Sexuality for Women With Spinal Cord Injury (original) (raw)
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Sexual function is a major concern for many individuals following spinal cord injury (SCI). Sexuality after SCI is a complex issue that is influenced by a number of social, psychological and physiological factors, including urinary incontinence (UI). To examine the experience of sexuality for women with SCI, to determine the impact of UI on sexual function and sexual satisfaction in these women, and to identify their main concerns regarding UI and sexuality. Using a phenomenological approach, seven in-depth interviews combining the interview guide approach and standardized open-ended questions were conducted. Two main categories were identified: Sexuality and the impact of UI on sex-uality. Related themes were uncovered within each category. Both categories revealed emerging themes including 13 for sexuality and 10 for the impact of UI on sexuality. Five additional themes relevant to the research question but that did not fit into the initial categories were also identified. Intimacy and the sexual experience were negatively affected by UI as a result of SCI, and by an excessive concern about autonomic dysreflexia. There is a significant shortage of information available for women with SCI regarding sexual function in general, but more specifically, a lack of information on sexual function as it relates to UI. Future research should focus on creating resources to assist in this area which may improve the quality of life for these individuals.
The impact of spinal cord injury on sexual function: concerns of the general population
Spinal Cord, 2006
Secure, web-based survey. Objectives: Obtain information from the spinal cord injured (SCI) population regarding sexual dysfunctions, with the aim of developing new basic science and clinical research and eventual therapies targeting these issues. Setting: Worldwide web. Methods: Individuals 18 years or older living with SCI. Participants obtained a pass-code to enter a secure website and answered survey questions. A total of 286 subjects completed the survey. Results: The majority of participants stated that their SCI altered their sexual sense of self and that improving their sexual function would improve their quality of life (QoL). The primary reason for pursuing sexual activity was for intimacy need, not fertility. Bladder and bowel concerns during sexual activity were not strong enough to deter the majority of the population from engaging in sexual activity. However, in the subset of individuals concerned about bladder and/or bowel incontinence during sexual activity, this was a highly significant issue. In addition, the occurrence of autonomic dysreflexia (AD) during typical bladder or bowel care was a significant variable predicting the occurrence and distress of AD during sexual activity. Conclusion: Sexual function and its resultant impact on QoL is a major issue to an overwhelming majority of people living with SCI. This certainly constitutes the need for expanding research in multiple aspects to develop future therapeutic interventions for sexual health and SCI.
Sexual rehabilitation in women with spinal cord injury: A critical review of the literature
2010
Study design: Review article. Objectives: Critical review of literature on the multiple aspects of sexual rehabilitation in women with spinal cord injury (SCI) from initial recovery to long-term follow-up. Setting: Neuro-urology Department. Methods: Studies on sexuality selected from PubMed from 1993 to 2009. Results: Literature supported by significant statistical analyses reports that females with complete tetraglegia deserved special attention immediately at initial recovery; sexual intercourse is much more difficult for them (as compared with other women with SCI) mainly because of autonomic dysreflexia and urinary incontinence. There are sparse data on predictable factors favoring sexual rehabilitation such as the age SCI was incurred, the importance of one's sexual orientation, and the SCI etiology. Information after initial discharge is based chiefly on questionnaires, which report that as more time passes since the injury, patients attain more sexual satisfaction compared with recently injured women. Studies on neurological changes after SCI, and their effect on sexual response, are supported by a significant statistical analysis, but with few SCI patients. One topic reported the effect of sildenafil on sexuality, without benefit. No paper offers any detailed analysis on the sexual impact of medical and psychological treatments related to SCI. Literature reports that some co-morbidities are more prevalent in women with SCI compared with able-bodied women but data on sexual functioning are missing. Conclusion: To improve sexual rehabilitation services, sexual issues and response require evaluation during periodical check-ups using validated questionnaires administered by a physician 'guide' who coordinates professional operators thus providing personalized programmable interventions.
