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Sex and Fertility After Spinal Cord Injury: Get Answers Here


  • Men with spinal cord injuries may experience changes to their sexual health and functioning.
  • They can struggle to get an erection or ejaculate, leading them to need assistance with sperm retrieval.
  • Despite men with spinal cord injuries having decreased sperm quality, they are still able to father children with the help of assistive technologies.
  • Talk to your doctor about potential sperm retrieval and insemination.

Men, Spinal Cord Injuries, and Sex

The average spinal cord injury (SCI) patient is male and in his early 40s. Prior to their injuries, these men may have had healthy sex lives and thought about starting or adding to families. But what happens now? Can men with spinal cord injuries have sex? If they can, are they still able to get a partner pregnant?

This article describes how spinal cord injuries affect men’s sexual functioning, particularly erectile function and fertility.

An Overview of Spinal Cord Injuries

Medical doctor looking at x-rays.

About 17,000 people in the United States experience SCI every year due to traumatic events like car accidents and falls. These injuries leave people with damaged nerves, ligaments, or discs in the spinal column. Because nerves run from the spinal column throughout the whole body, it is possible to lose the ability to move limbs or to feel sensation.

The spinal column starts at the base of the skull and runs down to the tailbone. Injuries at the middle and base of the spinal column (think middle of your back to the butt) lead to complications like:

  • Loss of bladder control
  • Loss of skin sensation
  • Changes to sexual health and performance

For men, this can mean trouble achieving erections (aka erectile dysfunction, or ED) and ejaculation.

So Men with Spinal Cord Injuries Can Have Sex?

Smiling family outside.

Some men are still be able to have healthy and fulfilling sex lives after a spinal cord injury. The level of sexual activity is often dictated by the seriousness of the injury, or if it is a complete or incomplete SCI.

If you have an incomplete spinal cord injury, some of your spinal cord functions are still intact, meaning your brain can still send and receive signals throughout the body, including to the penis. Men with incomplete spinal cord injuries can still get aroused by physical stimulation (touch, vibration, etc.), which bodes well for their ability to get an erection.

If your SCI is complete, on the other hand, you likely do not have any ability to move or feel sensation at or below the level of the spine where the injury occurred, likely eliminating your ability to have sex the way you did prior to the SCI.

How Does Sex with a Spinal Cord Injury Work?

For men, the main changes with sex are in sensation, getting erections that are hard enough for sex, and ejaculating, or producing semen.

Men with SCIs may have trouble getting or keeping an erection that is firm enough for sex. Fortunately, many popular and affordable drugs are available to treat this issue. In fact, research shows that erectile dysfunction (ED) drugs, particularly Cialis, can be helpful for men with erectile issues following a spinal cord injury.

Medications aren’t the only options for helping men have sex after an SCI. Other treatment options include:

  • Penile implants
  • Vacuum devices
  • Penile injections

However, of all the treatment options, men generally prefer oral ED medications over treatments like prostheses and vacuum devices.

Are Men Still Fertile After Spinal Cord Injuries?

Parent and baby lying down together.

Many men who experience spinal cord injuries are still in their child-rearing years, so fertility can be a major concern. Just as men with SCIs can experience erectile dysfunction, many men also notice a negative impact on their sperm. Still, most men can still father children but may need outside intervention to help them retrieve sperm for impregnation.

Common interventions to retrieve sperm include:

  • Penile vibratory stimulation (PVS)
  • Electroejaculation (EEJ)
  • Surgical sperm retrieval
  • Prostate massage

How effective these interventions are depends on the location of the spinal cord injury. For example, men with an injury between the skull and the T10 (thoracic) vertebra saw an 86% success rate of sperm retrieval with PVS, compared to 17% of men who had a spinal cord injury between the T10 vertebra and the base of the spinal cord. Alternatively, almost all men will ejaculate with the help of EEJ, which requires stimulating the prostate with electrical energy.

Regarding fertility, however, retrieving the sperm is only part of the equation. It is also important to look at semen quality. Unfortunately, it’s not uncommon for men with SCI to have abnormal semen quality. While the number of sperm found in semen is similar to men without SCI, sperm in men with SCI typically move less and have shorter lifespans.

Despite these concerns, men and their partners are able to pursue pregnancy just like other couples with fertility problems. For instance, men may undergo sperm retrieval so their sperm can be used to fertilize an egg that is then implanted as an embryo in their partner’s uterus. Alternatively, couples may choose to do intravaginal insemination with their partner’s retrieved sperm.

Let’s Recap

Couple lying down on a couch.

If you’re living with a spinal cord injury and want to know what options are available to you for a healthy sex life or adding to your family, help is available. Consider reaching out to a medical professional about your options.

How eDrugstore Can Help

If erectile dysfunction is your primary concern, we make it easy for men to talk to healthcare professionals and to get ED medications like Viagra, Levitra, Cialis, and others. Browse through our medication guide, or take advantage of our free online consultation by calling 1-800-467-5146.  A U.S.-licensed physician will help you find the best medication for your needs and write your prescription. Virtual health visits and shipping are always free.

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