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Women's sexuality.

Sexuality is an important factor in our lives; it sums up our sexual habits and the desires we have as sexual beings. It allows people to express their physical and emotional needs of intimacy.

Many people believe that women who sustain a spinal-cord injury (SCI) can't resume a sex life, however, this isn't true. Although women with SCI face emotional and physiological challenges, they're still able to engage in sexual activity post-injury.

For these women, sexual health education is a necessary component in adapting to their new life.

Understanding Intercourse

Omitting sexual activity after SCI can lead to lack of self-worth and confidence, as well as diminish one's satisfaction with life.

Women with SCI commonly experience many concerns and fears about expressing their sexuality and most importantly, the fear of engaging in sexual intercourse. They must be prepared to understand and manage the physiological changes of SCI.

The ability to contract muscles and degree of sensation may change depending on the level of injury and completeness. Nerve signals from the brain to the genital area are impaired, leading to decreased vaginal lubrication. A water-based lubricant such as K-Y Jelly can aid in providing more pleasurable sexual intercourse.

Women with SCI may also experience diminished or even a complete absence of sensation. This doesn't mean women with SCI can't enjoy sex. Communicating with your partner about sexual activity provides a great deal of emotional pleasure and sexual exploration can enhance the experience.

Other Concerns

Bladder and bowel management are common concerns for women with SCI when having intercourse. A number of precautions can be employed to allay these fears.

Self-catheterization prior to sexual intercourse can reduce urinary accidents. Suprapubic catheters can be taped to the abdomen to prevent the catheter from pulling out of the abdomen during intercourse. Indwelling foley catheters can be removed immediately prior to intercourse and reinserted properly afterward.

Maintaining a consistent regimen will reduce the possibility of an unexpected bowel movement occurring during intercourse.

Emptying the bladder and bowel prior to intercourse can help boost the woman's confidence.

Fear of not sexually satisfying a partner or the woman not finding satisfaction can prevent her from having a pleasurable sex life. If this is the case, a psychologist can provide women and couples with advice and methods to explore each other's interests and needs to reach a level of satisfaction.

Many women with SCI fear autonomic dysreflexia will occur if they have intercourse.

If symptoms of autonomic dysreflexia (a pounding headache, flushing of the face, nasal stuffiness or sweating above the level of injury) occur during sexual intercourse, sexual activity should be discontinued immediately.

If symptoms continue after stopping sexual activity, the woman's physician should be notified without delay.

Pregnancy & Safe Sex

Most women don't have a menstrual cycle for up to six months after their injury.

Once the menstrual cycle resumes, many women have success conceiving and birthing children. If the menstrual cycle doesn't return six months post-SCI, a physician should be consulted for possible treatment options.

Practicing safe sex is important for everyone to have a healthy sex life.

Having one sexual partner who is free of sexually transmitted infections (STI) and has no other partners greatly reduces the possibility of transmission of disease. One should always ask a potential partner about his or her sexual history. Condoms should be used by either men or women to help prevent STIs. Regular STI testing and gynecological exams must be performed to maintain optimal health.

It's best to receive knowledge of sexual health and share it with your potential partner soon after experiencing an SCI.

Increased awareness can help manage fears related to sexual intercourse. A physiatrist, a doctor who specializes in physical and rehabilitation medicine, can help address your concerns and guide you to other professionals, such as a psychologist, gynecologist or urologist for additional support.

Additional educational material on sexuality and reproductive health can be found at pva.org under consumer guidelines.

AMANDA MILISITS, RN, BSN, CLNC

Amanda Milisits serves as an associate director of Paralyzed Veterans of America's Medical Service Department in Washington, D.C.
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Title Annotation:health smarts
Author:Milisits, Amanda
Publication:PN - Paraplegia News
Date:Mar 1, 2016
Words:680
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