How Spinal Cord Injury Impacts Male Sexuality

If you’re a man with a spinal cord injury (SCI), the impact on your sex life depends on the location and severity of your injury. Explore the facts about sex centres in the spinal cord.

Get help understanding how SCI affects male sexual performance.

It’s natural to feel overwhelmed as you grapple with the impact of your spinal cord injury (SCI) on your sex life. But, the more you learn about your spinal cord and how it affects your sexual performance, the more in control you’ll feel.

Let’s start with the basics…

Spinal cord 101

The spinal cord is a complex and delicate bundle of nerves and tissues. It has four sections: cervical, thoracic, lumbar and sacral. Each section of your spinal cord controls different body functions. Within each section are many individual bones, called vertebrae. 

When you discuss the spine with your doctor, he or she may use medical abbreviations, such as “T11,” which stand for thoracic vertebrae in the eleventh spot. 

Sexual centres in the spinal cord

The spinal cord has two areas that impact erections (see below). Exactly how they affect erections depends on the location of your injury. It also depends on whether you have total or partial loss of function below the SCI (i.e. a “complete injury” or an “incomplete injury”). With incomplete injuries, individual cases must be considered, since there are many possible variations.

There are two different types of erections and either one or both may be impacted by your injury. Psychogenic erections come from your brain when you see, smell or hear something that triggers sexual excitement. Reflex erections come from direct stimulation of the penis.

Spinal cord centre for psychogenic erections: The parts of the spinal cord labeled T-11 to L-2 (see image) affect these erections. Some facts:  

• If these sections are mainly intact, you may be able to get an erection from mental stimulation
• If you have an injury below L2, you’ll likely be able to get this type of erection
• These erections can be long lasting, but often are not hard or large enough for penetration

Spinal cord centre for reflex erections: The parts of the spinal cord labelled S-2 to S-4 (see image) impact this type of erection. Some facts:

• If this centre is intact, impulses from penis stimulation may cause an erection
• If your injury is above S2, you may be able to have this kind of erection. However, the nerve fibres below S2, such S2 through S5, must be intact and working correctly.
• Reflex erections are often large and stiff enough for penetrations, but they may not last long. Repeated stimulation might be needed.

What it all means

Be encouraged by the fact that many men with a spinal cord injury can get some type of erection. Depending on your specific injury and the location on your spine, your erections may come from your brain or right from the source. Your medical team may be able to help you overcome your limitations. Medication or a mechanical aid might help you get back to a healthy and gratifying sex life.