Women's sexual functioning and sex life after spinal cord injury

Study design: Cross-sectional, mail-back questionnaire study. Objectives: To describe women's experiences of sexual functioning and sex life after spinal cord injury (SCI). Setting: Sweden, Denmark, Norway, Finland, and Iceland. Methods: All community-living SCI women treated at spinal cord centres in Sweden, Denmark, Norway, Finland, and Iceland meeting inclusion criteria (n=963) were mailed the study-specific SCI Women Questionnaire. Out of the 532 respondents, 392 reported having had sex after injury and were thus included in the study. The included women had a mean age of 42 years (range 18-68) and a mean time since injury of 11 years (range 2-54). Results: The SCI women reported that the injury caused many changes in their sex life and affected many aspects of their sexuality negatively. Some changes were of a physical nature (for example, decreased, lost, or changed sensation; difficulties to achieve orgasm; bladder or bowel problems; and difficulties to move and position oneself) whereas other changes were of a psychological nature (for example, feeling unattractive or less attractive, having less self-confidence, and difficulties to meet or find a partner). Conclusion: Successful SCI rehabilitation requires a holistic approach, taking into account the patient's physical, psychological, and interpersonal circumstances. Given that many women with SCI remain sexually active but often experience less satisfaction after injury, it is important that rehabilitation efforts address this aspect of the patient's life. Our results elucidating strategies applied by women with SCI to compensate for loss of genital sensation and cope with physiological impairment during sexual activity may serve to help professionals in developing rehabilitation programmes for women with SCI. Spinal Cord (2011) 49, 154-160; doi:10.1038/sc.2010.51; published online 11 May 2010