Sexuality for Women with Spinal Cord Injury (Part 2)

You and Your Partner

Many women worry about whether or not they can maintain a relationship after injury. In reality, it is impossible to predict the success of any relationship. Lasting relationships depend on a number of factors such as personal likes and dislikes, common interests and long-term compatibility. All relationships take hard work, dedication and commitment.

Women with SCI need to help their partners understand the issues of spinal cord injury and the areas of concern. Communicate clearly and work together to solve problems. This is a great way to build physical and emotional intimacy.

Areas of Concern

Table 1 ranks ten common areas of concern for women with SCI. While these concerns may be more common right after injury, these are life long issues that may always need special attention. The best way to feel good about these concerns are to discuss them with your partner ahead of time, be aware of what could happen and be prepared to deal with any problems that arise. In time, you and your partner will become more at ease in dealing with these issues.

Bladder management 

Bladder management is a concern for most women with SCI. There are a number of ways to reduce the chance of urinary accidents during sexual activities. First, women might limit fluid intake if they are planning a sexual encounter. Drinking too much fluid increases urine output and causes the bladder to fill more quickly. Women who use intermittent catheterization for bladder management can empty their bladder before engaging in sexual activity. Women who use a Suprapubic or Foley catheter may have concerns about the tubing. The Foley can be left in during sexual intercourse because the urethra (urinary opening) is separate from the vagina. If the catheter tube is carefully taped to the thigh or abdomen so that it will not kink or pop out, it should not interfere with intercourse. Women also have the option of removing the Foley catheter before sexual activities, but the catheter needs to be properly reinserted following sexual activities.

Bowel management

Bowel management is another concern for women with SCI. The best way to avoid accidents is to establish a consistent bowel management program. Once a routine is established, an accident is much less likely to occur. For added confidence, empty your bowel and avoid eating before sexual activity.

Sexual satisfaction 

Sexual satisfaction may be an issue for some women who wonder whether or not they can be sexually satisfied or satisfy a partner. Talking to your partner, experimenting with new ideas and working together will help you find mutual satisfaction.

Sexual exploration

Sexual exploration can also help couples enhance their physical pleasure. The goal is to find sexual activities that are interesting, enjoyable and mutually pleasurable. As couples work together, it may help to try different methods of giving and receiving physical pleasure. Some couples may find that methods for gaining sexual satisfaction are the same as before injury. However, those "old" methods may not be satisfying. Sexual exploration can help you and your partner enhance your physical pleasure. The goal is for both you and your partner to gain mutual satisfaction. Hopefully, you will then find that sexual activity is interesting and enjoyable. It may also be necessary for some couples to explore a variety of sexual positions to find comfort during sexual intercourse. This exploration may be needed especially if spastic hypertonia (muscle spasms or contractures) or pain occurs during sexual activities. If spastic hypertonia or pain is a problem, it is recommended that you talk to a doctor for advice on treatment.

Sexual arousal 

Sexual arousal is the emotional and physical process of stimulating excitement and readiness for sexual activity. Emotionally, you will likely find that you are still aroused by the same things as before your injury. These emotionally stimulating activities might include dressing up, a romantic dinner, showering together or an erotic film. This is another opportunity for sexual exploration. It may help to know what other women with SCI find physically arousing. Also, it is often helpful to "explore" your body and see what works before being sexually active with a partner. Women have reported they can achieve arousal through their mouth and lips, neck and shoulder, clitoris, stomach, vagina, thigh, breasts, buttocks, ears and feet.

Reference: http://www.spinalcord.org/resource-center/askus/index.php?pg=kb.page&id=1579

Read about  Sexuality for Women with Spinal Cord Injury (Part 1)