Advanced Care Program: Paralysis

Male Sexuality

Sex is a natural part of life and deserves attention in helping you maintain a quality life style. The fact that you might be paralyzed does not mean you no longer have the desire for sex. The fact that you may be less mobile does not mean that you can not be pleased or please someone. The loss of sensation or genital function does not mean you have lost your sexuality. As a male with paralysis you will experience difficulty in achieving an erection. The paralysis may interrupt the signal that allows communication between the brain and the male sex organs making it difficult to achieve an erection. An erection might occur in individuals with paralysis beginning in the lower lumbar or sacral area and individuals with incomplete SCI above the T12 level by thinking or fantasizing or reading sexual material. For the above and other individuals with paralysis an erection might be achieved by stimulation of the scrotum, penis, or anus as long as the individual has functioning reflex systems at sacral two, three or four segments of the spinal cord.

If you have an incomplete injury, you will be more likely to ejaculate after sex. If you have a complete injury or incomplete injury and do not ejaculate, you are experiencing retrograde ejaculation (due to the shorter distance to the bladder and the inability of the bladder neck to close, the semen travels into the bladder instead of the urethra). You might experience a normal ejaculation sporadically, most of the time or not at all. If you wish to have children and do not have any discharge of semen as a result of intercourse you will need to speak with a fertility expert. If you have any discharge and do not wish to have children, you will need to practice birth control.

There are a number of products or methods which can be utilized to achieve an erection:

• Penile implants can be surgically installed in the penis to produce artificial rigidity.
• Penile injections are available that produce erections by dilating the arteries which pump blood into the penis.
• Oral medications such as Viagra or Cialis may be helpful for some individuals, but may be too expensive or produce undesirable side effects.
• Vacuum therapy is available to produce an erection. This device works by placing the penis inside a tube and air is pumped out of the tube which causes the blood to flow into the penis to achieve an erection. A constriction ring is then placed at the base of the penis to maintain the erection. Vacuum therapy is covered by Medicare.

Before having sex, empty your bladder and decrease your fluid intake prior to engaging in sex. Avoid bowel accidents during sex by planning around your bowel program and schedule. Establish an environment or setting that is both accessible and conducive for sex. Handle all hygiene issues prior to engaging in sex or use these activities as foreplay in heightening excitement. If a lubricant is required use a water soluble lubricant jelly, such KY. Do NOT use Vaseline or an oil-based lubricant for lubrication during sex.

It is very important to remember to practice safe sex. Sexually transmitted diseases STDs) can affect you as easily as anyone. Take proper precautions – use a condom to reduce your risks of STDs.

Paralysis Topics

Recognizing and Preventing Autonomic Dysreflexia
Recognizing and Preventing Pressure Sores
Recognizing and Preventing Urinary Tract Infections
Skin Care
Osteoporosis and Fractures
Spasticity
Bowel Management
Respiratory Complications
Smoking and Paralysis
Male Sexuality
The Importance of Range of Motion Exercises
Female Sexuality
Nutrition & Spinal Cord Injury
Wheelchair Cushion Maintenance
Latex Allergies