Women’s Sexual Health and Reproductive Function After SCI

Top Spinal Cord Inj Rehabil, 2017 · DOI: 10.1310/sci2301-20 · Published: January 1, 2017

Simple Explanation

Spinal cord injuries (SCI) can disrupt sexual function and reproduction in women, leading to changes in vaginal lubrication, genital congestion, and orgasm. However, women with SCI can still experience sexual pleasure and satisfaction. Women with SCI can experience sexual responses through psychogenic or reflexogenic stimulation depending on the level and extent of the injury. Understanding these pathways can help women with SCI adapt to their new lives and maintain a positive attitude toward sexual health and motherhood. Pregnancy is possible for women with SCI but requires close monitoring due to potential complications such as decreased level of functioning and increased risk of decubitus ulcers, weight gain, and autonomic dysreflexia.

Study Duration

Not specified

Participants

67 women with varying degrees and levels of SCI

Evidence Level

Not specified

Key Findings

1
Women with SCI can experience sexual pleasure and orgasm through psychogenic or reflexogenic stimulation, with different neurological pathways mediating these responses.
2
Pregnancy is possible for women with SCI, but younger age at the time of injury and pregnancy, marital status, motor score, mobility, and occupational scores are significant predictors of successful pregnancy.
3
Women with SCI may experience unique medical problems during pregnancy, labor, and delivery, including decubitus ulcers, weight gain, urological complications, postural hypotension, and autonomic dysreflexia.

Research Summary

Sexual pleasure, orgasm, and pregnancy are possible for women with SCI, but primary, secondary, and tertiary impacts of SCI may affect sexual adjustment and should be addressed during rehabilitation. Determinants to childbearing and care of women with SCI who are pregnant require consideration of physical, physiological, and psychosocial factors. Communication with and education of women with SCI are mandatory after injury in order for women to understand their sexual and reproductive health and to learn about the options that are available for a safe pregnancy, labor, and delivery.

Practical Implications

Holistic Approach to Sexual Rehabilitation

Treatment should consider a holistic approach using autonomic standards to describe remaining sexual function and to assess both genital function and psychosocial factors.

Importance of Addressing Psychosocial Factors

Psychosocial issues must be addressed as possible contributors to sexual dysfunctions (e.g., lower self-esteem, past sexual history, depression, dating habits).

Close Monitoring During Pregnancy

Pregnancy may decrease the level of functioning (e.g., self-care, ambulation, upper-extremity tasks), may involve complications (e.g., decubitus ulcers, weight gain, urological complications), and must be monitored for postural hypotension and autonomic dysreflexia.

Study Limitations

1
The relatively lower pregnancy rate makes prospective studies about obstetrical complications difficult.
2
No studies have examined the physiological factors involved with fertility following SCI.
3
Literature is conflicting about whether women with SCI experience more anxiety and fear regarding pregnancy and caring for a child than able-bodied women.

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