In preparation for sexual activity, vaginas need to become moist to make penetration of a partner or sex toy easier and to prevent tissue irritation and tearing. This is called lubrication. Spinal cord injuries may cause lubrication to decrease or the time it takes for lubrication to occur may take longer.

Stimulation to the vagina, even when sensation is absent, can cause reflexive vaginal lubrication but this method may not be sufficient enough to allow for penetration. Lubrication can be added by using a water-based, non-petroleum lubricant. Some water-based lubricants have sugar in them and should be avoided because these can sometimes lead to vaginal yeast infection. Warming gels should also be avoided if you have difficulty detecting temperature on certain parts of your body. Silicone lubricants, which are harder to remove from skin, are longer lasting and generally feel more natural. They don't taste good and they should not be used with silicone sex toys as they can stick to the toys. More information on this can be found on pages 2-3 of this PDF created by Craig Hospital: 786.Sexual-Function-for-Women-After-Spinal-Cord-Injury.pdf (craighospital.org)

More information on lubrication can be found on this website created by the United Spinal Association: Sexual Aids - United Spinal Association

Another part of arousal in people with vaginas is swelling of the clitoris. Just as with blood flow to the penis for erections, blood flows to erectile tissue in the clitoris, making the clit feel and look fuller and firmer. This can be sexually appealing to both the individual and a partner due by enhancing visual pleasure. Further, when the clitoris is engorged with blood, it becomes more sensitive to touch and other sensations, which can help with achieving orgasm.

There are pumps available that can be used to facilitate this part of arousal and can be explored but measures need to be taken to ensure your safety. When exploring options, it would be beneficial to talk with a gynecologist on the best options for you. Safety features such as quick air release and finding out if the devices highest level of intensity is safe for your body are important considerations. The EROS clitoral therapy device is a small, battery powered vacuum device designed to enhance clitoral engorgement and is available by prescription. There are various sized pumps that can be used for the clitoris as well as the vulva and may be options to explore.

Before trialing any equipment or toys, you should always speak with your health care providers to ensure no further complications will occur.