Sex and Spinal Cord Injury: A Guide for Women, part II

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This is a follow-up article to Sex and Spinal Cord Injury: A Guide for Women, where I shared my personal journey with sex after my own SCI and some introductory tips. Below are some additional tips to assist you with working towards a healthy sex life post-SCI.

 

Empty yourself out and put a towel down

A big concern that a lot of people have about sex after sustaining an SCI is the possibility of having an episode of incontinence during the act – bladder or bowel, or both. The good news is that there are ways you can try and prevent this from happening.

If you catheterize intermittently, empty out your bladder prior to sexual activity; if you have an indwelling catheter, some women find it helpful to tape it to their thigh to help keep it out of the way for penetrative activities. For the bowel, things can get a bit more complicated. It seems like techniques for avoiding incontinence during sexual activity vary depending on who you ask, or which rehabilitation facility’s website you go to. Some say to do a full bowel program and then wait two hours before you have sex; some recommend only clearing the rectum of any stool prior to sex; others recommend clearing the rectum as well as going light on food and drink the day of sexual activity. I say, do what works for you — which may involve trial and error at first.

Sometimes, despite our best efforts at preparation, accidents still happen. It’s a good idea to put down a towel or pad underneath you just in case any accidents do occur for easy clean up, especially when you are still learning your body.

But what about the psychological effects? I know the fear of incontinence sometimes made me so distracted that I found it hard to enjoy myself – sometimes I avoided sex altogether because the possibility caused me so much anxiety. And when accidents did happen to me, I was embarrassed and ashamed. To this day, I order my partner out of the room and don’t allow them to help me clean up; that’s simply how I deal with it. Other people may feel less discomfort than I and might be just fine with letting their partners participate in clean up. It’s not so much about how you deal with it, it’s more about getting to a place where you feel comfortable participating in intimacy, period.

Speaking of partners, you need to be with one who understands that you don’t always have control over what your body does and who doesn’t make you feel ashamed about that. If they do, then they are not the right person for you. Don’t ever feel like you have to stay with somebody because you are disabled. Living with an SCI is challenging, and you don’t need the added stress of being with someone who doesn’t support you during vulnerable moments.

I know the fear of incontinence sometimes made me so distracted that I found it hard to enjoy myself – sometimes I avoided sex altogether because the possibility caused me so much anxiety.

Foreplay!

Foreplay is often essential to good sex — there are, of course, exceptions to this rule. But when you have a body whose pleasure signals can be a little more subtle and complex, you may find that foreplay is even more essential than it was before your injury.

Foreplay isn’t simply physical and doesn’t have to be confined to the bedroom. It can start much earlier and involve little things that are exchanged between you and your partner that express to the other that you desire them. Certain looks or smiles, different touches, phrases whispered into the ear that leave you – or them — wanting more. The buildup of tension throughout the day can create anticipation for what’s to come.

Certain looks or smiles, different touches, phrases whispered into the ear that leave you – or them -- wanting more. The buildup of tension throughout the day can create anticipation for what’s to come.

SCI and Orgasms

Many people with SCIs report that above their level of injury, their bodies become more sensitive than before. Skin is more responsive to light touches and strokes; body parts that never really did anything for them before suddenly become erogenous zones. Or things that were already enjoyable become very intense. Perhaps if you already liked having your earlobes sucked on, that might become a mind-blowing experience for you now. Other popular spots are the neck; inside the shell of the ear; the shoulders; the inside of the elbow; and the hands and fingers.

If it’s comfortable, another place to experiment with touch can be the back. Since this is where the center of our pain is for many of us – emotionally as well as physically – exploring this area may make you feel vulnerable. If you feel safe doing this with your partner, it can be a wonderful way to build intimacy and trust.

For me, allowing my back to be explored showed me things I never knew about it. I thought that I had a clear demarcation at my level of injury – that is, above thoracic 9, I could feel things; below it, I couldn’t. It turns out that my back is a jumble of sensations, a terrain with peaks and valleys of sensitivity and numbness. The movement of a tongue over certain areas feels incredible; the pull of fingers over another is very uncomfortable. There is a golf-ball-sized patch of skin on my right shoulder blade that feels nothing. The stroke of a finger down the middle of my back creates the sensation of a series of delicate, glass-like threads being pulled, not unlike the strings of a harp.

sci and sex

It turns out that my back is a jumble of sensations, a terrain with peaks and valleys of sensitivity and numbness. The movement of a tongue over certain areas feels incredible; the pull of fingers over another is very uncomfortable.

The exploration of the skin around the precise level of your injury, front and back, is also something you may want to try. This is often a very sensitive area – which can be a double-edged sword. Many of us may experience only the uncomfortable, sometimes painful edge of that sword. On that area of my own body, just the sensation of my clothing rubbing against it as I inhale and exhale can be painful, so every day I wear tight-fitting undershirts to try and combat this issue. But let’s look at the other sword edge for a moment. If you have an area like this, you may be able to play with the super-sensitive skin that resides there. Ask your partner to try running their tongue very softy around it; a very light trailing of fingertips can also feel good. You can try other soft things such as feathers or velvet – if your partner has long hair, they can even drag the tips of it over your skin.

A spinal cord injury does so many unexpected things to your life — considering how difficult it can be to live with an SCI sometimes, why not take time to explore some of the wild sensations it may leave in its wake?

 

Nipple stimulation

Speaking of wild sensations, don’t neglect a renewed exploration of your nipples. As I mentioned, many people with SCIs have increased sensitivity above their level of injury – and the nipples are no exception. Some women report that they can achieve orgasm via nipple stimulation alone. Even if your feelings don’t reach orgasm status, it’s worth checking out. If you don’t have a partner that can help stimulate you using their mouth, you can try putting a bit of lubrication on your fingers for added sensation.

 

Positioning

After sustaining an SCI, many people wonder how they are going to manage positioning during sex. This is highly dependent on you level of injury and also whether it is complete or incomplete. Since it is much easier to show positions than to describe them, I’ve gathered some videos to help give you some ideas.

When getting into positions, be aware of your own safety. Make sure that your limbs won’t fall in ways that may suddenly yank on your back, or that they won’t fall onto any hard surfaces (like wheelchair parts or bed edges) that may result in bruises or fractures. In addition, be sure that any straps or ties that you use aren’t cutting into your skin. As always, don’t be afraid to speak up during the act – if, say, you’re holding your leg up but feel your strength giving out, or you think a strap is pressing too hard into your hip, that needs to be communicated so you can stay safe. And so you can relax and enjoy yourself!

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Lubrication

After an SCI, women often experience a decrease in vaginal lubrication during arousal. Since decreased sensation is also many times a part of this package, using artificial lubrication is extremely important. Vaginal (and anal) tissues are delicate, and you don’t want them to be injured during sex. Be sure to reapply as needed – this means you need to check, or have your partner check, to see if it needs reapplication. A good way to see how long a lube might last is to put some between your hands and rub them together until they start to go dry.

Be aware that ingredients in certain lubricants do not mix with certain condoms and toys! Depending on the components in the lube and the materials the condom or toy is made of the lube will begin to degrade the condom or toy, creating the danger of damage or even breakage. Here’s a guide on how to use the right lube with the right condom or toy: How to Choose the Best Lube for Your Sex Life.

I hope some of these tips help you feel more comfortable pursuing a fulfilling sex life post-SCI. Remember, it’s important to try to maintain a sense of both adventure and humor. You may experience some setbacks along the way, but after a while you will become more comfortable in the bedroom and with your body.

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