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Intercourse & Pleasure With a Spinal Cord Injury

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abs1993 asks:

I'm seventeen and partially paralyzed from the waist down. I injured myself and got a spinal cord injury about a year and a half ago. I can move my legs, but not all of my muscles work. I've been going out with my incredible boyfriend for a while now and we have started having vaginal sex. One of the downsides of a spinal cord injury is that everything from the waist down has a little less feeling than normal. It's really hard for me to get anywhere past feeling turned on, and I think it has something to do with my numbness. I make sure my boyfriend is really careful to not hurt me and communicate with him pretty well. Are there any lubricants or other products that I could use to make sex a little more pleasurable for me? It usually doesn't hurt, but I have a hard time feeling anything. I see commercials for stuff, but I don't really know if they work. Thanks!

Heather Corinna replies:

I asked my hands-down favorite writer about sex and disability, Cory Silverberg, to answer this one for you.

Here's what Cory had to say:

It already sounds like you have a good sense of what's happening with your body since the spinal cord injury and one of the great things about having incredible boyfriends (or partners of any kind) is that they're hopefully into talking about sex and figuring out how you can both experience sexual pleasure and satisfaction, however you define it.

I'll start by answering the lubricant question because it's the easier part of it. But then I also want to throw out a few other ideas for you to think about since you mentioned not getting past feeling turned on.

The story we get told about sex and spinal cord injury (from doctors, from the media, even from well meaning, but not so well informed, sex educators) is usually a very specific one, all about the things you supposedly can't do, or the ways that sex is "special" when you do it.

I can understand why most doctors and rehabilitation professionals talk about it this way. First of all, they don't tend to know that much about sex, and what they do know is all about the medical aspects of sex. Second of all, they are trained to isolate injuries and impairments, and as a result, instead of interacting with you as a whole human being, they really think of you as a 17-year-old "spinal cord injured patient." The focus on injury makes it hard for them to see you as a whole person, which of course you are. They aren't the only people who think this way, which is one of the reasons why lots of people who live with experience of disability start to feel fractured themselves, when everyone wants to break you down to your component parts it can be hard to feel whole.

Sexuality is one of those things where, if we really want to get into it, we have to think about the whole person. But now I'm getting to the second part of my answer, so let me get to lube first.

If vaginal intercourse is uncomfortable or painful because there isn't enough lubrication between the bodies, resulting in dry skin rubbing against dry skin and causing irritation, then a lubricant may be very helpful. In fact, if lack of lubrication is the only problem, using a store bought lubricant might solve it. In general, I recommend using a lubricant that doesn't use chemical preservatives, scents, flavors, or glycerin. These things may not be a problem, but for some people they can be, and having tasted a lot of flavored lube in my time I can promise you, the strawberry/kiwi flavor isn't worth the possible urinary tract infection or skin reaction!

If you and your boyfriend are already comfortable talking about sex, you may want to try lube and then talk about it to see how it changes the experience for both of you.

You mention that vaginal intercourse usually doesn't hurt, so I'm going to take that to mean sometimes it does hurt? If so, that's also worth exploring a bit. A lot of us grow up with the idea that some of the time sex will hurt and it's something we need to tolerate, a part of having sex. Not true. Unless your goal is to feel pain, if you're having any kind of sex and it hurts, you shouldn't assume you need to tolerate it. There are always dozens of things that you can do to change sex around that may reduce or eliminate the pain. The first step is to talk about it and try to figure out what's happening.

Often, when someone who has had a spinal cord injury, or someone who has lived experience of any disability, talks about difficulties with sex the assumption is that whatever is the problem must be related to the injury or to the disability identity. Not true. There could be lots of reasons why vaginal intercourse sometimes hurts and sometimes doesn't, and those reasons may have absolutely nothing to do with your spinal cord injury. Most health care people (including a lot of sex educators) will make the assumption that if you've had an injury any problems you're having with sex must have to do with that. You may find partners do this also. You may even do it yourself.

