Sex and Intimacy

Note: Adult language will be used in the following learning portal. Please be advised.

Put away your doubts; you can have sex after a spinal cord injury. We won’t lie – having damage to the spinal cord does make things different. With decreased sensation and not being able to move as easily, your sex life may require some creative thinking. And yes, you can still enjoy sex and have babies, as well.

For men with spinal cord injuries, getting and keeping erections is the biggest problem after an injury. It doesn’t respond the same. Medicine or treatments will be needed to help in this department. For women, positioning during sex and giving birth can be the trickiest aspects of sexuality and fertility post-injury.

But remember, the most important thing to keep in mind is that you are still YOU. Your spinal cord may be damaged, but your wheelchair doesn’t define you. And don’t worry, you can find a partner who doesn’t just see the wheelchair. There are many open-minded people out there, and several of them marry people with spinal cord injuries.

Want to know more? Read on for some of the most important things men and women need to know  about sexuality and fertility after a spinal cord injury.

Females

Some like to think that women have it easier after a spinal cord injury when it comes to sexuality, but realistically, sexuality is hard for everyone after a spinal cord injury. For women, one of the biggest changes is that the vagina doesn’t lubricate as easily as before. Lubrications help a lot with this, so make sure you have plenty of lube if you plan on having sex. Don’t let this new change bring you down. Many couples, even those without spinal cord injury, use lubrication to make sex more fun.

Decreased sensation is another big problem for women. Many women may think “Why have sex if I can’t feel it?” after their injury. Many think achieving orgasm is impossible too, but they are wrong. There are studies that reveal with the right amount of stimulation to the G-Spot, paralyzed women can still reach orgasm.

It simply feels good to be with someone in an intimate way. Getting out of your wheelchair and into someone’s arms… there’s nothing else like it. After you get in bed, finding the best positions takes some work, but no matter your torso strength and ability, there are at least a couple of positions out there that you should be able to do.

Having sex side-by-side or even in your wheelchair is possible, too. Sex from behind and with the woman on top are possible if you have a partner willing to help, or if you’re strong enough to be on top. Sex toys, positioning pillows, sex bouncers, and sex swings also help a lot. Make sure to experiment until you find what’s needed to have a pleasurable sexual experience.

Additionally, women with spinal cord injuries can get pregnant just as easily as before. While some choose not to carry a child for their own personal concerns, most can carry a child successfully without any complications. Always remember to use birth control whenever engaging in sexual activity if you are not trying to conceive.

When it comes to giving birth, many paralyzed women will schedule C-Sections. However, giving birth naturally is still possible, even if you can’t “push”. When in labor, the muscles in a female’s body will naturally contract. The only issue to be worried about is autonomic dysreflexia during childbirth. Since severe pain can trigger autonomic dysreflexia, many women schedule a C-Section just to be safe.

Males

For men with spinal cord injuries, things get a little bit more complicated in the sexuality department. For positioning help, the Intimate Rider is a product that enables many men with SCI to have a more active role in bed. As for maintaining an erection post-injury, most need medicine to help. Mainstream erection medications, such as Viagra, will only help men with spinal cord injuries from the T6 level and below.

Everyone above the T6 level will need stronger medicine to help with erections. A procedure many men with spinal cord injuries use is the Medicated Urethral System Erection, MUSE. This procedure uses a medicated pellet that is placed into the urethra. Once the pellet is absorbed by the surrounding tissue, the penis becomes erect.

And if that doesn’t work, consider a stronger medicine called Alprostadil. Alprostadil is injected directly into the base of the penis to achieve an erection. A doctor will show you how to do this at home, and note that (because of side effects) this medicine should only be used once a week. This medicine may sound scary at first, but most can’t feel the injection, and the drug works swiftly.

Otherwise, a vacuum pump or a prosthetic penis have been used by men with spinal cord injuries. Orgasming, however, is something many men with spinal cord injuries struggle with.

If a man with a spinal cord injury wants to get their partner pregnant, they can! However, they will need to try a few methods to ensure conception. The first method to try is a special vibrator that helps stimulate an orgasm: the Ferticare Vibrator. If that product doesn’t work, minor surgery can be used to remove sperm so it can be implanted into their partner’s womb. This procedure is called Invitro-Fertilization and has helped thousands of men with spinal cord injuries have children.

Takeaway Points

• Sex is still possible after a spinal cord injury
• Decreased sensation can be overcome in creative ways
• Women with spinal cord injuries experience a lack of lubrication
• Many women with spinal cord injuries will have C-sections to ensure a safe birth and avoid autonomic dysreflexia
• Viagra and other generic erection medicines only work on men with spinal cord injuries T6 and below
• MUSE is a procedure used by men to achieve an erection, and involves a medication pellet under the urethra
• An injection called alprostadil is another option for men to achieve an erection above the T6 level
• A Ferticare vibrator or a surgical procedure to the testicles can be used to extract sperm and conceive a child

Helpful Links:

• Sexuality for Women with Spinal Cord Injury (PDF) – UAB-SCIMS – http://images.main.uab.edu/spinalcord/SCI%20Infosheets%20in%20PDF/Sexuality%20for%20Women%20with%20SCI.pdf
• Sexuality for Men with Spinal Cord Injury (PDF) – UAB-SCIMS – http://images.main.uab.edu/spinalcord/SCI%20Infosheets%20in%20PDF/Sexual%20Function%20for%20Men%20with%20SCI.pdf
• Pregnancy and Women with Spinal Cord Injury (PDF) – UAB-SCIMS – http://www.msktc.org/lib/docs/Factsheets/SCI_and_Pregnancy_.pdf