Spinal cord injuries (SCI) are serious. Damage depends on the level and extent of the injury.
Can a SCI victim have a normal sex life?
Well, may not be normal, but they can still enjoy sex.
One needs to understand the arousal system to get to the depth of it.
Arousal is of two types-
1- Psychogenic
2- Reflexogenic.
1-In Psychogenic arousal, message travels from the brain to the nerves in the genital area via spinal cord. The T11–L2 ( T- Thoracic, L- Lumber) level is responsible for the psychogenic pathway.
Hence people injured above the level of the T11 do not generally experience psychogenic erection or vaginal lubrication; but those with an injury below T12 can.
The psychogenic pathway is sympathetic. It also sends inhibitory signals that prevent the physical arousal response. In response to sexual stimulation, excitatory signals are increased and inhibition is reduced.
2-The Reflexogenic pathway activates the parasympathetic nervous system in response to the sensation of touch.
It is controlled by a reflex arc that goes to the spinal cord and is served by the sacral segments of the spinal cord at S2–S3.
A woman with a spinal cord lesion above T11 may not be able to experience psychogenic vaginal lubrication, but may still have reflex lubrication if her sacral segments are not injured.
Likewise, although a man may not get a psychogenic erection when mentally aroused, but he may still be able to get a reflex or “spontaneous” erection.
These erections may result in the absence of psychological arousal when the penis is touched even by clothing, but they do not last long and are generally lost when the stimulus is removed.
Reflex erections may increase in frequency after SCI, due to the loss of inhibitory input from the brain that would otherwise suppresses the response in an uninjured man.
Conversely, an injury below the S1 level impairs reflex erections but not psychogenic erections.
Like other reflexes, reflexive sexual responses may be lost immediately after injury but recover over the period of time.
Tertiary sexual dysfunction results from psychological and social factors.
Loss of bladder or bowel control adds to the misery. Reduced libido, desire, or experience of arousal could be due to psychological or situational factors such as depression, anxiety, and changes in relationships.
Both sexes experience reduced sexual desire after SCI.
With proper guidance the paraplegics can get some of their sexual life back.
Sexual Health and Wellness 