Sex and The Single Wheelchair

Armen Hareyan's picture

Much to the surprise of some people, life does go on after spinal cord injury (SCI). People with SCI hold challenging, interesting jobs, travel around the world on business and for fun and have loving emotional and sexual relationships. Dr. Diana Cardenas, chief of rehabilitation medicine at University of Washington Medical Center and project director of the Northwest Regional SCI System, says most patients who have had an SCI find early on that they have the same sexual drive they had before the injury.

"They'll have concerns about sexuality and may have misgivings, because everybody has certain myths they believe about people with spinal injuries, that they're not capable of having sexual relations with a partner, for example," Cardenas adds. "They need to get an education on this when they're ready. That may not be immediately after a spinal injury, but it should be within the first few weeks. Generally, that person should not be leaving the hospital without having information and the opportunity to discuss how their particular SCI may affect their sexual function."

No two SCIs are exactly alike. The location and extent of the injury can determine just how much sexual expression is still possible.

"The actual nerve fibers that are affected are important. If a patient has any sparing, any incompleteness of the injury, then it is fairly impossible to predict just how much sexual response remains," Cardenas says. "Even people who have complete injuries are still able to enjoy a sexual life after SCI."

Research studies have shown that about 50 percent of women are capable of orgasm after SCI, including some women who had a complete injury.


"Human sexual response is not totally dependent on having genital sensation or totally dependent on what one thinks of as traditional intercourse," Cardenas says. "The brain really is the main sex organ in the body. Research shows that there are blood flow changes and activation in certain parts of the brain when people are engaged in sexual activity, showing that SCI doesn't affect that part of the brain at all. A person has many ways to explore sexual satisfaction."

Part of dealing with sexuality and SCI can be in learning to communicate in different ways. While a child may cope with school, camp and other ordinary activities as if SCI were just a fact of life, adults who have been in long-term relationships at the time of an SCI may find they have to make some changes. Cardenas advises looking to a health care provider or even a psychologist or peer counselor (someone who has years of experience with SCI) for information and advice during this process.

"A lot of folks who have been married for 30 years are used to sometimes no communication, and then after an SCI, communication becomes really important," Cardenas says. "You may actually have to change. You will likely find more ways to express yourself that you didn't realize were there before. I hear all the time, particularly from men, that they become more mature, more romantic, more aware of pleasing their partner and being more open to hugs and kisses - things that women are happy with, too."

She adds, "If you think of yourself as a sexual human being, then you're going to be much more content. If you're in a relationship where you don't feel that way, that's not a good situation. A clinical psychologist can help if you're having major problems with a relationship or your marriage. An SCI may pose many challenges, but it should not prevent you from expressing your sexuality or seeking satisfaction with life."

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This page is updated on May 12, 2013