People who suffer from spinal cord injuries often develop physical complications that affect their ability to function sexually. These problems can include a reduction in genital sensitivity, the loss of orgasmic ability, and difficulty maintaining bladder control. Many individuals with spinal cord injuries are also susceptible to autonomic dysreflexia which is a dangerous autonomic nervous system reaction that can be generated during sexual activity. Although many people with spinal cord injuries do experience sexual difficulties, most maintain and enjoy the ability to engage in intimate sexual activities and pursue interpersonal relationships.
Sexual Complications in Males with Spinal Cord Injuries:
In males, the loss of genital sensation is one of the most common sexual problems that can result from spinal cord injuries. K.D. Anderson and J.F. Borisoff found that out of the 199 males with spinal cord injuries that they studied, "46.9% reported having some type of genital sensations while 53.1% had no genital sensation" (Anderson and Borisoff, 2006). Other common sexual complications found in men with spinal chord injuries include the absence of orgasms and ejaculation. Even though males with spinal cord injures usually develop some sexual problems, most still maintain the ability to have penile erections when they receive direct stimulation to their genitals.
Sexual Complications in Females with Spinal Cord Injuries:
Most women with spinal cord injuries can exhibit normal sexual responses, including nipple erections and clitoral swelling. Even though some females with spinal cord injuries loose all feeling in their genitals, many still have enough vaginal sensitivity to experience orgasms. According to Janet Shibley Hyde and John D. Delamater (2008: 2003), "approximately 50 percent of women with spinal-cord injuries are able to have orgasms from stimulation of the genitals." Although some women with spinal cord injuries do not retain enough vaginal sensitivity for physical orgasms, many learn to successfully achieve psychological orgasms that are very satisfying.
Bladder and Bowel Complications:
Individuals with spinal cord injuries often loose the ability to affectively control their bladders and bowels. This can be very embarrassing, and as a result, some people with spinal cord injuries become fearful to have sexual contact. According to Anderson and Borisoff (2006: 330), in their study "19.6% reported that sometimes bladder and bowel problems did interfere and 15% reported yes to these issues preventing them from seeking sexual activity." Even though individuals with spinal cord injuries may find the dysfunction of their bladder and bowel to be very uncomfortable, these problems do not inhibit most people with spinal cord injuries from pursuing sexual contact. According to Anderson and Borisoff (2006: 330), "64.7% of all participants stated that bladder/bowel issues did not prevent them from seeking sexual activity with a partner."
Dangers of Autonomic Dysreflexia:
Autonomic dysreflexia (AD) is a hazardous physical state that sometimes occurs in individuals with spinal cord injuries. It occurs when they come into contact with irritating stimuli below the area of the damaged vertebrae. Irritants that can cause autonomic dysreflexia include a full bladder and sexual activity. If individuals with spinal cord injuries develop autonomic dysreflexia, it typically causes them to experience a dangerous rise in blood pressure, which can be harmful and sometimes fatal if left untreated. According to Anderson and Borisoff (2006: 330), "31.8% of patients reported experiencing AD during sexual activity." Although these statistics seem dangerously high, the study revealed that most individuals with spinal cord injuries who show signs of autonomic dysreflexia during sexual contact also exhibit the same symptoms during bowel care. Because of this most individuals with spinal cord injuries that do not undergo autonomic dysreflexia during bowel maintenance can probably take part in sexual activity without experiencing a dangerous rise in blood pressure.
Individuals who have suffered spinal cord damage may struggle with feelings of depression and self-doubt because of the injury. As a result some people with spinal cord injuries find it difficult to develop intimate connections with others. Although many individuals with spinal cord injuries endure serious emotional hardships, most eventually do become engaged in sexual relationships. According to Anderson and Borisoff (2006: 331), out of the surveyed individuals that had suffered a spinal cord injury "87.4% had been involved in some type of sexual relationship post injury." Anderson and Borisoff's study also revealed that a desire for intimacy is the most common reason why people with spinal cord injuries pursue sexual relationships. The researchers stated, "When asked what the primary reason for pursuing sexual activity was, more that half of the people (57.7%) listed intimacy need" (2006, 331).
Although Individuals who have suffered spinal cord injuries can experience some sexual complications and emotional struggles, most eventually develop intimate physical relationships with others. Given these facts, we strongly encourage people with spinal cord injuries to feel empowered to seek intimate relationships and sexual experiences.
Anderson, K D, and J F Borisoff. "The impact of spinal cord injury on sexual function: concerns of the general population." Spinal Cord 45(2006): 328-337.
Hyde, Janet, and John Delamater. Understanding Human Sexuality. Tenth ed. New York: McGraw-Hill , 2008.