Anonymous on September 8, 2011

After my injury, I’m afraid of incontinence during oral sex...any suggestions?

I am a female C5-7 quad. Before my injury, my boyfriend frequently performed oral sex on me, which I enjoyed. Since my injury, we have not had oral sex because I am afraid of incontinence and am not sure how I will respond in terms of how it will feel, spasticity, name it. Any suggestions?

answered by Mitchell Tepper, PhD, MPH on September 8, 2011

I’m glad you asked this question. Adjusting to life after a serious injury like yours can be difficult. In addition to learning how to accomplish life tasks like grocery shopping and getting to work, it also means figuring out how to enjoy sex again. The good news is that many women with spinal cord injury (SCI) can still have a fulfilling and rewarding sex life.

Women with SCI often enjoy direct clitoral stimulation…by tongue, fingers, sex toy, etc.That said, the sensations you feel may be different from what you remember pre-injury.

Also keep in mind that, after SCI, it may take longer to orgasm. Why? Because the injury affects nerve pathways…plus, medications can also mute your level of sexual excitement and pleasure. In other words, be prepared (and prepare your partner) to spend more time on the process.

The best way to find out if you still like oral sex? Try it. There’s no way to know how you’ll respond to oral sex after SCI until you give it a shot. It might work well to approach this time with your partner as a learning experience…stay open to what happens and keep the lines of communication open.

About’re not alone. That’s a concern shared by many women with SCI. You may be able to reduce the risk of incontinence by simply not drinking many liquids before you have sexual activity – what doesn’t go in, can’t come out. Also, empty your bladder before sex, and avoiding alcohol and caffeine can help. If you have a catheter, remember that it’s generally safe to keep your catheter in during sexual activity, but talk to your doctor to make sure the type you have is safe to leave in place.

As for spasticity…research shows that between 65-78% of people with a chronic SCI experience some level of spasticity. Talk to your doctor about your level of spacticity and what treatments might make sense for you – from physical therapy, to medications, or even surgery in severe cases.   

While some of these suggestions inhibit the spontaneity of sexual activity a bit, being prepared can make all the difference. I wish you and your partner as you explore oral sex after SCI.

Related info:

Mitchell Tepper, PhD, MPH

Dr. Tepper directs sexual health education at An AASECT-certified sexuality educator and counselor, his areas of expertise include sexual dysfunctions, sexuality following disability or illness, pleasure and orgasm, relationships, and military and veteran couples' counseling. Dr. Tepper was educated at the University of Pennsylvania and Yale University.

Related Q&A's

What kind of medication can help a paraplegic have sex?
My partner’s spinal chord injury makes me feel self-conscious...what are some ways we can bring equal pleasure into the bedroom?
Are couples with one disabled partner more likely to get divorced?