Man in a wheelchair with his dog

Spinal Cord Injury, Depression, and ED


  • Every year, 20,000 people in the United States experience a spinal cord injury. 
  • Men with spinal cord injuries often experience erectile dysfunction and struggle with depression. 
  • A combination of treatment options that include Viagra and an antidepressant might be effective for men with spinal cord injuries.


Any damage to the spinal cord or nerves that attach to it can seriously affect your physical and mental health and well-being. Some spinal cord injuries (SCIs) in men can result in a loss of control over the lower body. As a result, men may experience loss of bladder control and erectile dysfunction (ED).

ED can affect your sex life, your relationship, your self-esteem, and even your mental health. This article explores the link between erectile dysfunction and depression in men with spinal cord injuries as well as treatment options.

About Spinal Cord Injuries

Graphic showing a human spinal column.

Your spinal cord includes vertebrae, ligaments, and discs along your spinal column. It is responsible for connecting your brain to the nerves running through your body, which is why together, your brain and spinal cord are referred to as your central nervous system.

When your spinal cord is healthy, it transmits signals from between your brain and nerves to control your movements, responds to sensations like pain or hot and cold temperatures, and takes care of involuntary functions like supporting breathing.

Unfortunately, about 20,000 people in the United States injure their spinal cords every year.

Common causes of spinal cord injury include:

  • Car crashes
  • Falls
  • Sports-related injuries
  • Violence
  • Alcohol use-related injuries
  • Certain diseases or health conditions (cancer, arthritis, infections)

Signs of a spinal cord injury include an inability to control your movements, numbness or tingling in your hands or feet, or feeling weakness in parts of your body. If you have any of these or other common signs, reach out to your doctor immediately

How Do Spinal Cord Injuries Impact Sexual Function?

Couple snuggling.

If your spinal cord injury is in the lower part of your spinal column (middle back and down through your tailbone), you might see an impact on your urinary and sexual function. These lower spinal cord injuries can lead to loss of bladder control, an inability to feel sexual sensations, and erectile dysfunction. Your SCI might also affect your ability to orgasm.

Obviously, this is a cause for concern for many men. Losing the ability to get an erection, feel pleasurable sensations, or even orgasm can affect your sex life, which might also affect your relationship with your partner.

Spinal Cord Injury, Erectile Dysfunction, and Depression

For these reasons and more, depression is common in people with spinal cord injuries (SCI) and in men with erectile dysfunction. In a study published in Urology that analyzed posts from men discussing erectile dysfunction (ED) on Reddit, almost 40% reported feeling depressed.

Similarly, in research published in the Archives of Physical Medicine and Rehabilitation, more than 20% of people with SCI were depressed.

ED can affect your mental health, and feeling depressed can impact how your body heals from injury, so it’s important that both are addressed by a medical provider.

Considering Your Treatment Options

Blue pills.

There are a couple of things to think about in terms of treatment. Are you wanting to treat the spinal cord injury itself, the erectile dysfunction (ED), and/or the depression? Most likely, you will want to treat each of these conditions, particularly because ED can affect your mental health and vice versa.

Only your doctor can determine if your spinal cord injury is temporary or permanent. If it is temporary, recovering may be a matter of waiting to allow your body to heal, doing physical therapy, and taking medications like Viagra (if your doctor says it’s safe for you to have sex while injured) to help with ED.

There are several treatment options for ED for men with SCIs:

  • PDE5 inhibitors like Viagra
  • Penile implants
  • Vacuum devices
  • Penile injections

While some of these treatment options may seem extreme, the good news is that in general, men with SCIs respond well to ED medications. These drugs may be helpful for your mental health, too.

Medications are also effective in treating depression. Your doctor may prescribe a class of drugs known as selective serotonin reuptake inhibitors (SSRIs) to help. What your doctor recommends will depend on your symptoms, your current health status, and any other medications you’re taking.

A word of caution: Some antidepressants can reduce sexual desire, so be sure to talk to your doctor about your erectile functioning and that you want an antidepressant with a low risk of sexual function impairment.

Finding the Treatment That’s Right for You

There’s no one best approach to treating ED and depression in men with SCI. Your healthcare team may recommend several options to try at the same time.

Possible recommendations may include:

  • Finding a way to get some physical activity (depending on your SCI).
  • Recommending an antidepressant.
  • Referring you to a counselor.
  • Prescribing an ED medication.

Be patient and talk to your team about what’s working and what you’d like to change.

Let’s Recap

Woman pushing a man in a wheel chair outside.

Spinal cord injuries, whether temporary or permanent, can affect your sex life. If you have a lower spinal cord injury, you might experience erectile dysfunction (ED), which could in turn lead to depression. Or you may have depression because of your spinal cord injury, which could affect your erectile function. Fortunately, treatments are available for both erectile dysfunction and depression.

Consider reaching out to a medical professional about your treatment options. There are online resources available, so you never have to set foot in a doctor’s office if you don’t want to.

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