Table 21: Systematic Reviews on Sexual Behaviour
- 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.
- 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).
- 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; Otero-Villaverde et al. 2015).
- 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). 5. For men, level and extent of injury have not been found to affect frequency of sexual activity (Alexander 1993).
- 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).
- 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).
- Males with SCI used condoms during penile-vaginal intercourse more often than females with SCI with their male partners. (Mona et al. 2000).
- Both women and men remain interested in sexual activity after SCI, but level of desire and activity levels decrease (Charlifue et al. 1992; Alexander et al. 1993; Julia & Othman 2011; Miranda et al. 2016 (Alexander 1993; White et al. 1993; Jackson & Wadley 1999; Fisher et al. 2002, Lysberg & Severinsson 2003; Cardoso et al. 2008; Julia & Othman 2011; Kreuter et al. 2011).