Take Matters in Hand

How can I find out if my penis still works and if I can have sex? I am 25 years old and they tell me I am paraplegic.

Your question is probably the second most frequently asked after “Will I be able to walk again?” following spinal cord injury.
The first step, is to establish a post-injury base level of sexual function and the most natural manner to discover this is masturbation. The new base level is then compared with pre-injury sexual function and projected forward in short, medium and long term goals.

Masturbation is something people don’t talk about but almost everyone does. In the Kinsey reports of 1948 Alfred C. Kinsey reported: “There are no other sexual activities which involve anywhere near so many individuals as are involved in heterosexual coitus and masturbation ... no other activity which provides so large a proportion of the total orgasms which the average male experiences in a lifetime.”

In recent European national surveys 95% of males and 89% of females reported that they had masturbated. Gloria Brame Ph.D, a clinical sexologist reported: “It’s a fundamental aspect of men’s health, right up there with brushing your teeth. And the more you know about what satisfies you solo, the more pleasure you get from sex.” She continued: “It relieves stress and keeps everything about your body – your heart rate, blood pressure, reproductive system, brain chemistry – in very good shape.”Australian research (2003) found that males who frequently masturbated had a lower probability of developing prostate cancer with men who averaged five or more ejaculations weekly (in their 20’s) at significantly lower risk. Female masturbation can also provide protection against cervical infections by increasing the acidity of the cervical mucus by moving debris out of the cervix.

Masturbation flushes out old, low motility sperm from the male genital tract. The next ejaculate then contains more fresh sperm, providing a greater chance of conception. (Low sperm motility is a common but yet-to-be explained factor in males with SCI).

Masturbation is the self-stimulation of the genitals to achieve sexual arousal and pleasure, usually to the point of orgasm, via touching, stroking or massaging the penis or clitoris until an orgasm is achieved. It is a normal and healthy sexual activity that is pleasant, fulfilling, acceptable, and safe.

And with Paraplegia?

As a paraplegic you should have adequate hand function to find your own answer to the question of sexual ability. I assume that your bladder control is by intermittent catheterization or that you have unaffected bladder function due to an incomplete spinal lesion. (In the unlikely event that you have an indwelling urethral catheter, masturbation can become somewhat problematic if not impossible.)

First, achieve an erection through psychogenic messages from the brain and reflexogenic manual stimulation of the penis (see Rolling Inspiration May/June 2010.) You can masturbate to find out if your penis remains rigid enough for orgasm and ejaculation. If this leads to orgasm and ejaculation you can resume sexual intercourse with your partner, perhaps with some minor changes in sexual positions due to your decreased mobility. This does not mean that you have to stop masturbating.Some SCIs are able to achieve ejaculation with masturbation even when ejaculation does not occur with intercourse.

To enhance pleasure, and produce stronger ejaculation, use penile vibratory stimulation (PVS) while masturbating.

This involves the application of a vibrator to the Corona frenulum trigger, a Y-shaped connecting membrane on the underside of the penis, that connects the foreskin to the glans (head) of the penis.

Some specially designed vibrators provide variable amplitude and velocity, but can be expensive and noisy. I have found a number of cheaper vibrators in adult stores with variable speed that work just as well for this purpose.

A word of caution on the use of vibrators – some SCIs may suffer symptoms of Autonomic Dysreflexia.

It Sounds so Self-Indulgent

Mutual masturbation, when two or more partners stimulate themselves in the presence of each other, allows a couple to reveal the map to their pleasure centers. By watching your partner masturbate, you discover the methods that they use and how they enjoy being touched. Mutual masturbation allows couples to enjoy each other and experience sexual release as often as they need.

An Apple a Day

In closing a leaflet was published in the UK last year by the NHS in Sheffield carrying the slogan, “ An orgasm a day keeps the doctor away”, it also said: “Health promotion experts advocate five portions of fruit and veg a day and 30 minutes’ physical activity three times a week. What about sex or masturbation twice a week?”

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