It can be difficult for couples to balance their relationship with the responsibilities of caregiving, but prioritising independence can help
As individuals with spinal cord injuries (SCIs) age, they face a unique combination of challenges related to sexual health, intimacy, and relationships. Ageing naturally affects sexual health for everyone, but for those with an SCI, these changes can be more complex due to pre-existing physical limitations or complications related to the injury.
This includes decreased sensation, difficulty achieving or maintaining erections, vaginal dryness, hormonal changes, and a decrease in sexual desire.
Compounded by ageing-related conditions like cardiovascular disease, diabetes, or arthritis, these factors can significantly impact sexual functioning on a physical and emotional level.
Let’s get physical
From a physical point of view, increased muscle stiffness or spasticity can be a challenge. As one ages, muscles may become stiffer, worsening mobility issues and making certain sexual positions uncomfortable or challenging.
Pelvic floor muscles play a critical role in sexual health and function. As they weaken with age, it can affect sexual performance and pleasure for both men and women.
Hormonal changes is another common complicating factor of aging. Decreases in testosterone and estrogen levels can lead to diminished libido, increased vaginal dryness, or erectile difficulties, all of which may be more pronounced in individuals with an SCI.
There are also medical conditions that can indirectly affect sexual activity. Cardiovascular disease, for example, influences sexual stamina and the ability to engage physically during sexual encounters.
Another common group of medical conditions relate to bladder and bowel difficulties. These types of complications could create anxiety around sex, making individuals self-conscious or reluctant to engage in intimacy.
A compounding difficulty for patients with high-level SCIs is Autonomic Dysreflexia (AD), which may increase in frequency with age, particularly if the individual is dealing with bladder or bowel issues that trigger this reflex. This can lead to a fear of sexual activity due to the unpredictability of such an episode occurring.
The heart of the matter
The psychological aspects of ageing with an SCI also play a significant role in sexual health. As individuals age, they may struggle with body image, reduced confidence, or fear of being less desirable. These emotional hurdles can create barriers to sexual intimacy, even when physical function remains intact.
Ageing and SCI may also bring about feelings of isolation, especially if one’s partner is experiencing health challenges of their own. It’s not uncommon for long-term couples to experience shifts in their sexual dynamics as both partners age, and an SCI adds another layer of complexity to these changes.
In some cases, people may experience a mismatch in sexual desire or physical ability with their partners, leading to frustration or resentment.
Possible remedies
Maintaining intimacy requires both partners to adapt, communicate openly, and remain committed to exploring new ways to connect sexually. It’s crucial to address not just physical challenges but also emotional and relational dynamics that may shift with age.
In light of these physical challenges, individuals with an SCI and their partners are encouraged to adopt a proactive approach that includes open communication with healthcare professionals who specialise in sexual health.
Treatment options like psychotherapy, hormone replacement therapy, medication, or pelvic floor exercises can help address many of these difficulties.
