EFFECTS OF SPINAL CORD INJURY ON SEXUAL FUNCTION
Spinal cord injury affects sexual function by disrupting the nerve impulses, or messages, between the brain and the rest of the body. When the genitals are stimulated, the brain registers excitement. When the brain is stimulated (for example, by sexual fantasies or talking to a partner about sex), the body may respond with physical excitement. If the spinal cord is damaged, these messages are disrupted, the extent of disruption depending on the level and completeness of the injury.A woman with spinal cord injury can continue to participate in sexual intercourse and other sex acts regardless of her level of motor impairment, though limited mobility may affect positioning and the extent to which she can take a physically active role. Her sexual function is affected primarily by loss of sensation. Vaginal lubrication, sexual excitation, and orgasm may be affected. Complete injuries result in greater disruption. Incomplete injuries have a greater likelihood of leaving a full range of sexual experience. Female fertility is not affected by spinal cord injury at any level.Men with spinal cord injury also have varying degrees of sensory and motor impairment that affect excitement, orgasm, positioning, and mobility during sex. Spinal cord injury also directly affects the ability to have an erection. Normally, men can get an erection in several ways.Psychogenic erections are caused by mental stimulus (sexual thoughts, seeing your partner naked, reading a story about sex): the brain sends messages through the spinal cord to the penis, causing an erection. Erections of this type do not occur after complete spinal cord injury, but can occur after incomplete lesions in some individuals.Reflexogenic erections are caused by direct stimulation of the penis, such as rubbing or stroking. These erections do not require communication between the penis and the brain. They are caused by a spinal reflex involving communication between sensory and motor nerves within the sacral spinal cord (a similar mechanism causes limbs to move involuntarily during a spasm, even though your brain cannot make them move voluntarily). Men with injuries at the cervical or thoracic levels can usually get reflexogenic erections. These can result from direct stimulation that is nonsexual, such as pulling on your catheter or friction from bed sheets or clothing.Spontaneous erections occur in response to internal physical stimuli, such as a full bladder – “morning erection” is a good example. Spontaneous erections, like reflexogenic erections, are caused by spinal reflexes. Men with complete injuries in the lumbar or sacral regions usually cannot get erections of any type.
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