Sexuality after a SCI is not lost, but rather evolving with a need to put focus on pleasure rather than performance
After a spinal cord injury (SCI), physical changes often take centre stage in discussions about sexuality, but the psychological aspects of desire are just as important. Many people with an SCI experience shifts in libido – including decreased libido due to emotional distress, body image concerns or changes in sensation.
However, desire is not purely biological, it is deeply influenced by thoughts, emotions, and mindset. With the right approach, libido can be reignited, leading to a fulfilling and satisfying sex life.
Sexual desire is often mistaken for something automatic, but it is shaped by a complex interaction of mental, emotional, and relational factors.
After an SCI, several challenges can contribute to a decline in libido, including psychological distress such as depression, anxiety, or PTSD related to the injury.
Body image concerns also play a role, as adjusting to a new body can impact confidence and self-esteem. Relationship dynamics may shift, especially if caregiving becomes a central aspect.
This could result in intimacy feeling different or awkward. Additionally, medications used for pain, spasticity or depression can have side effects that reduce sexual desire. Recognising these factors helps to create a path toward reigniting libido.
A common challenge post-SCI is shifting from a performance-based approach to sexuality to a pleasure-based one. Many people worry about whether they can “perform” as they did before, creating anxiety that suppresses desire.
Instead to prioritise pleasure, connection, and emotional intimacy. Sexuality is not limited to penetrative sex. It includes touch, anticipation, fantasy and emotional closeness.
One way to encourage this shift is through sensation such as focussed exercises where partners explore each other’s bodies without the goal of orgasm or penetration.
By removing the pressure to perform, these exercises allow individuals to reconnect with sensuality and enjoyment, creating a more relaxed and fulfilling sexual experience.
One of the most powerful tools for reigniting libido is mental arousal. The brain is the most important sex organ, and it plays a key role in building desire.
Engaging the imagination through erotic stories, media, or fantasy can stimulate arousal even if physical sensation has changed.
Practicing mindfulness and visualisation during intimacy helps individuals stay present in the moment and enhances pleasure.
Open sexual communication with a partner, including discussing desires, preferences and fantasies, can also help reignite excitement and create a sense of closeness.
Feeling attractive and desirable after an SCI starts from within, but it is common to experience self-doubt about sexuality. Confidence can be rebuilt through positive self-talk and focusing on personal strengths beyond physical ability.
Experimentation is key. Trying new ways to experience pleasure can boost self-esteem and result in sex feel exciting again.
Engaging with support networks, including others with SCI who have navigated similar challenges, can provide reassurance and practical advice.
Reigniting libido doesn’t happen overnight though, it requires patience, exploration, and self-compassion. The goal is not to “go back” to how things were but to create a new, fulfilling version of sexuality.
By shifting focus from performance to pleasure, engaging the mind, and building confidence, desire can be reignited, proving that sexuality after SCI is not lost. It’s simply evolving.
