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Top 10 Questions About Sexuality and Spinal Cord Injury Answered

Highlights

  • Sexuality and spinal cord injury can coexist — you can have a happy and healthy sex life after you’ve experienced a spinal cord injury.

  • Spinal cord injuries can cause erectile dysfunction (ED) and other challenges when it comes to sex.

  • Most men can still orgasm after spinal cord injury but may not be able to ejaculate normally.

  • It’s generally safe to have sex after spinal cord injury, but you may need to plan ahead for special considerations.

  • Many men living with spinal cord injuries benefit from ED medication and other support for sexual function.


While abilities will vary depending on level of injury and other factors, sex will likely change after a serious spinal cord injury. However, most men can still have a fulfilling sex life with the right support. We’re sharing the answers to your 10 most commonly asked questions about sexuality and spinal cord injury.

1. How Does Spinal Cord Injury Affect Sexual Function?

A spinal cord injury can affect your motor function, change how you experience sensation, and cause other side effects that interfere with sex. The level and severity of your injury will determine the extent to which your sexual function is altered. More severe, or complete, injuries typically result in more significant changes to sexual function.

Psychological, physiological, and social factors directly influence your sexual function after SCI. Your rehabilitation process will require patience, open communication, education, and the willingness to try new treatments to see what works best for you. You may want to consider building a care team of providers from a variety of backgrounds to help you achieve the best results.

2. Will I Be Able to Get an Erection After Injury?

Most men can still get an erection following spinal cord injury. However, your ability to get an erection will also depend on the level and severity of your injury. You might also need extra support in getting and keeping an erection.

Men who have injured their S2-S4 pathway, or who have a complete spinal cord injury, are more likely to have trouble getting an erection from stimulation alone. Men who have other types of spinal cord injuries may still be able to get an erection, but it may not be firm enough for sex. Your provider can work with you to determine the best stimulation methods, medications, or tools for you to both get and keep erections.

3. Will I Still Feel Sex with a Spinal Cord Injury?

Men living with spinal cord injury are likely to experience reduced sensation or a loss of sensation to different parts of their bodies. This might include the penis and surrounding areas. Your risk for experiencing a loss of sensation to your genitals will depend on the level and severity of your injury.

This doesn’t mean that you cannot feel sex or experience pleasure altogher. There are many ways to experience sex without relying solely on genital sensation. For example, you might focus more on foreplay involving other parts of the body.

Most men can still feel aroused and respond to physical stimulation after an SCI. Even if you experience genital sensation differently, you can still experience pleasure. It might take a little extra work and trial and error to find what feels best to you, but the results will be worth it.

4. Can I Still Orgasm with a Spinal Cord Injury?

Most men can still orgasm after spinal cord injury. However, many men experience retrograde ejaculation after injury. This means they can orgasm, but they don’t ejaculate normally.

Don’t call it quits if you have trouble reaching climax after injury. You will likely need to experiment with new stimulation techniques and new ways of experiencing pleasure. You might also need to work with your health care provider or a sex therapist to determine if surgery or other treatment methods are needed to regain your sexual function.

5. Are There Risks to Having Sex After SCI?

It’s generally safe to have sex after spinal cord injury. There are a few risks to take into consideration, but these typically depend on the extent of your injury. Always speak to your provider about your concerns if you’re nervous about resuming sex.

Potential risks include:

  • Autonomic dysreflexia (AD). This syndrome causes you to suddenly develop high blood pressure. This is most common in people with spinal cord injuries to the T6 or higher. Stop sex immediately if you suddenly experience symptoms of high blood pressure during sex.
  • Abrasions or skin damage. People with spinal cord injuries might experience reduced sensation or lubrication. This can make it difficult to notice tears or other types of skin damage during sex.

6. Can I Still Satisfy My Partner After Injury?

It’s common for men to report feeling anxious or insecure about resuming sex after spinal cord injury. But rather than comparing your new sexual experiences to your experiences before injury, it’s better to focus on new ways to both give and receive pleasure. You and your partner get to explore which tools, techniques, or treatments make sex enjoyable for you both.

This process might include redefining what sex means to both you and your partner. You and your partner are likely to have the best outcomes by practicing open and consistent communication. Approach your new sex life with curiosity as you get to know your body once again.

7. What Other Factors Do I Need to Consider Before Resuming Sex?

It’s normal for your level of interest in sex to fluctuate after spinal cord injury. It’s also normal to be worried about safety, side effects, or other complications. Planning for potential interruptions or complications can help this process go more smoothly.

You might experience changes to blood pressure, body temperature fluctuations, bladder and bowel control challenges, trouble breathing, or pain or discomfort during sex. Your level and severity of injury will impact your risk for additional challenges during sex.

A few ways to prevent interruptions or complications include:

  • Emptying your bladder before sex
  • Finding positions that are most comfortable for you
  • Putting a plan in place for AD, pain, or trouble breathing
  • Sticking to a bowel schedule
  • Using pillows or other supports to create the best angles and pressure possible for sex

8. Will My Spinal Cord Injury Make Me Infertile?

Many men can still produce healthy sperm after spinal cord injury. However, most men have trouble ejaculating normally after injury. The most common method of conceiving after injury is to have your provider retrieve sperm and then use the samples. This can be done using intra-uterine insemination (IUI) or in vitro fertilization (IVF) procedures.

9. Can Viagra Help with Sexuality After Spinal Cord Injury?

Viagra and similar ED medications, like Cialis and Levitra are often the first line of treatment for ED after spinal cord injury. ED medications are safe for use in most men, and Cialis has been tested specifically for men with SCIs. ED meds are also less invasive than surgical solutions to ED after injury. Your level and severity of injury will impact how well Viagra works for you.

Research supports the use of Viagra’s generic (sildenafil) for men with incomplete spinal cord injuries. A scientific review found that men who took sildenafil reported significantly improved erectile function compared to men taking a placebo. Men with complete spinal cord injuries may need additional therapies to support their erectile function.

10. What Other Treatment Options Are There for Spinal Cord Injury?

Many of the treatment methods used for ED in men without spinal cord injury also work well for men living with spinal cord injury. The best treatment for you will depend on the level and severity of your injury. You may also need to try different treatment options before finding what works best for you.

Many men with incomplete injuries or injuries above T6 benefit from oral medications like Viagra. However, some men cannot take Viagra or need more intensive treatment. Your provider can work with you to determine the best treatment method for your condition.

Alternatives to oral medications include:

How eDrugstore Can Help

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