Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom

Sexuality is important, and clinicians need a structured approach to address sexual issues with spinal cord injury (SCI) patients. This involves open communication, detailed history taking, physical exams, and neurologic assessments. Education about sexual potential, self-exploration, and routine follow-up are key. Treatment of related issues and simple techniques can improve sexual function. If needed, patients should be referred for specialized consultation. A structured program using vibratory stimulation, possibly with midodrine, can help achieve ejaculation and orgasm. Techniques for managing severe autonomic dysreflexia are also important.

• 1
  Greater sensory function in the T11-L2 dermatomes correlates with the ability to attain psychogenic erection and increase vaginal vasocongestion (lubrication).
• 2
  Individuals with complete lower motor neuron injury affecting their sacral cord are significantly less likely to experience orgasm compared to those with other SCI levels and degrees.
• 3
  Mild to moderate hypertension during sexual activity after SCI is likely a normal physiological event accompanying increased sympathetic activity during sexual arousal and orgasm.