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| Spinal Cord Injury and Sexual Functioning |
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United States |
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A spinal cord injury (SCI) affects a man's sexuality both physically and psychologically. The type and level of injury both can play a role on the impact that the injury has on a man's sexuality. After injury, men may face changes in relationships, sexual activity, and their ability to biologically father children. Men can also experience emotional changes that can affect sexuality. All of these issues involve both the man with SCI and his partner. Therefore, it is very important to understand and confront these issues as a part of the overall adjustment to life after injury.
Physical Changes
Men normally have two types of erections. The first is a psychogenic erection, which results from sexual thoughts or seeing or hearing something stimulating or arousing. The brain sends these messages through the nerves of the spinal cord that exit at the T10-L2 levels. The messages are then relayed to the penis, resulting in an erection. For men with spinal cord injury, the ability to have a psychogenic erection depends on the level and extent of injury. Generally, men with an incomplete injury at a low level are more likely to have psychogenic erections than men with high level, incomplete injury. Men with complete injuries are less likely to experience psychogenic erections.
The second type of erection is a reflex erection. This occurs when there is direct physical contact to the penis or other erotic areas such as the ears, nipples or neck. A reflex erection is involuntary and can occur without sexual or stimulating thoughts. The nerves that control a man's ability to have a reflex erection are located in the sacral segments (S2-S4) of the spinal cord. Most men with spinal cord injury are able to have a reflex erection with physical stimulation if the S2-S4 pathway is not damaged.
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