Sexual Health Q&A

Q&A
Spinal Cord Injury
How might spinal cord injury affect a woman’s sexuality?

Part of the sexual response cycle involves the transmission of messages between the brain and sexual organs. For example, when a person sees an attractive partner or feels that person’s touch, the brain processes the stimuli and triggers arousal in the genitals.

The spinal cord is essential for these messages. When the spinal cord is injured, the messages can’t be transmitted as effectively.

Many women stay sexually active after sustaining a spinal cord injury, but their experiences can change. The extent of changes often depends on the severity of the injury.

Some of the more common sexual changes include the following:

  • Sensations. Some women find that they have more sexual sensation in the neck, earlobes, lips, arms, and nipples than in the vagina or clitoris. It’s important for women to let their partner know where they enjoy being touched.
  • Lubrication. Vaginal dryness is common, and women may need to use a lubricant.
  • Orgasms. Orgasms might not be as intense as they were before the injury, and it might take more time to reach orgasm. Women with more severe injuries may not be able to reach orgasm at all.

Another common problem for women with spinal cord injury is incontinence. Women often feel ashamed and embarrassed if they leak urine during sexual activity. The situation may diminish their sexual confidence, self-esteem, desire, and satisfaction.

Women who experience incontinence during sex might try emptying their bladder before sexual activity. It can also help to avoid certain diuretic beverages like alcoholic and caffeinated drinks, which can trigger urination.

Can women with spinal cord injury regain some of their urinary and sexual function? A 2018 study involving two women suggests that this might be possible. After epidural spinal cord stimulation, the women had improved urinary function, and one of them was able to reach orgasm during intercourse. Still, more research is needed.

However, women with spinal cord injury may still enjoy sex, even if their function is limited. Sharing physical intimacy with their partners through cuddling, kissing, hugging can still be satisfying. In addition, a sex therapist can help couples better understand sexuality after spinal cord injury, adjust their expectations, and move forward with their intimate relationship.

Resources

Annals of Physical and Rehabilitation Medicine (via ScienceDirect)

Courtois, Frédérique, et al.
“Assessment of sexual function in women with neurological disorders: A review”
(Available online: July 13, 2017)
https://www.sciencedirect.com/science/article/pii/S1877065717300738?via%3Dihub

Handbook of Clinical Neurology (via ScienceDirect)

Courtois, Frédérique and Kathleen Charvier
“Chapter 13 - Sexual dysfunction in patients with spinal cord lesions”
(Volume 130, 2015, Pages 225-245)
https://www.sciencedirect.com/science/article/pii/B9780444632470000134?via%3Dihub

Newswise via American Association of Neurological Surgeons

“Immediate Restoration of Voluntary Movement with Epidural Spinal Cord Stimulation in Two Patients with Paraplegia”
(News release. April 25, 2018)
http://www.newswise.com/articles/view/693513/?sc=rsin

Medscape Medical News

Helwick, Caroline
“Female Paraplegic Patients Regain Function With Spinal Stimulation”
(May 3, 2018)
https://www.medscape.com/viewarticle/896098?nlid=122099_4503&src=wnl_dne_180504_mscpedit&uac=154791ET&impID=1623952&faf=1#vp_1

Sexual Medicine

Sramkova, Tatana, MD, PhD, et al.
“Women's Sex Life After Spinal Cord Injury”
(Full-text. September 29, 2017)
https://www.smoa.jsexmed.org/article/S2050-1161(17)30058-2/fulltext

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