How Spinal Cord Injury Impacts Male Sexuality

If you’re a man with a spinal cord injury (SCI), the impact on your sex life depends on the location and severity of your injury. Explore the facts about sex centers in the spinal cord.

How SCI Impacts Male Sexuality

Get help understanding how SCI affects male sexual performance.

It’s natural to feel overwhelmed as you grapple with the impact of your spinal cord injury (SCI) on your sex life. But, the more you learn about your spinal cord and how it affects your sexual performance, the more in control you’ll feel.

Let’s start with the basics…

Spinal cord 101

The spinal cord is a complex and delicate bundle of nerves and tissues. It has four sections: cervical, thoracic, lumbar, and sacral. Each section of your spinal cord controls different body functions. Within each section are many individual bones, called vertebrae. 

When you discuss the spine with your doctor, he or she may use medical abbreviations, such as “T11,” which stand for thoracic vertebrae in the eleventh spot. 

Sexual centers in the spinal cord

The spinal cord has two areas that impact erections (see below). Exactly how they affect erections depends on the location of your injury. It also depends on whether you have total or partial loss of function below the SCI (i.e., a “complete injury” or an “incomplete injury”). With incomplete injuries, individual cases must be considered, since there are many possible variations.

There are two different types of erections, and either one or both may be impacted by your injury. Psychogenic erections come from your brain when you see, smell, or hear something that triggers sexual excitement. Reflex erections come from direct stimulation of the penis.

Spinal cord center for psychogenic erections: The parts of the spinal cord labeled T-11 to L-2 (see image) affect these erections. Some facts:  

  • If these sections are mainly intact, you may be able to get an erection from mental stimulation
  • If you have an injury below L2, you’ll likely be able to get this type of erection
  • These erections can be long lasting, but often are not hard or large enough for penetration


Spinal cord center for reflex erections: The parts of the spinal cord labeled S-2 to S-4 (see image) impact this type of erection. Some facts:

  • If this center is intact, impulses from penis stimulation may cause an erection
  • If your injury is above S2, you may be able to have this kind of erection. However, the nerve fibers below S2, such S2 through S5, must be intact and working correctly.
  • Reflex erections are often large and stiff enough for penetrations, but they may not last long. Repeated stimulation might be needed.


Injuries above L-2

Injuries below S-2 to S-4

What does it impact?

Psychogenic erections (mental)

Reflect erection (stimulation)

What has changed

You’re not likely to get an erection coming from messages from the brain, but depends on whether your injury is complete or incomplete.

You’re not likely to get an erection from physical stimulation, but depends on whether your injury is complete or incomplete.

What hasn’t changed

Providing the areas between S-2 to S-4 is not injured, you may still be able to get an erection from physical stimulation.

Providing the areas between T-11 and L-2 are not injured, you may still be able to get an erection from mental images, sounds, or smells.

What can I do about it?

Focus on physical stimulation. The use of vibrators, sex toys, and constrictive penis rings to increase blood flow may help.

Focus on mental stimulation. You can also ask your partner to help you get aroused with sights, sounds, and smells that arouse you.

What else can help?

See your healthcare provider for medications or mechanical aids to help you achieve an erection.

See your healthcare provider for medications or mechanical aids to help you achieve an erection.

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What it all means

Be encouraged by the fact that many men with a spinal cord injury can get some type of erection. Depending on your specific injury and the location on your spine, your erections may come from your brain, or right from the source. Your medical team may be able to help you overcome your limitations. Medication or a mechanical aid might help you get back to a healthy and gratifying sex life.