Spinal cord injury influences psychogenic as well as physical components of female sexual ability
Spinal Cord, 2006
Study design: Secure, web-based survey. Objectives: Elicit specific information about sexual function from women with spinal cord injuries (SCI). Setting: Worldwide web. Methods: Individuals 18 years or older living with SCI obtained a pass code to enter a secure website and then answered survey questions. Results: Bladder and/or bowel incontinence during sexual activity and/or sexual intercourse were significant concerns and prevented some women from seeking sexual activity. Autonomic dysreflexia (AD) during sexual activity was interpreted negatively by many and was found to interfere with sexual activity. Most subjects reported difficulty becoming psychologically aroused as well as physically aroused, which were both correlated with feeling that their SCI had altered their sexual sense of self. An inverse relationship existed between developing new areas of arousal above the level of lesion and not having sensation or movement below the lesion. The most commonly reported sexual stimulation leading to the best arousal involved stimulation of the head/neck and torso areas. The majority of subjects reported having experienced intercourse postinjury. Most participants reported difficulty with positioning during foreplay and intercourse, vaginal lubrication, and spasticity during intercourse. Almost half reported experiencing orgasm postinjury and this was positively associated with the presence of genital sensation. Conclusion: SCI significantly impairs psychological and physical aspects of female sexual arousal. In addition, bladder and bowel incontinence as well as AD negatively impact sexual activity and intercourse. Sponsorship: Christopher Reeve Foundation (#36708, KDA); Reeve-Irvine Research Center.
Sexuality and Reproductive Health Following Spinal Cord Injury
2004
This report may be used, in whole or in part, as the basis for development of clinical practice guidelines and other quality enhancement tools, or a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products may not be stated or implied.
Sexual concerns after Spinal Cord Injury: An update on management
NeuroRehabilitation, 2017
Spinal Cord Injury (SCI) causes neurological impairment with resultant neurogenic sexual dysfunction which can compound preexisting psychological and medical sexual concerns. Understanding these concerns is important in managing the lifelong needs of persons with SCIs. To provide an overview of the impact of SCI on sexuality along with a framework for treatment of sexual concerns. To briefly review male infertility and its treatments and pregnancy in females after SCI. Interdisciplinary literature review and synthesis of information. The average age at SCI is increased, thus persons with SCIs may have preexisting sexual concerns. Sexual activity and satisfaction are decreased after SCI. Psychogenic sexual arousal is related to remaining sensation in the T11-L2 dermatomes. Orgasm occurs in approximately 50% of persons with SCIs with all injuries except subjects with complete lower motor neuron (LMN) injuries affecting the lowest sacral segments A structured approach to treatment incl...
Sexual Dysfunction After Spinal Cord Injury
Urologic Clinics of North America, 1993
Purpose of Review Spinal cord injury (SCI) has a massive impact on sexual function in the affected population. Discussion of male and female sexual dysfunction in patients with SCI including the currently known management/treatment options is presented in this review. Recent Findings Sexual dysfunction is an important aspect of daily life that needs to be acknowledged, discussed and managed following spinal cord injury. There are pharmaceutical and technological advancements which allow patients to adjust to their new norm. Discussion about sexuality following injury should be normalized and encouraged since it is entirely possible to have a healthy sexual relationship following injury. Summary Although there have been major strides in management of male sexual dysfunction following spinal cord injury, the same is not the case for their female counterparts. More research needs to be done on female sexual dysfunction, especially within the scope of patients with spinal cord injury since this is one of the major determinants owing towards quality of life for many individuals.
Sexual response in women with complete spinal cord injury
Sexuality and Disability, 1996
Sexual response in women with complete spinal cord injury cannot be understood without first defining sexuality. In the past, sexuality was viewed as having one purpose-reproduction. Today it is seen as an important aspect of health and personality functioning; it enhances the quality of life, fosters personal growth, and contributes to human fulfillment (Whipple & Gick, 1980).