Researchers and women with spinal cord injuries build a better understanding of sexual satisfaction

(Updated April 2011)

Loren Serano* enjoyed a great sex life with her boyfriend before her C3-4 spinal cord injury. After her accident, the prospect of resurrecting that intimacy was daunting. “When I first got out of rehab,” she says, “it would get really frustrating because he would get tired out trying to position my body, and I would be upset because I couldn’t do anything to help. Then we would both get mad and give up.”

Inhibited by the information that sex might stimulate bowel and bladder accidents, and discouraged by a lack of surface sensation, Serano wondered how to satisfy her sexual appetite, which hadn’t changed at all.

It’s not an uncommon scenario, according to experts like Dr. Marca Sipski-Alexander, who has done extensive research on arousal and orgasm in women with SCI (see “Reclaiming Your Health,” NM October 2011). “The potential for orgasm is still there,” says Sipski-Alexander, former chief of SCI services at the Miami VA and project of the South Flordia Model SCI System at the Miami Project to Cure Paralysis. But since popular belief is that the potential for orgasm is not there, “so many people with spinal cord injuries give up — they don’t masturbate, they don’t feel when they touch the surface, so they say, ‘What’s the point?’”

The point, says Sipski-Alexander, is that only the surface sensation disappears when you have a spinal cord injury. “Lots of internal sensations are still there,” she says, which accounts for menstrual pain, vague urges to go to the bathroom, labor sensations and other abdominal pain. “It’s my belief,” she explains, “that there might be some component of sensory function that relies solely on the autonomic nervous system and doesn’t require your brain to process.”

Her theory is supported by evidence that there is only one injury pattern that significantly impacts the ability to achieve orgasm