Paraplegic men can have erections, ejaculate, and feel pleasure, but it depends on the degree of spinal cord injury. Sexuality can be explored in various ways, especially with the support of a multidisciplinary team to understand that sex is not limited to penetration, allowing new ways to experience sexuality. Learn more!
Sexuality is an essential topic in everyone’s life, but for paraplegic men, it often comes with unique questions and challenges.
Is it possible to have erections, feel pleasure, and even start a family after a spinal cord injury? The answer is yes! Although paraplegia can impact sexual function, it does not define the limits of pleasure or intimacy. With adaptations, proper treatments, and professional support, paraplegic men can rediscover their sexuality and live fulfilling relationships that go beyond penetration, valuing emotional connection and intimacy.
Find answers to your questions for an active and fulfilling life.
Does paraplegia affect sexual function?
Paraplegia affects sexual function because it interferes with the central nervous system, consisting of the brain and spinal cord, which connects the brain to other parts of the body.
Specifically, spinal cord injury affects the sympathetic and parasympathetic systems. The sympathetic system is responsible for increasing blood flow to the sexual organs. The parasympathetic system relaxes blood vessels, allowing blood to flow into the male genitalia.
Since an erection is a central nervous system response to sexual stimuli that increase blood flow to the penis, making it larger and firmer, sexual function in men after a spinal cord injury can be affected.
Can wheelchair users have sexual relations?
Wheelchair users can have sexual relations if the injury is incomplete, meaning the person retains some sensation and movement below the injury site, including the lower spine.
The sexual life of men with spinal cord injuries requires position adaptations and bed adjustments but can still be satisfying.
Can paraplegic men have erections?
Yes, paraplegic men can have erections, but it depends on the extent and location of the spinal cord injury.
According to the article “The profile of sexuality in men with spinal cord injuries,” men with injuries in the lumbosacral spinal cord, the lower part of the spinal cord that controls the parasympathetic system, can have psychogenic erections.
A psychogenic erection results from visual, auditory, olfactory, tactile, and even emotional or sexual fantasies. The brain processes these stimuli and sends signals that can bypass unaffected areas of the spinal cord to reach the penis. However, psychogenic erections tend to lack the rigidity required for sexual intercourse.
Men with spinal cord injuries may also experience reflex erections triggered by physical stimuli on the penis or nearby areas. Reflex erections do not depend on the brain, so they can be more rigid and longer-lasting.
Regarding orgasm, the same study notes that while it may be impaired, it is still possible. Stimulating new erogenous zones, fantasies, and emotional connection can help achieve climax, even if less intense.
Can paraplegic men have children?
Paraplegia affects male fertility because it causes issues with ejaculation and sperm mobility.
The article “Fertility alterations experienced by people with spinal cord injuries: A qualitative study,” highlights that retrograde ejaculation, where sperm is retained in the urethra and expelled through urine, is common in men with this type of injury.
The study also notes that even if a spinal cord injury patient can ejaculate, sperm mobility tends to be below ideal.
However, paraplegic men can still have children through assisted reproductive techniques like in vitro fertilization (IVF). Sperm can be collected in two ways:
- Electroejaculation: This procedure is performed in a surgical center under general anesthesia and involves electrical stimulation.
- Vibrostimulation: Ejaculation is induced in a doctor’s office using high-frequency vibrators without sedation or anesthesia.
What to do in case of erectile problems?
Treating erectile dysfunction in men with spinal cord injuries typically begins with phosphodiesterase type 5 inhibitors, such as Sildenafil, Tadalafil, and Vardenafil.
This study states that Sildenafil, when administered at lower doses, is more effective in improving erectile function. It also suggests this medication for men at risk of experiencing stronger side effects at higher doses.
If oral medications fail, penile injections are an alternative. However, initial dosages should be lower than usual.
A penile implant may be considered when previous approaches fail. There are two types:
- Inflatable implant: The patient manually controls an implantable pump in the scrotum to achieve an erection.
- Semirigid implant: The penis remains semirigid, and the man adjusts its position manually for an erection.
Erectile dysfunction treatment also includes sexual therapy. Spinal cord injuries can impact self-esteem, and psychological support helps men manage insecurities.
Sexuality goes beyond erections
There is a phallocentric culture in which penetration is considered the only valid form of sex. However, sex is not limited to penetration. Sexuality can be explored in various ways:
- Valuing intimacy: Many paraplegic men report giving more importance to emotional connection, affection, and touch.
- Discovering new erogenous zones: Through kisses, caresses, and massages.
- Open communication: Honest conversations about desire, expectations, and limits are fundamental for sexual satisfaction. In cases of paraplegia, open discussions strengthen relationships.
- Taking care of mental health: Individual and couples therapy are vital in restoring the sexuality of paraplegic men.
Paraplegic men can have erections, and with the help of a psychologist, they can achieve a healthy and fulfilling sex life.
For more tips and information about health and sexuality, join the Dr. Paulo Egydio’s WhatsApp group.
