Sexual arousal is the body's way of physically and mentally preparing for sexual activity. Spinal cord injury can interfere with a male’s ability to obtain and maintain an erection as well as a female’s ability for vaginal lubrication. Further, reduced sexual drive or self-esteem can also interfere with arousal both physically and mentally. There are many strategies that can be used to enhance the psychological and physical aspects of arousal. Take some time to explore the resources below and talk with your health care providers on what options may be available for you.
General Overview
It is important to know that there are two main types of arousal. There is psychogenic arousal which is erection/lubrication that may come from sights, sounds, or thoughts that are stimulating. Following a spinal cord injury, just thinking about something sexy may not work as well because the area of the spinal cord injury responsible for psychogenic arousal is located at T11 to L2. Injuries above this level make it so that messages from the brain are unable to get through the damaged part of the spinal cord. For people who are able to experience psychogenic arousal, it may not be sufficient enough for intercourse and sexual aids can help.
The more sensation that is present from the belly button to the front pockets area, the more likely psychogenic arousal will be possible with things such as fantasy, romantic environments, and videos.
The other type of arousal is reflexogenic arousal, which is arousal that comes from physical touch or stimulation to genitals. The ability for this type of arousal is controlled by nerves in the lowest part of the spinal cord, S2-S4. Reflex arousal is possible in most people with an injury at T10 or above. For males, intact reflexogenic arousal means that they may experience erections when changing a catheter, cleaning their genitals, or even when pulling clothes or blankets over their body. Stimulation to the penis or areas around the penis may produce an erection even if not intended. Reflex erections can be brief and happen at inconvenient times.
It's important to pay attention and be aware of what causes you to experience arousal because it could be useful in the future. Practicing mindfulness techniques, being creative, and being open to exploring new possibilities for arousal will be beneficial for you as you explore your new sexual sense of self.
A key factor for achieving sexual pleasure and intimacy that is fulfilling and meaningful is to redefine sex and align your sexuality with your new body. A great video resource to further explore this can be Redefining Sex — Sexuality after SCI (sexualitysci.org)
Another great video on becoming comfortable with the new you can be found here: Confidence and Self Esteem — Sexuality after SCI (sexualitysci.org)
For information on sexual self-image and how strategies to improve this could help with overall sexual functioning, click to view this website: Sexual Self-Image (scisexualhealth.ca)
For a video description of sexual self-esteem and a personal story of a person with a spinal cord injury, click here: Sexual Health After Spinal Cord Injury: Sexual Self-Esteem (youtube.com)
For more information on strategies to enhance erection, click here: (link to erection tab)