, impaired sense of feeling, and the loss of natural sexual reflexes often happens after spinal cord injury. How your physical loses effects arousal, orgasm, and fertility naturally depends on your level of injury and whether your injury is a complete or incomplete spinal cord injury.

Victims of with spinal cord injury (SCI) always have questions about their sexuality, and these questions cannot be ignored. Early after injury, people with SCI often ask questions about their attractiveness, relationships, and ability to conceive and possibly have children. As a result, many clinicians understand the importance of discussing these issues.

How does a spinal cord injury affect sexuality?

In technical terms, spinal cord injury affects sexual ability as a result of the physiological changes caused by damage to particular nerve pathways. It is the location or the level of injury on the spinal cord that is the main determinant of sexual functioning, and wether the injury is complete or incomplete.

This may mean diminished genital sensation, loss of adequate erections or the ability to ejaculate for men, and decreased lubrication in women. In addition, decreased muscle strength and involuntary spasms may affect a person’s positioning and movement during sexual activity. Depending on the extent and location of the neurological damage, sexual function will vary.

Yet no matter the level of paralysis, all people with SCI will be capable of feeling physical attraction, excitement, desire, and love. They remain just as “sexual” as anyone else, maintaining the potential for intimacy and romantic fulfillment.

Before an individual with SCI begins to rediscover his or her sexuality, it is important to keep in mind that sensuality and personal expression are as vital to fulfillment as the sexual act itself. The focus should be on the process, not just the outcome.

Accordingly, the way someone feels about his or her sexuality and overall body image is crucial. This is understandably a major hurdle for most people in the first months post-injury. Their bodies have been a source of frustration; they have been damaged, aged, tested and measured. All the hospital procedures and the need for help with personal care can result in a complete loss of privacy and a sense of being sexless.

It is no wonder, then, that in the early days people coping with paralysis often admit to feeling less than desirable. Nonetheless, before someone can truly be intimate with another other human being, that person must first view him- or herself as acceptable – which may take time and therapeutic intervention.

SCI and the psychology of a sexuality

Generally, sexual activity declines after a spinal cord injury, often due to diminished biological sequalae of an SCI. While the need for sexual intimacy still remains for most, studies suggest that issues such as relationship factors, relationship quality, partner satisfaction and overall independence play a part in the difficulties that some people spinal cord injuries face.Also, and understandably, the concern about not satisfying one’s partner consistently seems to be an issue among many spinal cord injury victims. Together, these significant combined issues can lead to physical and emotional isolation, placing the spinal cord injury victim at risk for social and psychological withdrawal and depression.

Remember a spinal cord injury will not take away the ability to have a relationship, experience love, and experience the attraction between two people. There may be some difficulties with sexuality – as some people with spinal cord injuries will in fact have disability in sexual relations because of the restriction or lack of ability to perform sexual activity in the manner considered normal – but these challenges are unsurmountable. It’s important that spinal cord injury victims seek proper psychological assistance and counselling, and perhaps couples counselling at some point after the return home.

It’s been said in medical studies that sexuality education is often poorly integrated into the rehabilitation process – but the opportunity to further one’s knowledge about sexuality in general after a spinal cord injury should remain a crucial component to the process. Applied education, as well as psychological therapy to address sexuality with oneself and with others will no doubt enhance the overall rehabilitation outcome.

Proper psychological therapy will help a SCI victims regain confidence in themselves, in their ability to experience and give pleasure, and in their ability to experience intimacy and affection.

Can you have children after an SCI?

Fertility and Reproduction After a Spinal Cord Injury is certainly an important thing to understand after an SCI. Fertility refers to when a woman becomes pregnant when semen fertilizes an egg.  Even more important to understand is that having a spinal cord injury doesn’t really affect your ability to become pregnant or carry/deliver a baby, so deciding to have a baby is made in much the same way as anyone else.

However, pregnancy in female spinal cord injury victims are almost always considered high-risk pregnancies. There are many risks associated with this scenario that can affect the mother’s well-being and health. Some of these risks include:

  • Urinary tract infection
  • Hypotension
  • Pressure ulcers or sores
  • Premature labor
  • Muscle spasms
  • Digestive issues
  • Skin issues

It is possible for a female with a spinal cord injury to conceive and give birth, normally through caesarean section. A spinal cord injury generally does not affect a female’s fertility levels. However, this process will require significant support from a health care professional and regular medical exams. Generally, after 28 weeks, these exams should occur weekly in order to allow the professional to observe the cervix dilation.

For male spinal cord injury victims, reproduction could be affected in the form of a lower sperm count or a higher number of dead sperm cells. If the injured is experiencing ED but is interested in reproduction, a health care professional can stimulate ejaculation using specific in-clinic techniques. If this does not work, in-vitro fertilization or artificial insemination could be options.

A great resource for spinal for injury victims and fertility are the websites lookingglass.org and  disabledparent.net.

Another vital source of great information can be found via SCI Ontario. You can read more about spinal cord injury and sexuality here.

Treatments for Sexuality After a Spinal Cord Injury

There are treatments available that could help spinal cord injury victims recover their sexuality and their ability to experience sexual activity. Additionally, these treatments could assist individuals who are looking to reproduce.

  • ED medication in the form of pills or tablets
  • Injections: A doctor may prescribe an injection that goes into the side of the penis and allows it to become erect. When this is prescribed, the doctor will instruct the individual to be able to independently administer these injections at home.
  • Vacuum pumps: During this process the penis is inserted into a cylinder. Then, air is pumped out of the cylinder, which causes the penis to become erect. Once it has become erect, the individual will then place a ring on the base of the penis, which will allow him to maintain the erection.
  • Surgery: There are also some surgeries available to assist in recovering sexuality after a spinal cord injury. Usually, this surgery will involve inserting an implant into the penis permanently, which can assist in obtaining an erection but can also cause complications in some individuals.

A Hamilton Spinal Cord Injury Lawyer Can Help you Recovery the Compensation you need to Pay for Ongoing Therapy.

There’s no doubt that the complex, lifelong needs of a spinal cord injury victims must be accurately projected over his or her life expectancy. It’s vital that as a part of any life care plan for a spinal cord injury victims, that proper psychological funding is sought on a long-term or on a periodic basis, depending upon the needs of the person. Our Hamilton Spinal Cord Injury Lawyers work with some on Ontario’s best psychologists, life care planners and occupational therapists who are able to accurately project your life-long requirements – including proper therapeutic modalities to address your psychological well being.  Our Spinal Cord Injury Lawyers can be a valuable asset to your recovery and your ability to reintegrate through support such as specialist recommendations, professional development planning, and reliable legal advice. If you or a loved one has suffered a spinal cord injury and needs assistance or support, contact us at 905-333-8888 or through our online contact form. We will book a free consultation with you to confidentially address your needs and concerns.

We are easy to talk to, approachable, and we will never ask you for money upfront.  Give us a call or send us a note today. We would be more than happy to help.

Thanks to our experienced medical author Lesley Cornelius and our friends at NCBI for this information

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