People often ask ‘Can disabled people have sexual urges?’ Of course, aren’t they human beings? Even animals have them. On the one hand society talk extensively on the concept of integration and how the disabled people should lead a normal life. But when it comes to having intimate relationships they invariably get scared and pretend that such a problem does not exist and sex is hardly mentioned during various counseling sessions. In the case of spinal injured who have lead a normal life till a certain age, sex becomes more important because most of them have experienced it.
Probably soon after the accidents the injured may not experience sexual desires but gradually and slowly they return and do not diminish as time goes on. It is assumed they would as there is no outlet. Also it is a myth that the sexual energy can be sublimated by channeling onto creative activity. Sex and sexuality are more psychological than physical issues and when a person has reached a stage of reasonable psychological equanimity with his/ her physical condition then the matter can be addressed.
Sex is natural and we all need it and sometimes when this problem is not addressed it can lead to psychological trauma, frustration and may even heighten the already existing depression, thus lowering the self-esteem. But assertiveness on the part of the injured is important because nobody is going to think of you as a sexual being if you do not think of yourself as one. Your sexuality and your actions in the society are your responsibility.
The injury may alter many things, the attitude and one’s life style but not the process your body goes through when it is sexually aroused. There is rise in the blood pressure, the increase in the heart rate, and the reflexes of the muscles. What changes is the ability to feel sensation in the genital area and other parts of the body? The exact degree of change depends on the level of the lesion. For persons, however, the essential sexual functions are unaltered, though there may be a decrease in lubrication of the vagina and they may have little or no sensation on the clitoris. Many people with disabilities find that sexual intercourse in the traditional position is often difficult and sometimes impossible. But using differing positions can help to overcome problems.
It may take a little time, trial and error to find the position that is comfortable and satisfying. Getting an erection is one of the problems which men face. Men sometimes have a problem getting a full and stiff erection or the stiffness is lost before the intercourse begins. However if there is reasonable enlargement of the penis it should be possible to ease it into a woman’s vagina with the fingers of either partner. Also there are various aids to get an erection such as Penile injection of Papaverine, Vacuum erection aid, etc. Ejaculation is much more difficult than an erection.
Even if one is able to ejaculate, the patient may experience a retrograde ejaculation i.e. instead of from the penis the semen backflows into the bladder. In persons with higher lesion, sexual activity especially ejaculation may bring on autonomic dysreflexia, a condition where the blood pressure rises very high and can even lead to a heart attack if medical intervention is not applied. Even if ejaculation does take place the spinal injury generally affects the ability to produce viable sperms. Whereas in case of women the fertility is not affected by spinal injury, the periods may cease for a while after the injury but they would resume as earlier. They are fertile and thus women should think about contraception if in a sexual relationship.
* Also look at Sexuality under the link " Life after Spinal Injury "
