Barriers to sexual activity: counselling spinal cord injured women in Malaysia

Abstract

Study design: This study is a cross-sectional, face-to-face interview. Objectives: To examine the sexual activity in a sample of Malaysian women with traumatic spinal cord injuries (SCIs), identify the physical and psychological barriers to it, and explore their experiences with sexual counseling and rehabilitation. Setting: This study was conducted at the Spinal Rehabilitation Unit of a teaching hospital. Methods: All women who attended scheduled check-ups, over 1 year, and who met the inclusion criteria (age above 18 years, spinal injury of traumatic aetiology, living in the community and having completed the rehabilitation) were consecutively included in a face-to-face interview using a selfconstructed questionnaire. Sociodemographic and disability-related variables, barriers to sexual activity/ satisfaction and experiences of sexual rehabilitation services were obtained. Results: During the study period, 33/36 subjects were recruited. Although 67% indicated interest in sexual activity, only 24% was sexually active. The frequency of sexual activity declined after the injury, from 4.6 times per month to 1.5 times per month. Feeling unattractive, unable to satisfy the partner and less confident about sexual ability were top three psychological barriers to sexual activity, and the top three physical barriers were impaired genital sensation, positioning and vaginal lubrication. In all, 50% received some sexual information during rehabilitation. Rehabilitation professionals were expected to initiate sexual counseling by 62.5% of subjects. Conclusion: The effect of SCIs on sexual function is tremendous. Sexual counseling services must be improved and take into account the impact of psychological factors.

Sexual activity and sexual satisfaction in Korean men with spinal cord injury

“…6,7 However, to our knowledge, no previous formal academic study has described the overall current state of sexuality and sexual satisfaction among Asian men with motor complete SCI. In the present study, 62.7% of the participants were SA.…”

“…2,3 However, despite this impact, the sexual activity of individuals with SCI has largely been neglected as a focus of research and is one of the most unmet needs for this group of individuals. 4,5 In particular, although the sexual activity and coping strategies of people with SCI will likely be diverse across cultures because of cultural differences, 6,7 little research has been published regarding the sexuality of individuals with SCI, particularly in East Asia. In one of the few studies addressing this issue for an Asian population, a comparative investigation of the life satisfaction between long-term survivors of SCI in Sweden and Japan found that the percentage of sexually active (SA) males engaged in sexual intercourse was significantly lower in Japan than in Sweden, and also observed an absence of sexual counseling for disabled people in the former country.…”

A clinical trial report of autologous bone marrow-derived mesenchymal stem cell transplantation in patients with spinal cord injury

“…Previous studies have shown that 60–70% of SCI patients desired sexual relations (10); however, in China, patients remained reluctant to discuss their sexual health issues due to cultural traditions. As a consequence of this cultural taboo, a full assessment of erectile issues was not completed; however, the information from the limited number of individual SCI patients willing to discuss this subject was assessed.…”

Sexual satisfaction in women with spinal cord injuries

“…The related factors that we found in our study are not having a stable partner and the lack of sensation in the genital area, results that agree with the literature published to date. 6,10 Important factors in SCIs, such as the neurological level, ASIA or SCIM scores, age, time since SCI, urinary incontinence, chronic pain and spasticity, were not found to be related to sexual satisfaction.…”

“…4,5 In contrast, their sexuality undergoes changes due to urinary or intestinal incontinence, spasticity, pain or difficulty maintaining social relations, 6 which frequently lead to a reduced desire for 7 and frequency of sexual relations. 8 It is worth emphasizing that in recent years more studies on sexual disorders in women with SCIs have emerged, although the literature remains highly limited on this topic.…”