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SEX LIFE FOR PEOPLE WITH SPINAL CORD INJURY: TRYING NEW TECHNIQUES
Many individuals and couples are set in their sexual ways. As in other aspects of life, we may discover something that “works” sexually and then stick with it, perhaps not realizing we are excluding other potentially enjoyable activities. But after a spinal cord injury, certain sexual positions and actions may not be possible because of mobility and sensory changes. Innovation and change are now needed for success in making love, just as they are for success in work, parenting, and leisure activities.Cultural, religious, or personal taboos and fears may hinder your exploration of different sexual activities. And lack of communication with your partner can lead to embarrassment, anger, or disgust. You may need to explore your sexual values with your partner or perhaps seek help from a religious counselor or sex therapist in order to decide which sexual activities are acceptable to you. You’ll need to be open with your partner in discussing your sexual needs, desires, and intentions before introducing a new and potentially unwanted sexual practice.Motor impairments following spinal cord injury often require new positions for sexual intercourse. Finding a position that allows penetration may be fairly easy, but more experimentation may be useful in finding one that is the most pleasurable. In one study of thirty-one women with spinal cord injury, eleven different positions for sexual intercourse were recommended by different individuals!Some people with spinal cord injury prefer to make love in a wheelchair or other chair, rather than in a bed. Some prefer a waterbed, which provides motion, or an adjustable bed that assists with positioning.While muscle spasms can be an annoyance during sexual activity, they can usually be controlled by shifting position or putting pressure on the limb in spasm. However, some people find spasms an asset during sex, by making it easier to sustain a pleasurable position, enhancing stimulation of their partner’s body, or eliciting an erection. With practice, you may be able to trigger a spasm that enhances sexual pleasure.Other sexual acts may be more pleasurable than genital intercourse after spinal cord injury. A man who is unable to engage in intercourse because of limited mobility or erectile dysfunction can usually find a position in which he can orally stimulate his partner’s genitals. This can be a satisfying alternative to intercourse for a woman, while providing exciting tactile stimulation to the man’s lips, mouth, and tongue, where sensation is intact, as well as stimulation of other senses (taste, smell and vision). Similarly, a woman with spinal cord injury who has limited genital sensation may prefer to stimulate her partner orally so she can enjoy these tactile, taste, and olfactory sensations. Men or women with spinal cord injury who have some genital sensation may enjoy receiving oral sex. Combinations of oral sex and manual stimulation can be pleasurable to both partners.Both men and women may enjoy anal intercourse or stimulation, if this is an area of spared sensation. For men with spinal cord injury, Pleasure during intercourse and the ability to maintain erection may be enhanced by anal stimulation. Of course, for both men and women, anal stimulation increases the chance of a bowel accident and requires more careful attention to the mechanics of preparation for sex.Vibrators can provide intense stimulation, which may be helpful in producing sexual response even when sensation is limited, for both men and women. They can also be used for masturbation by people whose decreased physical dexterity or mobility makes manual masturbation impossible. A vibrator can be adapted with a special handle (similar to one you might use on a fork or pen) for people with limited hand use. Vibrators are generally safe, but sometimes cause autonomic dysreflexia (a sudden, potentially dangerous rise in blood pressure with headache). Signs to watch for are reddening of the skin, dizziness or lightheadedness, or your heart pounding in your chest. If any of these signs occur, stop using the vibrator. Ask your doctor about its safety before trying again.One technique for sexual intercourse that doesn’t require medical intervention and is helpful for some men with erectile dysfunction is called the “stuffing technique.” Rather than waiting for an erection before attempting penetration, the man stuffs his flaccid or semi-erect penis into his partner’s vagina and the stimulation by her vaginal muscles helps promote erection. Even if full erection is not possible, this technique can allow successful intercourse with enough stimulation of the vagina and clitoris to be satisfying to the female partner.Imagination, experimentation, and motivation are the keys to successful lovemaking after spinal cord injury. Willingness to try new techniques and methods and to educate yourself and your partner about sexuality are also important. Most people who have a loving partnership, with trust, caring, and affection, are able to find some way to make love and express their sexuality after spinal cord injury.
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