Sexual issues in a sample of women with spinal cord injury

Abstract

Study design: Semistructured interview. Objectives: To assess the degree of participation in sexual intercourse of a sample of women with spinal cord injury (SCI) in our community, to establish to what extent their sexual lives have been affected in comparison to before the injury, and to search for those factors that may have a major influence on both aspects. Setting: Spinal Cord Injuries Unit, A Corun˜a, Spain. Participants: A total of 37 women, average age 40 years, time since onset average 10 years. Results: In all, 62% claimed regular sexual activity after the injury. The women who suffered the injury before reaching the age of 18 years run a higher risk of not having physical relationships than those who were above that age when they incurred the SCI (P ¼ 0.04, OR 4.75). We discovered a significant drop in the frequency of intercourse (P ¼ 0.003) and the ability to reach an orgasm (P ¼ 0.008), after the injury. Of these women, 69% were satisfied with their current sexual activity and 77.4% considered the information they received from their doctors on the changes the SCI would cause in their sexuality to be either insufficient or nonexistent. Conclusions: There is a noticeable decrease in the frequency of intercourse as well as a significant reduction in the capability of reaching orgasm. Despite these changes and problems that ensue during intercourse as a result, most show satisfaction with their current sexual lives. On the other hand, the occurence of the injury before the age of 18 years may imply a greater risk of not having an active sex life in adult years. We consider it is essential to provide the appropriate sexual information during the process of rehabilitation, aimed at helping women with SCI to adapt to their new situation.Spinal Cord (2005) 43, 51-55.

Spinal cord injury influences psychogenic as well as physical components of female sexual ability

“…17,[20][21][22][23] Our study further revealed that these concerns are severe enough to prevent a considerable number of women from seeking sexual activity with a partner. It is possible that the fear of incontinence may contribute to psychological aspects of arousal as well.…”

“…In one study from Spain, 48% of the female subjects reported not using birth control. 21 A study from India found that 75% of the women with SCI did not use birth control. 22 In the US, one study found that 30% of women with SCI did not use birth control 17 and in our study 41% did not use birth control.…”

Sexual rehabilitation of women with a spinal cord injury

“…A study of 37 women indicated that these women are less likely to enter into a sexual relationship than any other group of SCI women (P ¼ 0.04). 41 Relationships Controversy exists over the importance of relationship status in rehabilitation to a satisfactory sexual life. Lack of partner availability is cited by 16.4% of a sample of SCI women as the cause of being sexually inactive (Po0.01).…”

Iatrogenic and Post‐Traumatic Female Sexual Disorder

“…A lack of respect of professional boundaries in the clinician-patient relationship is another neglected precipitating co-factor of FSD, especially for women who sought professional help in a vulnerable moment of their life [13,14] (see sub-chapter on Classification, etiology and key issues in FSD).They may behave as maintaining factors, through the most frequent mistake in the field of FSD: the diagnostic omission, which encompasses occasional or systematic diagnostic neglect, particularly in the area of biological/medical etiology of FSD [2,3,[4][5][6][10][11][12] and/or comorbidity between medical conditions and FSD [1-3,4-6,11-12, 15,16]. This chapter will discuss these three major areas of iatrogenic disorders, to open a mental window on the sexual scenario we clinicians often do not consider.The role of post-traumatic FSD will be briefly reviewed with a focus on spinal cord injuries [17][18][19][20], and ritual female genital mutilation (FGM) [21][22][23][24]. Sexual abuse, which may cause both a physical and emotional trauma, may be related to post-traumatic stress disorder and long term sexual disorders [25].…”

“…The role of post-traumatic FSD will be briefly reviewed with a focus on spinal cord injuries [17][18][19][20], and ritual female genital mutilation (FGM) [21][22][23][24]. Sexual abuse, which may cause both a physical and emotional trauma, may be related to post-traumatic stress disorder and long term sexual disorders [25].…”