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Question:
I have been a T8 para for three years, and have begun a relationship that includes sex. I know I can get pregnant, but I
don't know the best way to prevent it. Are there any birth control methods that are dangerous for people with spinal
cord injury?
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Answer:
by Mitchell Tepper: (05/16/2004)
All the usual options are open, but a few carry elevated risks or practical difficulties for people with limited dexterity. The
intrauterine device (IUD) may increase the risk of pelvic inflamatory disease, and women with loss of sensation cannot easily
monitor themselves for a perforated uterus or infection. Diaphragms and cervical caps may be difficult to insert, and atrophy
in the muscles surrounding the vagina can create problems with fit and efficacy. A partner can assist with insertion if you're
both comfortable with the situation. For reliability, spermicidal creams or jellies should be used with both methods.
Oral contraceptives that include estrogen present an increased risk of deep vein thrombosis (blood clots) for women with
spinal cord injury. For them, according to Dr. Sandra Welner, contraceptives containing only progesterone may be safer such
as the "mini-pill." Depo-Provera and Norplant are also possibilities, although there are growing concerns about erratic
bleeding. With Depo-Provera may also cause decreased levels of estrogen resulting in a loss of bone mass.
A condom in conjunction with a contraceptive jelly is still one of the easiest and safest methods of contraception, and it also
helps prevent sexually transmitted infections. Men with limited hand function may have difficulty putting on a condom but
once again, a partner can help. More permanent surgical options are tubal ligation and vasectomy. To choose the best and
safest method, consult a health care professional familiar with spinal cord injury or look in the phone book for your local
Planned Parenthood office.
--Mitch Tepper
Reviewed by Sexual Health Editorial Team
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