Impact Of Spinal Cord Injury On Sexual Function

 Impact Of Spinal Cord Injury On Sexual Function
A spinal cord injury(SCI) changes many parts of the body. This is especially true for those body parts that are at or below the level of the injury. SCI can change the way your bladder and bowel function. SCI has most likely changed your sexual function. This can be changes in sensation, the ability to achieve orgasm, or the ability to get and maintain an erection. For many men, having an erection is one of the first questions on their minds.

Will I Be Able To Get An Erection?

Erections are a combination of nerve stimulation (touch) and a vascular (blood flow) response. Changes in sexual function depend on level of injury and if the injury is complete or incomplete. Each person’s function will be affected differently, so it is important to understand the basics of how erections happen.

Types Of Erections

Psychogenic: This type of erection may come from sights, sounds or thoughts that are arousing. For many men after SCI, having an erection by just thinking about something sexy may not work so well. This is because the area of the spinal cord responsible for psychogenic erections is located at T11 and below. When a spinal cord injury is above this level, the message from your brain cannot get through the damaged part of your spinal cord.

For men that might be able to get a psychogenic erection, the penis often gets longer and fuller, but still may not be rigid enough for intercourse. Pay attention to what causes you to have an erection. It could be useful in the future.

Reflexogenic: It is also called a reflex or spontaneous erection. This type of erection comes from physical touch or stimulation to your penis or genitals. Stroking, touching or caressing the penis can produce this response. The ability to get a reflex erection is controlled by nerves found in the lowest part of the spinal cord (S2-3-4). Reflex erections from touch are possible in most men with an injury at T10 or above. Psychogenic erections from arousing thoughts, sights or sounds are not usually possible.

Spontaneous/Nocturnal: If you have ever woken up with an erection at night or early morning without stimulation, you have had a spontaneous erection. These can occur during sleep or when your bladder is full. With men that do not experience erectile dysfunction these can occur 3-5 times per night on average. Some men after SCI may still get spontaneous erections during the night and/or in the morning. How long the erection lasts will help you determine its usefulness for sexual activity.

Will I Be Able To Ejaculate?

Most men with spinal cord injury cannot ejaculate during sexual intercourse.

The spinal cord is involved with two phases of the ejaculatory process. The first allows semen to move into the urethra. The second allows that semen to be pushed out of the urethra. For all of this to happen, chemical messages need to travel between the brain and the genitals via the spinal cord. But when a man has spinal cord injury, this travel is impaired.


The findings presented here indicate that SCI not only impairs male erectile function and ejaculatory ability, but also alters sexual arousal in a manner suggestive of neuroplasticity. Additionally, the majority of men pursue sexual activity for pleasure rather than merely reproduction. Clearly, more basic science and clinical research needs to be pursued in a manner not restricted to fertility, but encompassing all aspects of sexual arousal, function, and satisfaction.
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