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Sexual Function in Men after Spinal Cord Injury

Medically reviewed by Last updated on Dec 2, 2022.

Is it possible to be sexually active after a spinal cord injury?

Your sexual response will depend on the location and severity of your spinal cord injury (SCI). You will need to make changes, but you can still have a fulfilling sex life. You may be able to have an erection but unable to keep it long enough for sexual activity. This is called erectile dysfunction (ED).

How is ED treated?

  • A vacuum device is a tube that is placed over the penis. A hand pump is connected to the tube and acts as a vacuum. This may help increase blood flow to the penis.
  • Medicines that help you have an erection may be prescribed. These medicines are taken before you have sex. Follow your healthcare provider's instructions on when and how to take these medicines. You may have a life-threatening reaction if you mix these medicines with medicines that contain nitrates. Medicines with nitrates include nitroglycerin and other heart medicines. Another type of medicine is in the form of a pellet and can be put into the end of your penis.
  • Injection therapy may also be used. Injection therapy is medicine that is injected into the side of your penis. This causes your erection to last 1 to 2 hours. You may need to have someone give you the medicine if you have trouble moving your hands.
  • Surgery may be recommended if other treatments do not work. Surgery may include a penile implant or prosthesis. Ask for more information about surgeries that can be done for ED.

Can I still get my partner pregnant after an SCI?

You may have problems with ejaculation and problems with sperm motility (movement). Many men are not able to ejaculate during intercourse, or they have retrograde ejaculation. Retrograde ejaculation is a condition that causes sperm to travel backwards into the bladder instead of through the urethra. An SCI does not affect the amount of sperm you have, but your sperm may move slower. Artificial insemination can be used to get your partner pregnant. Ask your healthcare provider for more information about artificial insemination.

What do I need to know about bladder or bowel control during sexual activity?

If you do not have control of your bowel or bladder, you may worry about having an accident during sexual activity. You can try to avoid an accident by closely following your regular bowel and bladder program. Plan your sexual activity after you perform your regular bowel and bladder program. Healthcare providers may suggest that you avoid drinking liquids for 1 to 2 hours before sexual activity. If you have a urinary catheter, you must remove the catheter to prevent the catheter balloon from moving. Movement of the catheter balloon could cause an injury.

When should I contact my healthcare provider?

  • You have signs and symptoms of a urinary tract infection:
    • Chills and fever
    • Urinating more often or waking from sleep to urinate
    • Blood in your urine
    • Urine that smells bad
    • Pain in your lower back (if you have still have feeling in this area)
    • Leaking urine
  • You feel that you need sexual counseling or education.
  • You have questions or concerns about your condition or care.

Seek care immediately if:

  • You have a sudden throbbing headache.
  • You have red, sweaty, or flushed skin above the level of your SCI.
  • You have cold and clammy skin with goose bumps below the level of your SCI.
  • You have a stuffy nose or nausea.
  • You have blurred vision.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your healthcare providers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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