Our expert says:
In the case of a male with a spinal chord injury there are a number of factors that play a role in sexual function. Firstly we need to seperate the concepts of sexual desire/libido and the concept of erectile function. When we talk about sexual desire and libido we are talking about what in men is both a psychological and physical phenomenon. The desire for sex can stem from a psychological/emotional desire for pleasure, touch, intimacy, connection, fun etc; it can also stem from a physical sensation in the genital area due to a spontanoeus swelling and erecting of the penis that happens to various degrees and due to various internal, external and psychological stimulation. It is not incommon due to the trauma of a spinal chord injury for the person to have a loss of psychologically based sexual desire/libido for various periods of time. This may return variably for individuals depending on how they come to terms with their trauma.
Then another factor that plays a role is whether the spinal chord injury is a complete or incomplete severing of the spinal chord and in the case of an incomplete spinal chord severing where along the spinal chord the incomplete lesion is situated.
In the case of a complete spinal chord injury men will generally not have erectile function and will also not experience awareness and sensation of arousal and pleasure in the genital area. Some men are able to have a prostaglandin injection to bring about an erection chemically and could enjoy the visual pleasure of seeing him penetrate his partner even if he cannot feel it physically.
In cases of an incomplete lesion some men do experience erections and sensation genitally. This will be individual to each person's case.
It will be helpful for your friend to discuss this in more detail with his physicians along his healing process and if necessary the assistance of a sex therapist when he is ready could be helpful.
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