Sexuality and the Human Body
The Male Reproductive System
The male reproductive system includes the penis, testes, scrotum and prostate gland. These parts all play a role in allowing a man to father a child. They also allow a man to have sexual pleasure.
The penis has 3 major functions:
- Allows urine to pass out of the body
- Allows semen and sperm to pass out of the body during sexual intercourse.
- Sexual intercourse
The scrotum is a sac that houses the testes. Because the scrotum is sensitive to touch, pressure and temperature, it protects the testes. It also has nerve endings for sexual pleasure.
The testes are oval shaped organs, housed in the scrotum that produce sperm. The testes are located in the scrotum because sperm need a lower temperature than the rest of the body to stay alive. They also produce testosterone (male hormone) to allow for sex drive.
The Prostate Gland
The prostate gland is located below the bladder and provides a thin milky fluid that sperm swim in for protection and nourishment.
Male breasts are sensitive to touch and can be an area of sexual pleasure.
1. Can I still have children?
In the past, men with SCI were unable to father children. Today, there is a new method called electroejaculation. It causes an ejaculation so a doctor can then place the sperm in the woman. This is a type of artificial insemination. It works in about 30% of males with SCI.
Vibrostimulation has also been shown to increase ejaculation and fertility. Sometimes a SCI may change the body temperature in the scrotum and cause damage to the sperm. This decreases the number of healthy sperm able to fertilize an egg.
2. Can I still have erections?
First, it is important to know that there are two kinds of erections:
Psychogenic Erection: This kind of erection occurs as a result of the brain thinking about something sexual.
Reflexogenic Erection: This kind of erection is the result of direct stimulation of the penis. The brain does not control this. A full bladder or bowel may cause this type of erection.
If a man has a complete SCI above the L2 level, he will not be able to have a psychogenic erection. However, the desire and excitement you think about in the brain is the same as before injury.
However, most males with SCI can have a reflexogenic erection. This may happen when you want it to, but it may also happen when you don't want it to. This type of erection may not remain firm enough to complete sexual intercourse. The chance of having erections decreases with lower level injuries.
3. Is it possible to overcome erectile problems?
Yes. There are several approaches to working with erectile issues.
A device call the Osbon ErecAid is a vacuum pressure device that draws blood into the penis and allows the male to have an erection that lasts about 30 minutes. It is affordable and can be used often.
There are two types of surgeries that provide penile implants for men with SCI. They are called penile prostheses.
Some men with SCI take shots of prostaglandin E1 (alone or with other medicines) into their penis to have erections.
Ask your doctor about medicines such as Viagra.
Discuss your options with your doctor.
4. Can I still ejaculate?
Ejaculation is usually impaired in men with SCI. Sometimes the sperm go backwards into the bladder, or it may be weak or stop. This does not pose any medical danger to you.
5. Can I have an orgasm?
The ability to have an orgasm depends on the amount of sensation below the navel.
If feeling below the navel is absent, orgasm may not occur, however, the pleasure leading up to and after orgasm is likely to remain.
If you are unable to have an orgasm because of SCI, you usually will not feel the frustration as before your injury.
7. If I do ICs, is there anything I should do?
Yes. Be sure to to empty your bladder before and after having sexual intercourse. Limit amount of caffeine and alcohol before sex as it may cause urinary leakage.
REMEMBER: Good hygiene before and after sexual intercourse will help prevent a bladder infection.
8. Is there anything I should do differently about my bowel program? Wait two hours after finishing your bowel program before having sex. If the person who does your bowel program is also your sex partner, do not talk about sex during your bowel program. Talk about other topics instead.
9. What should I know about sexual positions?
"Anything you can do, you can do." Act safely to prevent falls, but otherwise sexual positions are up to you.