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Overview

Sexuality and fertility management after a spinal cord injury (SCI) may help manage changes in sexual health. A spinal cord injury can affect sexual function, along with mental, physical and social well-being related to sexual health. Relationships between partners may be affected too.

But people who have had spinal cord injuries can be sexually active and enjoy sex. They also can have children. Therapies and treatments aimed at managing sexuality and fertility can help as you adjust to your body's changes.

Why it's done

Sexuality and fertility management after a spinal cord injury (SCI) is done because an SCI can affect the genitals and sexual function. After a spinal cord injury, it may be hard to achieve and maintain an erection and to ejaculate. Blood flow to the vagina and vaginal lubrication can change. You may notice changes in sex drive and in the ability to orgasm after an SCI. The ability to have children, known as fertility, also may be affected after a spinal cord injury.

Sexual activity and sexuality are important to many people after spinal cord injuries. Treatments, psychological therapy, fertility counseling and education can address these issues.

Risks

The risks of sexuality and fertility management after a spinal cord injury depend on the specific type of treatment. There are no risks associated with psychological therapy or fertility counseling.

If you take a medicine for sexual symptoms, there may be side effects. The most common medicine to treat erectile dysfunction is sildenafil (Viagra, Revatio). This medicine may cause headaches, flushing and mild low blood pressure. Flushing may cause patches of darker skin or dusky brown discoloration in people with brown or Black skin. It can cause pink or red skin in people with white skin.

Penile implants can lead to serious complications, including infection.

How you prepare

As you get ready for an appointment for sexuality and fertility management after a spinal cord injury, it may help to read educational materials. Ask members of your healthcare team for pamphlets or other information.

What you can expect

Sexuality and fertility management after a spinal cord injury (SCI) involves creating a comprehensive plan for rehabilitation. How much an SCI affects your sexuality and fertility depends on the level of spinal cord injury. It also depends on whether the SCI is complete or incomplete. Someone with a complete spinal cord injury loses feeling and the ability to move below the spinal cord injury. Someone with an incomplete spinal cord injury has some feeling and control of movement below the affected area.

Your rehabilitation plan can address the range of symptoms you're experiencing related to sexual function.

During sexuality and fertility management

Therapies for sexuality and fertility management after SCI may involve:

• Psychological therapy. The mental aspects of your sexual health after an SCI are as important as the physical aspects. It's important to feel good about your body and regain confidence to establish and maintain intimate relationships.

  A team of trained and experienced healthcare professionals such as doctors, nurses and rehabilitation psychologists can offer psychological therapy. They educate and counsel people after spinal cord injuries about the mental and social well-being aspects of their sexual health.

• Treatment for sexual dysfunction. People who have had spinal cord injuries may notice physical changes and may need treatment to help resume sexual activity.

  Treatment options include medicines and assistive devices such as vibrators, vacuum erection devices and penile constriction bands. Penile implants also may be an option.

• Fertility counseling. Trained healthcare professionals can discuss issues with you and your partner regarding sexual health and fertility. They can provide sexuality education and counseling.

  Pregnancy is usually possible after spinal cord injury, as well as a vaginal delivery. It's common for the menstrual cycle to pause after an SCI. But once it starts again, sexual activity can lead to pregnancy. If you wish to become pregnant, discuss any potential issues with your healthcare team.

Find support from friends. Educational and support groups can provide knowledge and help with coping skills. Support and education for partners also is an important part of sexuality rehabilitation after an SCI.

Results

Sexuality and fertility management after a spinal cord injury can help people continue to experience sexual pleasure and orgasm. Management strategies may help strengthen your relationship with your partner. Therapies and treatments also can help couples get pregnant and give birth.