Paralysis Resource Guide - (Page 125) HEALTH MANAGEMENT FOR WOMEN Paralysis itself doesn’t affect a woman’s libido or her need to express herself sexually, nor does it affect her ability to conceive a child. Generally speaking, sexuality in the paralyzed female is less affected than in the male; it is physically easier for the woman to adapt her sexual role, even though it may be more passive than that of a non-disabled women. The main difference in sexual functioning between women with disabilities and those without can be accounted for by the difficulties women with disabilities have in finding a romantic partner. Their level of sexual desire may be the same, but the level of activity is less because fewer women with disabilities have partners. There are no physiological changes after paralysis that prevent women from engaging in sexual activity. Positioning can be an issue but can usually be accommodated. Autonomic dysreflexia can be anticipated and controlled. Many women experience a loss of vaginal muscle control and many are unable to produce vaginal lubrication. Both problems are likely the result of the interruption in normal nerve signals from the brain to the genital area. There is no remedy for muscle loss. Lubrication, of course, can be improved. Typically, lubrication occurs as a psychogenic (mental) and reflex (physical) response to something sexually stimulating or arousing. It has been suggested that lubrication in women is the physiological equivalent of the erection in the male, and is probably innervated in the same way. Women can substitute water-based (never use oil-based, such as Vaseline) lubricants such as KY Jelly. Low sex drive is common among women with paralysis; indeed, it is reported among all women. Meanwhile, Viagra has been clinically tested by a group of women with spinal cord injuries; almost all reported that the drug stimulated arousal. In some, it enhanced lubrication and sensation during intercourse. In some conditions of paralysis, such as multiple sclerosis, cognitive problems can undermine sexuality. People with short-term memory or concentration loss may drift off during sexual activities in a way that can be disheartening to the partner. It requires love and patience, with lots of communication, to bring this out in the open and to seek the needed psychological or medical treatment. 125
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