Sexuality for Women

Research suggests that the main difference in sexual functioning between women with disabilities and nondisabled women can be accounted for by the difficulties women with disabilities experience in finding a romantic partner. Level of sexual desire is the same, but level of activity is less because significantly fewer women with disabilities have partners.

Generally speaking, sexual expression in the paralyzed female is less affected than in the male; it is physically easier for the woman to adapt or redefine her sexual role, albeit a passive one.

Women with paraplegia or quadriplegia and of childbearing age usually regain their menstrual cycle; nearly 50 percent do not miss a single period following injury.

Pregnancy is possible, and most spinal cord injured women can have normal vaginal deliveries, although certain complications of pregnancy are possible. Among these are premature and autonomic dysreflexia (for those with injuries above T-6, characterized by high blood pressure, sweating, chills, and headache) during labor. Also, loss of sensation in the pelvic area can prevent the woman from knowing that labor has begun.

There are also some special considerations related to contraception. Oral contraceptives are linked to inflammation and clots in blood vessels and the risk of these is greater in women with spinal cord injuries. Intrauterine devices cannot be felt in the paralyzed woman, and may cause undetected complications. Use of diaphragms and spermicides can be difficult for those with impaired hand dexterity.

Vaginal lubrication can be an issue. Some SCI women report that they do have reflex lubrication and others do not. When substitutes are needed, water-soluble lubricants, e.g., Today, Astroglide, KY Jelly, are preferable. Vaseline is not recommended; it is oil based.

Orgasm is possible for a paralyzed woman if there is some residual pelvic innervation, though this is relatively rare. Some men and women are able to experience what has been referred to as "paraorgasm" or "phantom orgasm," through reassignment of sexual response to areas of the body unaffected by the injury. This is described as a pleasurable, fantasized orgasm that mentally intensifies an existing sensation.

Sources: The Center for Research on Women with Disabilities, UAB Spain Rehabilitation Center/Medical RRTC in Secondary Complications in SCI, Paralyzed Veterans of America, National Spinal Cord Injury Association