What is Sexual Health?
Sexual health is an important part of your overall health and quality of life. After a spinal cord injury (SCI), changes in sensation, movement, sexual function, body image, fertility, or confidence may affect how you experience sexuality and intimacy. These changes are common, and you are not alone.
Sexuality and intimacy look different for everyone. Many couples find new ways to connect and enjoy intimacy after SCI including emotional and physical closeness, touching, hugging, kissing, holding hands, and romance. Talk openly with your partner about comfort, pleasure, concerns, goals, and trying new ways to be intimate. Adaptations can often be made to support sexual health and intimacy, and your rehabilitation or healthcare team can help you explore options that are safe and appropriate for you.
How Can SCI Affect Sexual Health?
You may notice changes in sensation, strength, movement, erections, vaginal lubrication, orgasm, energy, pain, muscle spasms, bladder or bowel control. Many treatments and strategies can help. Some frequently asked questions to discuss with your healthcare provider include:
- Can I still be sexually active after SCI?
- How will sexual activity change?
- Will I have orgasms?
- Will I be able to satisfy my partner?
- Are there any risks with intercourse?
- Can I have children?
Safety Tips for Sexual Activity
- Before: empty your bladder if recommended, complete your bowel program, check your skin, and choose a time when you are more energetic.
- During: move slowly, use pillows, protect areas with less feeling, and stop if you have pain or feel sick.
- After: check your skin, watch for pressure injuries, stay hydrated, and tell your provider about concerns.
Autonomic Dysreflexia (AD) and Sexual Activity
Autonomic dysreflexia (AD) is a sudden, dangerous rise in blood pressure. People with a spinal cord injury at T6 or above are at risk.
Sexual activity can sometimes trigger AD. Possible triggers include:
- Sexual stimulation or orgasm
- Vigorous stimulation of the genital area
- Use of vibrators or other sexual devices
- Menstruation, pregnancy, labor, or infections involving the bladder or reproductive organs
If you develop symptoms of AD during sexual activity:
- Stop sexual activity immediately.
- Sit upright if possible.
- Loosen or remove tight clothing, such as abdominal binders or compression stockings.
- Check for and remove the cause of the AD, if it can be done safely.
- If your symptoms do not improve quickly or your blood pressure remains high, call 911 or seek emergency medical care.
If you have a history of AD, talk with your healthcare provider before becoming sexually active. They may recommend keeping emergency medication, such as nitroglycerin ointment, available and will teach you when and how to use it safely.
If you are planning a pregnancy or are pregnant, work with an obstetrician (OB/GYN) who is familiar with spinal cord injury and autonomic dysreflexia.
Fertility After Spinal Cord Injury
Women can become pregnant after SCI at the same rates as age-related, unaffected women. If you do not want to become pregnant, talk with your healthcare provider or OB/GYN about the birth control option that is best for you. These may include:
- Condoms
- Oral contraceptive
- Birth control patch or Nuva Ring
- IUDs
- Implanted Hormonal Devices
- Injections
When to Contact Your Healthcare Provider
Sexual health and intimacy are important parts of your overall well-being. Talk with your healthcare team if you have concerns about sexual function, pain, skin changes, bladder or bowel function, autonomic dysreflexia, fertility, or treatment options.
Your healthcare team can help you find safe and effective ways to support sexual function, intimacy, fertility, and quality of life after SCI. You do not have to manage these changes alone. Sexual health is a normal and important part of rehabilitation.