Sexual Behaviour

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  1. Frequency of sexual activity and desire for sexual activity decrease after injury in both men and women (Alexander et al. 1993; White et al. 1993; Jackson & Wadley 1999; Fisher et al. 2002, Lysberg & Severinsson 2003; Cardoso et al. 2009; Julia & Othman 2011; Kreuter et al. 2011).
  2. Fisher et al. (2002) showed a significant increase in sexual activity between discharge from inpatient rehabilitation and 6-months later, while no further changes were found in the remaining 18 month followup and they suggested that the first 6 months post-discharge are optimal for sexual health interventions.
  3. For women with SCI, psychological barriers to engaging in sexual activity include: feeling unattractive, low self-esteem, low sexual desire, lack of confidence in sexual ability and ability to satisfy a partner, and difficulty meeting a partner (Julia & Othman 2011; Kreuter et al. 2011; Kreuter et al. 2008).
  4. Physical problems women with SCI cite as barriers to sexual activity include: impaired genital sensation, difficulty with positioning oneself, bowel and bladder problems, and vaginal lubrication (Julia & Othman 2011; Kreuter et al. 2011).
  5. For women, longer duration of injury and lower level of injury (not extent of injury) were significant positive predictors of participation in sexual intercourse (Jackson & Wadley 1999).
  6. For men, level and extent of injury have not been found to affect frequency of sexual activity (Alexander et al. 1993).
  7. The preferred type of sexual activity for men and women changes after injury. Preferred activities for women are kissing, hugging and touching, instead of penile-vaginal intercourse (Sipski & Alexander 1993) and for men, oral sex, kissing and hugging (Alexander et al. 1993).
  8. Males reported engaging in masturbation significantly more often than females whereas females indicated being involved in intimate touching more often than males (Mona et al. 2000).
  9. Males with SCI used condoms during penile-vaginal intercourse more often than females with SCI with their male partners.  More females with SCI used condoms during oral sex behaviour with their partners compared to males with SCI (Mona et al. 2000).
  10. Both women and men remain interested in sexual activity after SCI, but level of desire decreases (Charlifue et al. 1992; Alexander et al. 1993; Julia & Othman 2011).