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Male Sexual Dysfunction

Sexual Dysfunction after Spinal Cord Injury

Spinal cord injury disrupts neural pathways between the brain and genitalia, causing varying degrees of erectile, ejaculatory, and orgasmic dysfunction depending on the level and completeness of the injury.

75%
Success Rate
Lifelong management; best results with specialized SCI sexual rehabilitation
Duration
Multiple
Treatment Options
3+ Groups
May Affect

What is Sexual Dysfunction after Spinal Cord Injury?

Spinal cord injury disrupts neural pathways between the brain and genitalia, causing varying degrees of erectile, ejaculatory, and orgasmic dysfunction depending on the level and completeness of the injury.

Prevalence: Affects virtually all men with complete SCI; 80% with incomplete SCI

Symptoms and Signs

  • Inability to achieve psychogenic erections
  • Reflex erections may still occur (if upper motor neuron)
  • Absent or impaired ejaculation (anejaculation)
  • Difficulty achieving orgasm or anorgasmia
  • Reduced or absent genital sensation
  • Bowel or bladder dysfunction affecting intimacy
  • Body image and self-esteem concerns

Causes and Risk Factors

Common Causes

  • Interruption of descending neural pathways
  • Damage to sacral reflex arc (S2-S4)
  • Loss of sympathetic outflow (T10-L2)
  • Autonomic dysreflexia risk during sexual activity
  • Secondary complications (pressure sores, spasticity)

Risk Factors

  • ⚠️Complete (vs incomplete) spinal cord injury
  • ⚠️Cervical or thoracic level injury
  • ⚠️Lack of early rehabilitation education
  • ⚠️Depression and psychological adjustment

Treatment Options

Expected Outcomes: Most men can achieve erections with treatment; ejaculation possible in 50-80% with vibrostimulation

Available Treatments:

  • PDE5 inhibitors (effective for reflex erections)
  • Intracavernosal injections (highly effective)
  • Vacuum erection devices
  • Penile implants (for reliable erections)
  • Vibrostimulation for ejaculation
  • Electroejaculation (for fertility)
  • Psychosexual counseling
  • Assisted reproductive techniques for fertility

Prevention Tips

  • Early rehabilitation with sexual health education
  • Bowel and bladder management before sexual activity
  • Positioning strategies for comfort and safety

Ready for Professional Help?

Our sexology specialists can provide expert assessment and personalized treatment plans.

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