Sexual rehabilitation in women with spinal cord injury: a critical review of the literature

Abstract

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.

Sexual problems of women with spinal cord injury in Turkey

“…2,3,11,12 Issues relating to sexual functioning and sex life in women after SCI have received relatively little attention in the scientific literature or in clinical rehabilitation efforts. 1,2,13 One reason may be the male dominance among individuals with SCI. Female sexual dysfunction is less problematic than for males with SCI; the majority of paraplegic or tetraplegic women will continue to menstruate, ovulate and may reproduce.…”

“…Female sexual dysfunction is less problematic than for males with SCI; the majority of paraplegic or tetraplegic women will continue to menstruate, ovulate and may reproduce. 2,3,11 In our study, all patients wanted to receive information about sexuality, sexual life, fertility and pregnancy. Many authors have also noted that most women do not receive any information about sexuality at any time after injury.…”

“…Kreuter et al 6 reported that 61% of patients with SCI receive no information about sexuality. 2 At the time of investigation, 40% expressed a wish to receive information. Many women pointed out the importance of being offered the opportunity to talk to someone with good knowledge about the impact of a SCI on sexuality and sexual life.…”

“…1,2 Sexuality constitutes a fundamental part of people's lives, integrating physical, emotional, intellectual and social aspects. 3 A long-term disability can have a profound impact on a woman's innate sense of sexuality, sexual function and, occasionally, fertility.…”

“…[3][4][5] Comparatively little research on sexuality in the population with SCI focuses specifically on the sexual concerns of women. 2,3,5,6 However, in recent years there has been growing acknowledgement of the sexual concerns of women with SCI. Despite this, the conveyance of this knowledge to the women with SCI appears to be insufficient.…”