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Changes usually occur in a person's sexuality after a spinal cord injury, but many people with a spinal cord injury (SCI) are able to have satisfying sex lives. Damage to the spinal cord impairs its ability to transmit messages between the brain and parts of the body below the level of the lesion. This results in lost or reduced sensation and muscle motion, which can impair sexual function. Impairments can include loss of ability have an orgasm, to get an erection, to ejaculate, or for the vagina to become sufficiently lubricated. Sexual dysfunction can also result from more indirect effects, such as pain and side effects of medications, or psycho-social effects including depression and altered self-image. However, many people with SCI report satisfaction with their sex lives, and many experience sexual arousal and orgasm. Neural plasticity may account for increases in sensitivity in parts of the body that have not lost sensation, so people often find newly sensitive erotic areas of the skin in erogenous zones or near borders between areas of preserved and lost sensation. People with SCI employ a variety of adaptations to help carry on their sex lives healthily, including changes in the types of sexual acts they engage in and the areas of the body they focus on. Treatments such as drugs, devices, and surgery exist to help men achieve erection and ejaculation. Although male fertility is reduced, men with SCI are still able to father children. Women's fertility is not usually affected, although special considerations must be taken for a safe pregnancy and delivery. People with SCI may also need to take special measures during sexual activity to deal with spinal cord injury effects such as weakness and movement limitations, and to avoid damaging skin in areas of reduced sensation. Education and counseling about sexuality can be a helpful and important part of SCI rehabilitation but is often missing or insufficient. ==Sexuality and quality of life== Spinal cord injury is extremely disruptive to sexuality, and it most frequently happens to young people, who are at a peak in their sexual and reproductive lives.〔 Sexuality includes not just sexual behaviors but also sex drive, relationships, self-image, reproduction, sexual orientation, and gender expression.〔 The importance of sexuality as a part of life is not diminished by a disabling injury.〔 Although for years people with SCI were believed to be asexual, research has shown sexuality to be a high priority and an important aspect of quality of life for people with SCI.〔〔 In fact, of all abilities they would like to have return, most paraplegics rated sexual function as their top priority, and most quadruplegics rated it second after hand and arm function.〔 SCI can cause insecurities surrounding sexual identity, particularly if the disability precludes fulfillment of societal taught gender roles, such as male sexual prowess.〔〔 Men who have strong sexual desire but who are not able to perform sexually may be at increased risk for depression, particularly when they believe strongly in traditional masculine gender norms with sexual function as core to the male identity.〔〔 SCI may necessitate a reappraisal of assumptions about gender norms and sexual function in order to adjust healthily to the disability; counseling can be helpful in this process.〔 Despite the fact that loss of sexual function can harm a person's self-esteem and reduce quality of life,〔 patients' needs for care dealing with sexuality and disability are often unmet by providers.〔 Like sexual activity, sexual satisfaction frequently decreases after SCI;〔 however as time goes by people usually adjust sexually, adapting to their new bodies.〔 Sexual satisfaction depends on a host of factors. Some of these are more more important than the physical function of the genitals. Sexual satisfaction depends on intimacy, quality of relationships, satisfaction of partners,〔 willingness to be sexually experimental, and good communication.〔 People are often as concerned about failing to keep their partner satisfied as they are about meeting their own sexual needs.〔 A catastrophic injury such as SCI can put strain on marriages and other relationships. Relationship stress and excessive dependence in relationships can increase risk of depression, while supportive relationships can be protective.〔 People with SCI do not get divorced more often than the rest of the population, but marriages that took place before the injury fail more often than those that took place after (33% vs. 21%). People married before the injury report less happy marriages and worse sexual adjustment than those married after, possibly indicating that spouses of people who were injured after marriage had difficulty adjusting to the new circumstances. For those who chose to become involved with someone after an injury, the disability was an accepted part of the relationship from the outset. 抄文引用元・出典: フリー百科事典『 ウィキペディア（Wikipedia）』 ■ウィキペディアで「Sexuality after spinal cord injury」の詳細全文を読む スポンサード リンク
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