Sexual Function Explained for Men with Spinal Cord Injury

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“In the spinal cord, there’s two areas that control sexual function,” explains Diane Rowles, a nurse practitioner at the Rehabilitation Institute of Chicago. Knowing where these two areas are and what type of erections they produce helps people get a better understanding of how men’s sexual function works (or doesn’t work) following a spinal cord injury.

Psychogenic Erections

The T11 to L2 area along the spinal cord controls a man’s psychogenic erection, or where the stimulus originates in the brain. Seeing someone naked or having a sexual dream are examples of a stimulus that begins in the brain. From the brain, the stimulus travels down the spinal cord, and once it reaches the T11-L2 section, a psychogenic erection is produced.

Reflexogenic Erections

The S2-S4 area controls a man’s reflexogenic (or reflex) erection. This means that the stimulus does not come from the brain. Instead, the stimulus for a reflex erection comes from external sources such as rubbing the thigh or even catheterization. “The message goes into the spinal cord, loops around, and comes back out,” explains Diane.

Understanding your own sexual function

“People who have injuries high up in the cervical level or the high thoracic level, if their injury is complete, meaning no messages are getting through, then they’re likely not to have psychogenic erections,” says Diane. On the flip side, these same individuals with high injuries are likely to experience reflex erections since those erections do not involve the brain.

“People who have low injuries, below L2,” explaines Diane, “the damage and the swelling is at the bottom of the spine, more likely to interfere with the reflexes. They’re not as likely to have spasms and other reflexes. But, that T11-L2 center is still connected to the brain, so they get psychogenic erections.”

Then there are some men, typically with injuries in the T11 to L2 area, who may be unable to experience any type of erection because of the damage to the specific area of the spinal cord.

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