It is a common misconception that people with spinal cord injuries become infertile post injury. Fertility is an aspect of sexuality that is important for a person with a spinal cord injury and their partner to be educated on as the relationship progresses.
Fertility in Men
Male fertility is reduced after a spinal cord injury because of the ability to have an erection, ejaculation, and the quality of semen.
The spinal cord is associated with the nervous system. Therefore, impaired coordination of input from different parts of the nervous system could be a reason as to why men with spinal cord injuries have difficulty with ejaculation. Ejaculation can be either psychogenic or reflexogenic and the level of injury to the spinal cord affects a man’s ability to ejaculate. Men with higher level injuries may require more physical stimulation in order to ejaculate. There are areas of spinal cord when damaged men may experience premature ejaculation not accompanied by an orgasm.
The sexual functions of an erection, orgasm, and ejaculation can occur independently. However, it is thought that the ability to ejaculate is linked to the quality of erection and the ability to orgasm is linked to the ejaculation facility.
Fertility in Female
Spinal cord injury does not permanently reduce female fertility. However, there is thought to be a stress response that can happen immediately post injury that can alter fertility hormones in a woman’s body. Menstruation can also stop post injury, but usually returns within five months. After menstruation returns, women with spinal cord injuries conceive at a rate close to other women without spinal cord injuries.
The number of women with spinal cord injuries giving birth to healthy babies is steadily increasing. However, women with spinal cord injuries are considered high risk pregnancies. A good seating system for wheelchairs is important to maintain proper seating position and prevent pressure sores. Women can experience problems with establishing a center of gravity as weight is gained. Autonomic dysreflexia (extreme increase in blood pressure) for women with T6 injuries and higher can be a risk to both mother and baby during labor. Anesthesia may be considered for women who experience abdominal cramps, increased spasticity, and episodes of autonomic dysreflexia. Babies born to women with spinal cord injuries are usually born premature, if not, they can be smaller in size.
Check out Part 1 in Discussing Sexuality in Spinal Cord Injuries here.
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