anonymous on September 8, 2011

What kind of medication can help a paraplegic have sex?

My 34-year-old boyfriend has been a paraplegic due to spinal cord injury from the waist-down for seven years. He told me he’s able to perform sexually with the aid of medication. What type of medication could he be talking about?

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

Thanks for your question, and for being open to your boyfriend’s abilities after his spinal cord injury (SCI). While I’m happy to offer you some information about sex with someone who has SCI. Of course, I encourage you to speak with him about it directly, too.

Do all men with an SCI experience erectile dysfunction (ED)? Not necessarily.For men with SCI, the ability to have an erection often depends on where the spinal cord was injured (whether it was closer to the neck or closer to the tail-bone) and how complete the breakage was.

There are actually two types of erections that men can get. One originates in the brain when he’s visually excited by someone or something he sees – that’s called a psychogenic erection. The other type of erection is a reflex erection that occurs from physical stimulation.

Many men with SCI can still have a reflex erection as long as their sacral nerves haven’t been damaged, but men who have a complete spinal cord injury often have trouble with psychogenic erections.

Even if your boyfriend can have a reflex erection, ED can be an issue for many men with SCI. Luckily. there are several treatment options for ED. The most common and least intrusive treatments are phosphodiesterase inhibitors (PDE) – the type of medication that includes Viagra, Cialis and Levitra. These medications increase blood flow to the penis, which helps with erections…but a man still has to feel sexually interested for proper function.

So your boyfriend could have been referring to a PDE…but you’ll have to ask him to find out. And if he hasn’t already, it’s a good idea for him to talk to his doctor about this type of treatment so he fully understands its risks and benefits.

There are also other, more invasive treatments for ED, including penis injections, vacuum pumps or surgical implants.

Are there other options for satisfying sex without treatment? Absolutely. If you’re both willing to experiment and be creative, you can discover new ways to enjoy sex. You may even find sexual satisfaction without penetrative intercourse, relying instead on touching, caressing, vibrators, sex toys or other props to give each other sexual pleasure.

Again, trust and good verbal and non-verbal communication are key as you explore the possibilities within your boyfriend’s sexual functioning. I wish you both good sexual health.

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.

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