The brain plays a large part in the ability of ejaculate, and in SCI the brain – penis connection is lost. Thus ability to ejaculate return less frequently, although some men experience a `phantom orgasm’, without ejaculation, when their partner reaches orgasm. However, many do have an orgasm with ejaculation through the use of vibrator. Finally, as everybody knows, ejaculation is only one reflex part of the orgasm and the rest is in the mind. A number of SIPS are capable of fathering children. Sperms can be obtained, if ejaculation can’t be produced by normal masturbation, by the use of a powerful vibrator applied to the gland penis, or by electro-ejaculation, involving the introduction of electrodes into the rectum under anesthesia. The semen may then be introduced into the partner’s vagina using AID/AIH equipments or a simple rubber tube – a technique which couples may learn to carry out for themselves without difficulty.

There is a considerable amount of research at present being conducted in the field of fertility of SCI.

For women however the essential sexual functions are unaltered, though there may be a decrease in lubrication of the vagina and they may have little or no sensation on the clitoris. In case of women the fertility is not affected by spinal injury, the periods may cease for a while after the injury but they would resume as earlier. They are fertile and thus women should think about contraception if in a sexual relationship.

Autonomic Dysreflexia If one has a high lesion, sexual activity and especially ejaculation may bring on autonomic dysreflexia. If this happens, one should stop immediately, check all possible causes, sit upright if you have been laying down, and do not hesitate to call the doctor if any symptoms persist. Sublingual Nifadipine in emergency.