Here is sexuality for men on the Christopher Reeve's website. http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5917433/apps/s/content.asp?ct=5865547 http://www.christopherreeve.org/site/c.mtKZKgMWKwG/b.5917433/apps/s/content.asp?ct=6769155
Sexual function is a major concern of men with paralysis. Men wonder if they can "do it" or whether sexual pleasure is a thing of the past. They worry that they can no longer father children, that mates will find them unattractive, that partners will pack up and leave. It is true that, after disease or injury, men often face changes in their relationships and sexual activity. Emotional changes occur, of course, and these can affect a person’s sexuality. It is important to note that healthy sexuality involves warmth, tenderness, and love, not just genital contact. Still, erections and orgasms are the top issues after paralysis. Normally, men have two types of erections. Psychogenic erections result from prurient sights or thoughts and depend on the level and extent of paralysis. Men with complete parlaysis usually do not have psychogenic erections. A reflex erection occurs involuntarily by direct contact with the penis or other erogenous zones (ears, nipples, neck). Most paralyzed men are able to have a reflex erection unless nerves in the sacral spinal cord (S2-S4) are damaged. Orgasm after paralysis is possible for some men but it is often not the same as it is usually defined. It can become less physical, less focused on the genitals and more a state of mind. It is important to know that loss of sensation does not rule out loss of sexuality. While many men who are paralyzed can still "get it up," the erection may not be hard enough or last long enough for intercourse. Numerous treatments (pills, pellets, shots and implants) are available for treating erectile dysfunction (ED). Be sure to see your doctor for accurate information on the various options. The best-known clinical treatment for ED, Viagra (sildenafil), improves the quality of erections and sexual activity in many paraplegic men. There is some clinical evidence that men with MS benefit from Viagra. Men with blood pressure issues (high or low) or vascular disease should avoid this drug. Other newer medications that purport to surpass the efficacy of Viagra include Cialis and Levitra. They may have beneficial effects for paralyzed men but no clinical data is available. Another erection option involves injecting a drug (papavarine or alprostadil) into the shaft of the penis. This produces a hard erection that can last for an hour or more. Caution: these drugs can result in priapism, a prolonged erection that can damage the penis. Injection erections can also cause bruising, scarring or infection and may not be the best option for those with limited hand function. A medicated urethral suppository is another option. A drug pellet (containing alprostadil) is placed into the urethra, causing blood vessels to relax and fill the penis with blood. This might be an alternative for the 30-40 percent of men who fail with Viagra. Vacuum pumps are a non-invasive, non-drug way to produce an erection. The penis is placed in a plastic cylinder; as air is pumped out, blood is drawn into the penis. Hardness is maintained by placing an elastic band around the base of the penis. This produces a bluish looking erection that may also be cold to the touch. Be sure to remove the band after 30 minutes to avoid skin irritation. Medicare and insurance companies often pay for these devices (you need a prescription though), including a battery-operated model best for those with limited hand function. A penile prosthesis (a semi-rigid or bendable rod or inflatable device) is another choice, but because it is permanent and requires surgery, it is carries a higher risk for complications than other options. Surgery can cause bleeding, infection, or allergic reaction to anesthesia. Following a routine outpatient procedure, a four to eight week recovery period is necessary before the implant can be used. The device itself, especially the more complex inflatable units, can malfunction or become damaged. Ejaculation and fertility are also major issues facing men with paralysis. Men want to know, can I still father children? Ejaculation is not always possible but there are ways to retrieve viable sperm. A vibrator is an inexpensive and fairly reliable tool to produce an ejaculation at home or in a clinical setting. Rectal probe electroejaculation is an option (albeit in a clinic with several technicians around) if the vibratory method is not successful. Borrowing from animal husbandry, electroejaculation places a probe in the rectum; a measured electrical stimulation produces an ejaculation. Once sperm are collected they can be used in various means of artificial insemination, including in vitro techniques and micromanipulation. Sometimes the retrieved sperm are healthy but not strong swimmers, and not hardy enough to penetrate the egg. Because of their reduced motility, the sperm need a little high-tech help. The recent development of intracytoplasmic sperm injection (ICSI), which involves the direct injection of a single mature sperm into an oocyte (egg), can often lead to conception. There are lots of success stories but high-tech, assisted fertility is not a slam-dunk. It can be emotionally draining and also quite expensive. Get the facts and treatment options from a fertility specialist experienced in issues of paralysis. Some couples grappling with infertility have successfully utilized donor sperm (from a sperm bank) to impregnate the woman. Couples may want to explore the very rewarding options available to adopt children. Sex after stroke: Heart disease, stroke or surgery doesn't mean that a satisfying sex life must end. After the first phase of recovery is over, people find that the same forms of lovemaking they enjoyed before are still rewarding. It is pure myth that resuming sex often causes a heart attack, stroke or sudden death. Still, fears about performance can greatly reduce sexual interest and capacity. After recovery, stroke survivors may feel depressed. This is normal, and in 85 percent of the cases it goes away within three months. To be sure, a man can continue or initiate a romantic and intimate relationship with a partner after a paralyzing disease or injury, but it’s important to discuss physical issues and feelings and to feel free to explore new ways to express intimacy. Whatever seems satisfying and pleasurable is OK as long as both partners agree. While it's been said that the largest sex organ is the brain, it's not always easy to make major adjustments in one's sexual persona. Professional counseling can help in working through feelings of fear or anxiety over establishing or continuing a healthy relationship after paralysis. Safe sex: The risk of sexually transmitted disease (STD, including gonorrhea, syphilis, herpes and the HIV virus) is the same after paralysis as it was before. Prevent sexually transmitted diseases by using a condom with a spermicidal gel. --- On Thu, 5/6/10, jeff bernier <[email protected]> wrote: From: jeff bernier <[email protected]> Subject: [TMIC] just wondering To: [email protected], [email protected] Date: Thursday, May 6, 2010, 5:12 PM im sure some on the list may find this offensive and to you i appologise,but i think it is a legitimate question,can somone with paraplegia still be able to achieve an erection or be able to experience ejaculation,again im not trying to offened anyone,but im looking for answers. DIPLOMACY DOES NOT WORK WHEN DEALING WITH NUT'S HELL BENT ON DESTROYING US.
