“Now that I can’t feel anything in my legs, my arms and on my skin – how am I going to be able to feel sex again?”
That is the number one question for people with spinal cord injuries, especially at the beginning.
Here’s straightforward advice from Dr. Marcalee Alexander, professor at the University of Alabama School of Medicine, who’s been answering sex questions for decades. She outlines a positive approach for getting back your sex life.
Sexual response is internal – not external:
Because we perceive sensation and orgasm to be a response to external touching, it’s important to understand most of it comes from triggers in the brain and nervous system. That’s good news when it comes to SCI because individuals can learn to find ways to feel sex even after paralysis.
Prescriptions can get in your way:
Drugs and therapies can interfere with your sex life – or lack thereof. Anti-hypertensives (blood pressure meds) bladder meds, anti-seizure meds, narcotics, anti-depressants and anti-spasticity meds can all cause lack of libido in both men and women. Consider asking your primary physician to wean you off or consider replacements to some of your everyday therapies. Revisit in a few weeks to see if you feel better sexual sensation.
Why the level of your injury matters:
People with an injury below T-10 generally have a difficult time with orgasm. They need to discover how to achieve psychogenic arousal. This type of arousal happens when a person sees, hears, or fantasizes about something sexual. Combining it with physical stimulation – with or without a partner – can make all the difference. Experimentation and practice are key.
It may not only be the SCI that’s controlling your libido:
Preexisting conditions and illnesses such as hypertension, diabetes, heart disease, chronic pain, depression and anxiety, prostate or urologic conditions and menopause may be partially to blame. Many require medications that can interfere with your libido. Consulting your primary care physician or a psychotherapist can help you make positive adjustments.
Libido enhancing meds:
More is available for men than for women.
Men: Viagra and Cialis are the gold standard for men. Men can also benefit from vacuum pumps, vibration and penile injections. Last resorts include penile implants and applying a TENS device to genitals.
Women: A new drug called Vyleesi has recently been FDA-approved for pre and postmenopausal women. It’s taken by self-injection 45 minutes prior to sexual activity and has been found to improve desire and decrease anxieties. A drug-free option for women is a daily clitoral suction device that has lasting effects on desire.
And finally…don’t drop the issue
Get your doctor and therapists involved in the conversation about intimacy during and after your stay in rehab. Find local experts and peers who have had similar issues. Keep talking about it during your tune-ups as well. Don’t drop the issue.
Still want more?
Our “Voices of Experience” video series has TWO episodes about sex after SCI — one for women and one for men. Both have helpful information for yourself and your partner.