December 31st, 2014
Male sexual function is a product of optimal physical, sexual and emotional stimulation that is mediated by hormones and spinal nerves. There are several physiological and neurological factors that may present with sexual deficits.
According to a new study published in the International Journal of Impotence Research (1), the effectiveness of an individual’s erotic sense can be significantly altered after an acute or chronic injury to the spinal cord. Investigators compared the sexuality of 187 males with or without spinal cord injury and concluded that males with spinal damage have a much higher prevalence of erectile dysfunction, premature ejaculation and other disorders such as:
Injury to spinal cord affects the neurological component of sexual activity, but may also involve psychological and physiological components in poorly managed cases. Here’s how:
For optimal sexual functioning, two spinal pathways are very important; these are parasympathetic sacral pathway (S2 –S4) and sympathetic afferents of D10–L2. The sacral part of the neurological pathway is activated as a result of tactile or touch stimulation; whereas sympathetic pathway of sexual stimulation responds to visual, auditory and psychological impulses (such as sexual thoughts).
In simple words, any spinal injury that directly or indirectly involve these nerve roots can present with sexual dysfunction. It is imperative to understand that the intensity of sexual dysfunction is dependent on several factors such as:
For example, if sacral part of the neurological pathway is damaged, the erections can still be achieved with psychogenic pathway (visual or auditory stimulation or watching/ listening to erotic material). Likewise, if sympathetic roots are damaged, tactile stimulation (or penile stimulation) would help in achieving erections. The quality and duration of erections will be compromised in most cases.
It has been observed that spinal cord injury to other nerve roots can also lead to sexual dysfunction due to:
The mobility of sperm and the ability to ejaculate may be affected but spinal cord injury does not lower the sperm count. Ejaculation may be severely compromised and some individuals may also experience retrograde ejaculation (a condition that is marked by backward ejaculation into the bladder instead of urethra). However, pregnancy can be achieved by artificial means and assistive techniques.
Speak to your primary care provider to learn various functional options.
Additionally, individuals who experience erectile difficulty after spinal cord injury can get benefited from a variety of interventional tools like prosthetic vacuum implants (artificial implants that can be manually used to maintain steady erection) and vasoactive chemical agents that are mostly available in the form of injectable drugs. These drugs can increase the duration of erection up to 30 minutes (2).
You must seek help from a primary care provider; if:
You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive.