Effects of level and degree of spinal cord injury on male orgasm

Abstract

Design: Controlled, laboratory-based analysis. Objective: To determine the impact of spinal cord injuries (SCIs) on the ability to achieve male orgasm. Setting: US academic medical center. Methods: A laboratory-based analysis of the ability of 45 men with SCIs and 16 able-bodied control subjects to achieve orgasm coupled with a detailed neurologic examination, history and physical examination, and administration of the International Index of Erectile Function. Results: Men with SCIs were less likely than controls to achieve orgasm. Mean latency to orgasm, blood pressure and heart rates at orgasm were not significantly different between controls and SCI subjects. Men with incomplete SCIs were more likely to achieve orgasm than those with complete SCIs. A disconnect was noted between the presence of orgasm and the presence of ejaculation. Men with complete lower motor neuron dysfunction affecting their sacral segments were less likely to achieve orgasm than men with any other patterns of SCI. Conclusion: These results document the ability of men with complete SCIs to achieve orgasm. Characteristics of orgasm in men with SCIs as compared to able-bodied subjects are similar. Although orgasm and ejaculation are more likely to occur together, a number of men with SCIs achieve orgasm without ejaculation. Further research should explore the possibility of retraining ejaculatory and orgasmic responses in men with SCIs.

Neuroanatomy and neurophysiology related to sexual dysfunction in male neurogenic patients with lesions to the spinal cord or peripheral nerves

“…Its appearance is not related to the level of the lesion and is the result of cerebral processing of peripheral and central impulses. 26 Besides a decreased latency for orgasm 7 little is known about orgasms in male patients with spinal lesions, the discussion on the neuroanatomy is out of the scope of this publication.…”

Premature ejaculation associated with lumbosacral lesions

“…Observation of dribbling ejaculation in men with lumbosacral lesions is not surprising, given the impaired innervation of the perineal muscles responsible for expulsive ejaculation, which has been described by authors in the early literature. 3,4,9 Complaints of anhedonic or non-climatic ejaculation, or lack of orgasm in men with lower motor neuron lesions has been described elsewhere 17 and is unsurprising given that these patients have lost sensation caudal to the lesion, in particular from their genitals. Lost climactic sensation during ejaculation might also be explained by the fact that these men with lumbosacral lesions cannot experience even mild autonomic hyperreflexia which has been associated with climactic responses in men with SCI.…”

Sildenafil in women with sexual arousal disorder following spinal cord injury

“…Similar findings were noted in men. 7 Sildenafil citrate was the first approved selective phosphodiesterase type-5 inhibitor and has been successfully used to treat erectile dysfunction in men with SCIs. [8][9][10] Because a laboratory-based pilot study determined that sildenafil use was associated with significantly improved subjective sexual and genital arousal in women with SCIs, 11 a 12-week randomized controlled trial was conducted in women with female sexual arousal disorder (FSAD) as a result of SCI (paraplegia/tetraplegia).…”