Sex Part Three: Answers to the Questions I Had When I Was Newly Injured

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Feb 09, 2023 | by Kayley Lawrenz

Welcome back to this series on sex after spinal cord injury (SCI). I am thrilled that you chose to read part three of this series. As I mentioned in the first part of this series, I will now discuss autonomic dysreflexia.

Sex and autonomic dysreflexia

Sexual activity has the potential to cause autonomic dysreflexia.

Suppose you have an SCI at or above the T6 level (Thoracic vertebrae). In that case, you will likely experience autonomic dysreflexia due to normal body functions (e.g., needing to urinate) or stimuli to areas of the body below the level of your SCI.

If or when autonomic dysreflexia develops during sexual intimacy and genital penetration, you should take these steps:

  1. Stop engaging in the sexual activity causing autonomic dysreflexia and place yourself in an upright position to reduce your blood pressure. You should also remove any tight clothing you may be wearing and make sure your body is not sitting on something causing uncomfortable pressure.
  2. If the autonomic dysreflexia does not begin to stop after taking the first step, you should monitor your blood pressure and empty your bladder.
  3. If the autonomic dysreflexia still has not subsided, you should call 911 and inform them of what is happening. You may require emergency medications to lower your blood pressure.
  4. If after medication your autonomic dysreflexia does not subside, your medical team should begin investigating other things that may be causing the autonomic dysreflexia, such as pressure points or bowel issues.

I have experienced mild and severe autonomic dysreflexia while engaging in sexual intimacy. I often experience mild dysreflexia when I first begin engaging in penetrative sexual intimacy, but it usually subsides once I am warmed up and fully lubricated. When it does not subside, I often start to feel pain accompanied by it (I have some sensation in my genitals). So, I stop or tell my partner that what they are doing is painful. If I begin experiencing severe autonomic dysreflexia, I immediately stop what we are doing.