Among other considerations, people with spinal cord injury have questions about one of our most important human behaviours – sex!
Spinal cord injury almost inevitably affects sexual behaviour, because sexual response often depends on “messages” travelling via the spinal cord, and SCI can block those messages. But although SCI presents challenges, they do not need to be insuperable. There are various options available to put sex in its rightful place – where it’s fun and functioning. On its website, the International Society for Sexual Medicine (www.issm.info) answers many frequently asked questions:
“What are common sexual problems for men with SCI?
The degree of sexual function after SCI often depends on the location and severity of the injury. Some common sexual problems for men include:
- Erectile dysfunction (ED). Men with ED are unable to achieve or sustain an erection necessary for satisfying sex. A number of treatments are available, although some work better than others. For example, men who lose hand function might have trouble managing penile injections for ED.
- Ejaculatory problems. Some men with spinal cord injury are unable to ejaculate (anejaculation). Others have retrograde ejaculation; their semen flows backward into the bladder instead of out the tip of the penis.
How does SCI affect a man’s fertility?
- The ejaculatory problems caused by SCI can make it difficult for men to father children. However, methods are available to stimulate ejaculation.
- Penile vibratory stimulation involves applying a vibrator to the tip of the penis. (Men who lose sensation in their genitals should be careful not to injure the penis.)
- With electroejaculation, a doctor inserts an electrical probe through the rectum and uses electrical stimulation to prompt ejaculation.
- Sperm can also be retrieved from the testicles for use with in-vitro fertilisation.
What are common sexual problems for women with spinal cord injury?
- Women with spinal cord injury often see changes in their orgasms. Many women still feel sensations in their vagina and clitoris, but their orgasms might not be as intense as before and the orgasms might take more time and stimulation to achieve.
- Some women feel a sexual response (called ‘phantom orgasms’ or ‘paraorgasms’) when another part of the body is stimulated.
- Women with more severe injuries may not be able to reach orgasm at all. However, by communicating and sharing physical intimacy with their partners, they can still enjoy sex.”
Elna McIntosh is a sexologist and has for the past 30 years helped couples and individuals to explore their sexuality “outside of the box”. Her greatest claim to fame – surviving breast cancer … twice.