Sexuality and Paraplegia – Is Pleasure Possible Post Paralysis?

When it comes to sexuality with a couple, many people automatically jump the physical act of just having sex – but there’s so much more sexuality, for everyone, than just having sex. 

Sexuality and Paraplegia

Talking about sexuality means more than just what goes on in a couple’s bedroom once the doors are closed. Sexuality is all about the intimacy you and your partner share together, your preferences, your own body image, your desires and your fantasies.

When it comes to talking about paraplegia and sexuality, there are so many questions about how this will affect someone’s sexuality – especially if they have a partner and they don’t want to disappoint them or worry they will feel differently around you and being intimate with you.

If you are living with a paraplegic partner, you may have some concerns like:

  • Will I still have orgasms?
  • For men – can I still get an erection?
  • Will I still be able to satisfy my partner?
  • What about bowel and bladder accidents? (losing control of bowels and/or bladders is very common with spinal cord injury patients)
  • Are there any risks to having sex with my partner?
  • Will having sex with my partner be physically different now? How will it be different?

How Does Paraplegia Affect My Sexual Function?

The answer to this really depends on the person. For people who were born paraplegic, this is the only way they have ever lived so there won’t be anything to compare it to for when the time comes they are ready to sexually intimate with a partner.

For those who are now paralyzed because of an accident or spinal cord injury, they know what sex with their partner used to be like so they may become concerned about how this will affect their relationship with their partner.

As mentioned, a spinal cord injury can really affect bladder and bowel control. For anyone who has had a partner, an accident can be embarrassing and really alter the mood if it happens while you’re in the middle of being intimate.

On top of that, there can be changes in the sensation of having sex or in the ability, or even what it takes, to achieve an orgasm. For men – one of the biggest concerns they have is whether they will be able to get, and maintain, an erection going forward.

Can a Paraplegic Get an Erection?

It’s important to know that there are two parts to getting an erection: nerve stimulation (touch) and vascular (blood flow). Changes to a man’s sexual function will depend on the level of the injury experienced – so each person’s experience really will be different and there is no way to know until it’s time to try.

wife with his paraplegic husband

There are three types of erections, and each type could be affected differently by an injury leaving someone paralyzed.

Psychogenic

This kind of erection will come from sights, sounds, smells or thoughts that are arousing to an individual. For men, after experiencing an injury, thinking these thoughts may not be enough to achieve an erection anymore.

The area of the spine that is responsible for psychogenic erections is located at T11 and below. If the injury is above that it means the message from your brain can’t get through the injured part of your spine to produce an erection.

In this case, the penis may get longer or fuller, but it may not be hard enough to participate in intercourse.

Reflexogenic

This kind of erection comes directly from physical touch – it’s a reflex or response. Stroking or touching the penis can produce this kind of erection. This kind of erection is controlled by the lowest part of the spinal cord, so for men who cannot get aroused with thoughts and sights this kind of erection may still be possible.

Sometimes men will experience this kind of erection when having their catheter changed or just being bathed and cleaned in that area – even if it’s not intentional at all. These erections are usually brief, even if they happen at the most inconvenient times.

Spontaneous/nocturnal

These usually happen when men wake up with an erection, even without any kind of physical touch or stimulation. If a man doesn’t have any kind of erectile dysfunction, he may experience these nocturnal erections 3 or 4 times a night. This kind of erection usually lasts long enough to participate in sexual activity, if that is what both partners want.

 

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Enhancing Your Sexual Experience as a Paraplegic

If you are having troubles getting an erection to be intimate with your partner there are a few ways you can enhance your experience

Toys

There are toys and assistive devices that can help you to maintain an erection so that you can participate in intercourse with your partner.

Medications

You could talk to your doctor about whether using a medication is the right option for you and will work for your situation. This may not be the right option for everyone but it’s worth exploring if other options are not working for you.

Injections/pumps

You can purchase pumps or get injections that help men with getting an erection so they can be intimate with their partner. Again, this is something that may not work for you so you may have to do some research to determine if this is the right option for you and your partner.

 

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A Woman’s Sexual Experience as a Paraplegic

Whether you’re paraplegic or not, a woman’s sexual experience is much different than a man’s so it only makes sense that it needs to be considered differently.

For women, their vagina will become lubricated when they are aroused to in anticipation of having intercourse. Sometimes, when a woman has had an injury this physical function of lubrication may not work as well or it might take more time than it used to.

There are many different kinds of lubricants available for purchase, and really which one you choose will be between you and your partner. Some lubricants may have ingredients you are allergic or sensitive to (and didn’t know it) so it may take some trial and error to find the one that works for you.

woman on a wheelchair having a date in a park

The Physical Part of Having Sex

As we know, having sex is a very physical act. When your partner is paralyzed and not able to move around as easily as they did before, this can really change how you both experience having sex.

After an injury, being intimate with your partner for the first few times will feel like the very first time you ever had sex. There will likely be some awkward moments and fumbling around – it will take some time to get to know each other again because this is almost a new body that both of you are getting to know.

The physical part of having sex, and intercourse, will likely not look the same as it used to for you and your partner – and that’s ok, but it will take time. Your partner is likely struggling with the changes to their body, and likely feel very self-conscious so try to be patient and communicate with your partner during this time. Ask them what they like, what they don’t like – even if you think you know – and encourage them along the way.

 

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Can a Paralyzed Man Get Their Pregnant?

Experiencing an injury that leaves you paralyzed doesn’t change that you want to have a family with your partner, or maybe you already have children but want to have more.

Living With a Paraplegic Partner

An injury like this will change your life, no question, but it doesn’t mean you have to give up on everything you want. Now, that being said for men who want to have children after being paralyzed they may be able to do it.

For men with spinal cord injuries, they have a 10 – 15% chance of naturally conceiving with their partner. However, with today’s medicine there are many fertility treatments available that can help couples who wish to have children with conceiving.

The trouble with this is that many insurance plans and benefits do not cover this kind of fertility treatment so it may become really expensive for couples who go down this route. Couples have reported that the cost of using this kind of fertility treatment is similar to that of going through IVF treatment.

 

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Can Paralyzed Women Get Pregnant and Deliver a Baby?

As it was mentioned, men who have an injury that paralyzed them, or even if they were born paraplegic, there is a lower chance that they will be able to get their partner pregnant.

For women who are paralyzed, it’s a little different. The good news is that for the vast majority of women, an injury that leaves you paralyzed (or even being born paralyzed) will not affect your ability to get pregnant and have a baby.

Now the way that the pregnancy is handled, and there may be some challenges surrounding parenting in the beginning but there is a very good chance that as a woman you can definitely have children when you’re paraplegic.

While being paralyzed will change your life – no question – but it doesn’t mean you can’t enjoy the parts of your life you used it, including sex. Things will look different for having sex with your partner but with some patience and time, and a lot of communication, you and your partner can get back to enjoying a very fulfilled sex life – including your intimacy level.

About Estephanie Jill

Estephanie Jill (EJBP, BSPT, PTRP) is a licensed physiotherapist. She is a home health care provider, laboratory technician for physical therapy students, medical transcriptionist, and an advocate of the physiotherapy profession. Apart from that, she loves writing. Playing to her strengths, she mainly writes around health and fitness, She has been commended for her writing in the past. Her other passions include commenting on societal changes and writing life reflective pieces. She enjoys meaningful conversations, and detaching from the digital world to do yoga and meditation. She is a self-confessed foodie who enjoys eating for the experience and then burning it all off through exercise.