Sexuality, relationships, and fertility after spinal cord injury

Sexual function after SCI

The impact of SCI on sexual function depends on factors such as:

• Level of injury

• Completeness of injury

• Physical sensation and movement

• Emotional wellbeing

• Medication and overall health

Everyone’s experience will be different.

Sexual function for men

For men, spinal cord injury may affect:

• Ability to achieve or maintain an erection

• Sensation in the penis

• Ejaculation and fertility

Some men may still experience sexual pleasure or orgasm differently, including pleasurable sensations above the level of injury, sometimes referred to as a “phantom orgasm”.

While fertility can be affected, many men with SCI are still able to father children with medical support and fertility treatments.

Medical options may include:

• Penile vibratory stimulation

• Electroejaculation

• Fertility and reproductive support services

For more information on these, see the helpful resources below.

Sexual function for women

For women, spinal cord injury may affect:

• Sexual desire and arousal

• Genital sensation

• Lubrication

• Comfort during sex

• The way orgasm is experienced

Some women may temporarily stop menstruating after injury, often for several months. However, spinal cord injury itself does not usually prevent natural conception (getting pregnant).

Pregnancy after SCI

Many women with SCI go on to have healthy pregnancies and become parents.

However, pregnancy after SCI can involve additional medical considerations, including:

• Bladder and bowel complications

• Pressure injury risk

• Blood clots

• Autonomic dysreflexia

Regular medical monitoring and specialist healthcare support are important throughout pregnancy.

Intimacy and relationships after SCI

People living with SCI can absolutely continue to enjoy intimacy, relationships, and sex, although it may require some adjustment and planning.

Open communication with your partner is important. Talking honestly about:

• Comfort

• Positioning

• Sensation

• Boundaries

• Support needs

Can help reduce stress and improve confidence and connection.

Exploring intimacy in different ways

Many people discover new ways to experience intimacy after injury.

This may include:

• Increased sensitivity in other parts of the body

• Exploring touch differently

• Using positioning supports or pillows

• Using lubricants or assistive devices

• Trying adaptive sexual equipment

Intimacy is about much more than physical function alone, and many couples find new ways to maintain closeness and connection.

Planning ahead can reduce stress

Because bladder and bowel function may be affected after SCI, some people find planning ahead helpful before sexual activity.

Strategies may include:

• Emptying the bladder and drainage bags beforehand

• Completing bowel routines earlier

• Ensuring skin is clean and dry

• Planning around catheter management

• Keeping towels or protective bedding nearby

Accidents can still happen, and that’s okay. Honest communication and preparation can help reduce anxiety and make intimacy feel more comfortable.

Parenting after SCI

Many people with SCI are still, or become active, capable, and engaged parents.

Parenting may involve adapting routines, equipment, or the home environment, but people living with SCI continue to raise families, care for children, and build meaningful family lives.

Peer support and lived experience can often be especially valuable when navigating conversations around relationships, intimacy and parenting after injury. You can chat with our peer support team here.

Talking to someone can help

Questions about sexuality, fertility, and relationships are common after spinal cord injury, but many people feel unsure about where to start.

You may find it helpful to speak with:

• A GP or medical specialist

• A psychologist or counsellor

• A Spinal Nurse Advisor

• A peer mentor with lived experience

At estara, we understand these conversations can feel personal and sensitive. Our peer mentors and specialist teams can help connect you with information, support, and services in a respectful and supportive way.