PHYSICAL CHANGES
Spinal Cord Injury (SCI)
"Will I respond the same as before?"
Every spinal cord injury is different. The impact that a particular SCI has on sexual functioning varies and depends on many factors:
- · type of injury (complete or incomplete)
- · the level of the injury
- · medications used.
There are no definite rules about how a person's sexual response changes after a spinal cord injury. Generally, when bowel and [bladder control: link to consumer bladder changes section] and genital sensation are affected there will be changes in genital-sexual response.
My main concerns were whether I would be able to satisfy a woman and whether - physically - I would function the same way that I had before. And, could I function in a way that would satisfy me? Would the sensation be the same? These were my sorts of concerns
--- Byron
Complete Spinal Cord Injuries
If a complete spinal cord injury has occurred, the following aspects of sexual functioning are likely to be affected:
- · Genital sensation or orgasm
For women and men with spinal cord injuries that are complete at any level, there is not likely to be any genital sensation or [orgasm: link to male orgasm page and female orgasm page] feelings resulting from stimulation although some people learn to transfer erotic feelings from other parts of their bodies that do have sensation. (see below)
- · Erotic mental and physical feelings
A complete injury -regardless of the level - does not rule out erotic sexual feelings. Many people are able to shift their source of eroticism so that the brain receives sexual signals from parts of the body other than the genitals. The brain learns to react sexually to pleasurable touching in other areas of the body. For example, the ear lobes and the back of the neck can be erogenous areas. This experience will be different than before but can be as fulfilling; some people describe the feeling as less intense or more diffuse. A person's attitude is all-important here. If you are convinced that sex only means intercourse in a certain position, then there may be little room to explore other possibilities. If you are more open and creative, the possibilities are less limited.
- · Erection to touch (reflex erections)
Men who have injuries that are T10 and above are likely to experience uncontrolled reflex [erections: link to male erection pages] in response to touch on the penis. This happens because the reflex arc (from the penis to the lower part of the spinal cord and back again) functions independently of the brain. This type of erection is often welcomed by men with SCI since it means they can get an erection for sexual activity. Sometimes men with SCI are unhappy with reflex erections because it may happen when they don't want it to - during a catheterization or anytime when the penis is touched. For some men with SCI, the reflex erection may not be completely reliable or may not last long enough for some type of sexual activity; in these cases, some form of [erection enhancement: link to erection enhancement pages] may be used.
When an injury occurs in the lower part of the spinal cord (below T10) reflex erection to touch is not possible. However, purely mental stimulation (a sexual thought or fantasy) can lead to some enlargement of the penis. Some seminal fluid - which can contain sperm -may flow. After this emission of seminal fluid, the erection is usually lost. Men who have a complete SCI below T10 generally choose to use some form of [erection enhancement: link to erection enhancement page].
For women, spinal cord injuries can affect [vaginal lubrication: link to section on vaginal lubrication in women's section]. Some women will no longer lubricate when they have sexual thoughts and others will not lubricate when they are touched in this area. These changes will vary. All women have changes to lubrication at different times in their monthly cycle and may experience changes to lubrication following menopause. Some specific information on changes that may occur in women after injury.
Most men with a spinal cord injury - whether complete or incomplete - experience some disruption in [ejaculation: link to male section on ejaculation]. However, ejaculation is a complex response and there can be much variation between individuals.
Incomplete Spinal Cord Injuries
There is no clearly defined way to determine what genital response will be when the injury does not result in a completely damaged spinal cord. Factors such as location of the injury and the amount of sensation and motor functioning can be important in predicting changes to sexual response. If you are able to control both your bowel and bladder that is generally predictive of normal or close to normal sexual functioning.
