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Possible Effects Of SCI On Sexual Function
(05/04/2004) by Unknown
SCI impairs messages from the brain to other parts of the
body. Every SCI is unique depending on level and
completeness of injury. Accompanying other functional
changes resulting from SCI may be changes in sexual
functioning. Some type of change in sexual function (ability to
attain or maintain an erection, to lubricate, to ejaculation, to
orgasm, to feel sensations in the genitals) is experienced by
roughly 80-90% of people with SCI.
Likely changes in genital function have been associated with
various levels and completeness of SCI. Changes in erectile
function in men or changes in lubrication in women often
result from SCI. For men with cervical SCI (broken necks)
and other thoracic injuries above T10, erections are likely to
result from direct stimulation to the penis or scrotum, and
indirect stimulation to the penis from a full bladder, for
example, or from stimulation to the anus or rectum. These
are often referred to as "reflex" erections and are not always
associated with sexual activity. Reflex erections are common
during catheterization, bowel routines, and range of motion
exercises of the legs and are beyond our control. Erections
that result from messages sent from the brain are not likely in
men with complete injuries above T10. In women with
cervical SCI or complete SCI above T10, erection of the
clitoris and lubrication of the vagina is likely to result from
direct or indirect stimulation to the vulva (pubic area, clitoris,
outer and inner lips, vagina) but is not likely from messages
sent from the brain. For both men and women with injuries
between L2 and S2, it is believed that sexual responses
resulting from messages sent from the brain (psychogenic)
and sexual responses resulting from direct or indirect
stimulation to the genital area (reflexogenic) are likely,
however they are not likely to be coordinated. In men with
lesions below L2, seminal emission (the stage prior to
ejaculation where sperm and seminal fluid is forced into the
urethra) may accompany intense arousal. We cannot make
valid generalizations about changes of sexual functioning
when injury is between T10 and L2 or when injury is
incomplete. In all cases, we need to rely on our own
observations of our sexual function and assess our own
ability. It is also helpful to learn how to talk about our sexual
function with appropriate health professionals or our sexual
partners.
While there are expected changes in sexual function based
on the level of SCI, the ability to experience sexual
satisfaction and orgasm after SCI has not been significantly
related to level of injury. Factors associated with positive
sexual adjustment include the level of sexual knowledge,
openness and communication with partner, and time since
injury. Time since injury is associated with a general increase
in self-esteem and an increase in sexual self-esteem. Being
familiar with our options will help in guiding further
exploration of sexual issues with various members of the
rehabilitation team or other specialists as needed. This article appears in the following topics:
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