Taking precautions to ensure safe sex is just as important after a SCI. DANIE BREEDT investigates
When thinking about safe sex, everything that you learned in sex education still applies. You need to consider all types of sex, including oral, manual, vaginal, and anal. Safe sex includes preventing unwanted pregnancy and protecting against sexually transmitted infections (STIs).
Common methods of contraception are condoms, birth control pills, patches, intrauterine devices (IUDs), rings and injections, vasectomy (commonly referred to as getting ‘snipped’) and tubal ligation (commonly referred to as getting ‘tubes tied’).
After a spinal cord injury (SCI), ejaculation for males may be affected, which lowers the chance of getting someone pregnant; however, it’s not impossible. The risk for STIs are the same for males with or without a SCI.
Generally, unless there has been pelvic trauma, a woman’s reproductive system is unchanged after a SCI. Typically, right after injury (while the spinal cord is in shock), your period stops for about six to eight months. During this time, pregnancy is unlikely. But once your period returns, your chances of becoming pregnant remain the same as before your injury.
Similar to men, the risk for STIs remain the same as before. Regular STI screenings are recommended every six months to a year and more frequently if you have different partners. For men, condoms are the most common method of birth control and the only one for STI prevention.
They are most effective when applied properly. A vasectomy is a common method for birth control, however, it does not protect against STI.
For women, there are several hormonal and non- hormonal methods of birth control available. Most of these options are suitable for women with a SCI. However, your level of injury and level of sensation are factors to consider. It is recommended to consult with your doctor about what options are most suitable for you. It’s also important to note these methods can protect you from pregnancy, but not STI.
Women with SCI may experience worsened or different symptoms pre and during menstruation compared to pre-injury. These can include spasms, autonomic symptoms such as sweating, flushing, headaches and goosebumps. Many types of contraception may help to reduce these symptoms.
Many women with SCI struggle with frequent urinary tract infections, requiring the use of antibiotics. There have been reports of certain antibiotics affecting the effectiveness of birth control. Any form of hormonal birth control is considered a medication and may have interactions with other medications. So, it is important to get your medical advice from a doctor with knowledge of SCIs.
It is important to know where to find information about contraception and STIs and know who your resources are (for example, doctors, nurses and rehabilitation staff). There is a fine balance between taking risks, being safe, and making choices so that sex can still be fun and pleasurable.
