Love, Sex and Spinal Cord Injury
Love is in the air. And we couldn’t talk about love, in all its glory, without bringing up sex. Granted, there’s a lot more to love than sex (and more to sex than love), but one thing’s for sure: they’re some of the most powerful forces in our lives. And when they’re combined - well, there’s fireworks.
Yes - Disabled People Have Sex!
There’s an assumption that sex is something disabled people don’t get to do: that paralysis means no more intimacy or adventurousness in the bedroom (or anywhere else). The truth is, sex after spinal cord injury can be just as adventurous, intimate and mind-blowing as it’s always been. It’s just a little different - and sometimes, a little difference can be a very good thing.
But it can also take a long time to achieve that pleasure and intimacy again. Injury level, recovery priorities, mental wellbeing and the effect of SCI on relationships can all affect how long the process takes.
There’s also the details of anatomy, the mechanics of sex and finding new ways to manage the laws of physics while in the throes of passion.
Men’s Sexual Health after SCI
Let’s get right into it: spinal cord injury does affect erections, orgasm and ejaculation.
The sacral nerves between S2 and S4 are responsible for reflex erections from stimulation. In incomplete injuries, signals can be passed to the brain and erections can happen. Sometimes, they’re short-lived or not strong enough for sex, but this can be managed and augmented with a range of aids and treatments.
The most important thing to do is talk to a doctor before self-prescribing any Viagra-type medication. These pills can affect blood pressure, which can affect the management and prevention of autonomic dysreflexia in people with injuries at T6 or higher.
Pills aren’t the only solution - pumps and implants can be prescribed, as well as direct injections into the penis. Depending on hand function and other medications in use, the best solution will vary from person to person.
A patient and loving partner will help make the process intimate, and maintain spontaneity in the moment.
Orgasms and Fertility
The next two biggest questions about sex concern climax and fertility. The Christopher and Dana Reeve Foundation offers this statistic:
“A study of 45 men with SCI and 6 able-bodied controls demonstrated that 79 percent of the men with incomplete lesions and 28 percent of those with complete injuries achieved orgasm in the laboratory setting.”
Keep in mind that this was a laboratory test, and psychologically, a laboratory might not be the best place to achieve orgasm.
Psychology and sex are intertwined. The definition of masculinity, orgasm and sexual climax may be different after SCI - but the pleasure and excitement of sex after injury is still there. The barriers to sexual pleasure and desire can often be mental; the pleasures and intimacy of an active sex life after injury are more likely if a person is open to trying new things and changing their perspective.
In Sweden, around 30 children are born to dads with SCI every year. Having children is also a very real prospect for men post injury. Ejaculation doesn’t always happen naturally in men after injury, but fertility is generally good - although sperm count and mobility can be affected. There are non-intrusive ways to induce ejaculation and get sperm, even at home - and a spinal injury unit can refer people with SCI to fertility specialists for a shot at parenthood.
Women’s Sexual Health after SCI
Spinal cord injury affects natural lubrication and sex drive. Some women worry about unwanted bowel movements and urination, and loss of their femininity. A patient and loving partner will understand and help with all of this, and sex can still be amazing and rewarding in new ways.
Sexual arousal and desire for women is contextual - relaxation is often the key to a satisfying and fulfilling sexual encounter
Sensation and Orgasm
Studies show that women with spinal cord injuries report extremely high levels of satisfaction with their sex lives. Ability to achieve orgasm is reported by most women with legions down to T5 level, and most report a high level of arousal with natural lubrication occuring.
Even injuries beyond T5 level don’t completely remove the ability to climax, and some doctors think female orgasm may not be dependent on the spinal cord at all. It can take practice, but for most women with SCI, orgasms are there to be had.
The majority of women with SCI do however feel a lowered libido, affected by a number of factors - most of which are mental. These can be hard to overcome, but patience and communication are the key.
Fertility and Pregnancy
After injury, 50-60% of women will experience the loss of their period - but menstruation typically resumes within a year or less and this doesn’t impact fertility. Pregnancy is possible, and spinal cord injury doesn’t affect the development of a baby in any way.
Mums to be might not be able to feel much movement during their pregnancy and labour pains may not be experienced at all, which means other cues have to be taken to know when it’s time for baby to be born.
There can be risks - infection, autonomic dysreflexia, clotting and respiratory problems included. A doctor experienced in SCI pregnancy can guide you through the risks and help you make informed decisions.
The bottom line is that there’s nothing stopping a woman with SCI becoming pregnant and being a mother. For more information on pregnancy and parenting, visit SCI Parenting.
Romance, Losing Love and Finding Love Again
SCI is hard for loved ones to cope with. A cocktail of emotions can last for years. Some relationships can flourish post injury - some can become even stronger. Either way, the relationship and roles within it will change, and that can be hard to adjust to.
Communication, commitment and compliments are the backbone of trust in any relationship. Counselling and coaching can be helpful for individuals, couples and for whole families. Coaching and counselling are not a sign of weakness - they’re the hallmark of people who love each other and want to get back on track, maybe even improve on what they had.
Relationships can become strained, and marriages can end. Even with counselling and commitment, some things just can’t be resolved. Sometimes people weren’t together for the right reasons in the first place.
It can happen to anyone: but when you have a spinal cord injury, it can feel like moving on from a breakup or divorce is impossible. Fear of rejection and finding ways to meet people are all too common - but these are problems for non-injured people too.
You should really consider dating and love when you’re ready - even if being single is working for you. Happiness and self-assuredness are supremely attractive features - and you could find yourself attracting people without even trying. And as we mentioned before, an open mind is the key to unlocking potential - and love is no different.
Patients and outpatients at Stoke Mandeville and Southport can be seen free of charge by Michelle Donald PG Dip.PST, Psychosexual Therapist, COSRT Accredited. To make an appointment, contact Michelle by email - firstname.lastname@example.org.
Aspire Law is a specialist law firm, working for people with SCI. We want to help and support everyone affected by spinal cord injury - not just with legal help, but with the most important and wonderful things in life.
For information and spinal cord injury legal advice, get in touch: give us a call on 0800 030 2040.