So how do you start to figure out what's going on?

My first question would be to ask you to think about the times you have vaginal intercourse where it hurts and times when it doesn't hurt. Can you think of any differences between them? Maybe it's related to your mood? The time of day? Maybe it has to do with all the other kinds of sex you have before you start having vaginal intercourse? Maybe it has to do with positions, or how you or your partner is moving? We talked about lubricant already, and if it is about lubrication it could be related to your menstrual cycle. The thing to do is start thinking about it and doing some sleuthing. You say that you don't get much passed feeling turned on. For most people vaginal intercourse isn't going to be fun or feel good unless we're really turned on. So if intercourse is important to you, what you might need to do is think about ways of making sure you're both really turned on before moving to intercourse. The good news about this is that the homework can be a lot of fun!

It's hard for me to make a lot of specific suggestions because I don't know you, but here are a few general thoughts, and you can always write back with more information if you want. Most sex educators will say that the foundation to enjoying sex is knowing what feels good in your body and your mind. I'm not sure how much sexual exploration you did before your injury, but it's true that your injury will have changed some of the ways your body feels and the ways you perceive feeling in your body. Different isn't a bad thing though. All it means is that the cookie-cutter solutions offered by most magazine articles, self-help books, and pornography probably aren't going to do it for you. Since sexuality is something unique for each of us, the truth is that cookie cutter solutions are never the answer anyway (although lots of people are willing to settle for them).

One of the first things you can do is to start exploring your own body. Sensation has shifted, so learning where you feel pleasure is key to discovering how best to get turned on and have sex. There are no rules here (forget what you've been told about sex being in the genitals) any part of your body that you enjoy having touched or you enjoy thinking about becomes a part of your body you may want to include in your sex life. Of course, these things change too, it's not like there's a spot where someone can touch you and you'll always feel turned on. But what can be helpful is to try and explore, on your own time, your sexual body. I wrote an article that takes people through this process, if you're interested you can read it here.

Sex isn't just something that we experience in our bodies. Sex is mental and emotional and for some people spiritual. So the next place to explore is your mind. Do you have sexual fantasies? Do you give yourself permission to have time to yourself just to think about sex? Are there thoughts or feelings that you find sexy? Or are there things that you think about that may have nothing to do with sex (maybe a rainstorm, shopping, traveling to Ireland) but still excite you or turn you on in other ways? Sexual thoughts and fantasies don't have to be connected to what you want to do with your boyfriend. For many of us it is the thoughts and feelings that get us going, that let us relax and focus on our partners and ourselves, and let us open up to feeling greater sexual pleasure. Taking some time for yourself to think about this may also be a good thing to try.

There are so many other ways to think about this, so I want to remind you this is just one way to explore.

I want to share one more thought. While some people may enjoy sex when they are very tense, for lots of us, in order to experience sexual pleasure we have to be relaxed enough to focus on and fully experience what's happening in the moment. This can be very hard, particularly for those of us who have had negative sexual experiences in the past. But also for people who tend to think a lot and find it hard to "turn off their minds". As with everything else, there isn't one way to do this, but if you're finding that you are only able to get so far with your sexual feelings it might have something to do with you not feeling relaxed, or not being able to really focus on your time with your partner. If you find yourself distracted during sex - maybe your mind wanders, maybe you start thinking of what you have to do tomorrow, or you start worrying about how the sex is going to go - that could be a huge reason why you aren't getting past the point of feeling turned on.

I’ll leave it there for now. I hope some of that was helpful, feel free to email back if you have specific questions or are looking for any other resources. If you’ve got the money and you like buying books and reading them I did co-author a book about sex and disability, The Ultimate Guide to Sex and Disability, but among the many beautiful things about Scarleteen, one of them is that it’s free!

I'll also leave you with some extra links I think might help you out:

written 11 Mar 2011 . updated 17 Nov 2012

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