Term Paper: Sexual Health Is Not Restricted

Pages: 14 (4272 words)  ·  Bibliography Sources: 1+  ·  Level: College Senior  ·  Topic: Anatomy  ·  Buy This Paper


[. . .] Patients given a collar by ambulance personnel or on arrival at hospital do not necessarily have a broken neck. These collars are placed as a precaution in all patients until exams show the absence of spinal injury. Other (more comfortable) collars are used to support the neck during recovery these collars are more comfortable. (Quencer & Hawighorst, 2001)

Surgery is often required to stabilize a fracture. There are several systems in use by surgeons but the operation may involve inserting metal plates and screws to support the injured spinal column. (Johnston, 2001) Bed Rest and traction devices are non-invasive options that allow the fracture time to heal. Better Practice Guidelines are available on a number of health related issues. These guidelines are compiled with the assistance of expert advice and research on the topics under scrutiny.

Among males, erectile and ejaculatory functions are activities that require the interaction between the vascular, nervous and endocrine systems. An erection is controlled by a reflex arc that is mediated in the sacral spinal cord. Ejaculation signals the culmination of the male sexual act and is primarily controlled by the sympathetic nervous system. Similar to the sympathetic innervation of the bladder, these fibers originate in the thoraco-lumbar spinal cord and travel into the sympathetic chain. These fascicles then travel through the splanchnic nerves into the hypogastric plexus. After synapsing in the inferior mesenteric ganglion, postganglionic fibers travel through the hypogastric nerves to supply the vas deferens, seminal vesicles and ejaculatory ducts in the prostate. (Bancroft, 1989)

Adaptation to an SCI is a gradual process that extends over a prolonged period of time. Successful sexual adjustment is influenced by many factors such as age at time of injury, quality of social supports, physical health, gender and severity of the injury. It is suggested to the sufferer to achieve as quick a closure as is possible so the quality of life can be nurtured and developed. Attempts to recapture the past sexual proclivities and habits are general detrimental. The patients are counseled to learn new sexual abilities.

The effect of spinal cord injury on sexual response is depends on the degree of completeness or incompleteness of the patient's injury and whether the neurological damage affecting the individual's sacral spinal segments is an upper or lower motor neuron injury. Whether a spinal cord injury is considered complete or incomplete is determined by whether they have voluntary rectal contraction and whether they have the ability to perceive sensation around their rectum.

Previous research suggested that female sexual function would be affected similarly to male sexual function in that psychogenic and reflex lubrication will be maintained in a comparable fashion to males, depending on the level and degree of the woman's spinal cord injury. Recent laboratory-based research performed supports the hypothesis that women with complete spinal cord injuries and upper motor neuron injuries affecting the sacral spinal segments will maintain the capacity for reflex lubrication while losing the capacity for psychogenic lubrication (Sipski, Rosen, & Alexander, 1995).

Also, in women with incomplete injuries and upper motor neuron injuries, research indicates the preservation of the ability to perceive pinprick sensation in the T11-L2 dermatomes may be able to be used as a predictor for the ability of psychogenic lubrication. Similar to male sexual functions, females with spinal cord injury have been shown to have the capacity to achieve orgasm approximately 50% of the time, and this has not been found to be related to the degree of injury. This has also recently been confirmed via laboratory-based research (Cooper, 1995) Lesions of the orbital parts of the frontal lobes may remove moral-ethical restraints and lead to indiscriminate sexual behavior, and that superior frontal lesions may be associated with a general loss of initiative which reduces all impulsivity, including sexual. During the acute rehabilitation phase, a sensitive discussion regarding sexuality is appropriate. The person with SCI may inquire about issues such as dating, attractiveness, relationships, parenthood and physical appearance. Other topics of interest may include erections, lubrications, sensation, orgasm, ejaculation and fertility. Many individuals will inquire about sexuality as it related to bladder and bowel function. Even if the patient does not initiate discussions about these topics, it is important for members of the rehabilitation team to provide basic information.

Women with spinal cord injuries suffer from temporary loss of their menstrual periods after their injuries lasting about four to six months. Resumption of periods occurs similar to their previous fashion. Menstrual pain is still present after spinal cord injury and there is generally not a decrease in the ability of a woman with a spinal cord injury to conceive. For this reason, the need to use birth control must be emphasized with women who have spinal cord injuries.

For those women who become pregnant after spinal cord injury are liable to suffer potential complications associated with pregnancy and spinal cord injuries. These can include anemia, problems with transfers due to weight gain, urinary tract infections, pressure sores, and, most significantly, autonomic dysreflexia, which frequently occurs during labor in women with injuries above the level of T6. This is often confused with preeclampsia. There is an increased risk of caesarean section in women with spinal cord injuries; however, more recent works have not shown this increased incidence.

The issue of birth control can give rise to problems for women with SCI. Condoms provide contraception as well as diminish the risk of transmission of sexually transmitted diseases. Hand coordination is important in instances of using contraceptive methods, e.g. diaphragm. Oral contraception is associated with increased incidence of thrombo-embolism and must be prescribed with caution in women with SCI. Oral contraceptives that contain only progesterone may be safer than medications that contain both estrogen and progesterone. IUD (intra-uterine devices) may be associated with increased incidence of pelvic inflammatory disease (PID). Untreated PID may lead to autonomic dysreflexia. In addition, women with SCI may not be able to perceive if the devise has migrated out of the cervix. (McDonald & Fish, 2002)

Immediately after SCI, 44 to 58% of women suffer from temporary amenorrhea. (Berezin et al., 1989) As mentioned earlier, while menstruation usually returns not soon after injury, the level and completeness is not correlated with the interruption of menstrual cycles. In a few of women with SCI, there are also changes in cycle length, duration of flow, amount of flow and amount of menstrual pain. Most women with SCI are fertile.

Pregnant women with SCI have an increased risk of urinary tract infections, leg edema, autonomic dysreflexia, constipation, thrombo-embolism and pre-mature birth. Since uterine innervation arises from the T10 to T12 levels, patients with lesions above T10 may not be able to perceive uterine contractions or fetal movements. During the second and third trimester, pregnant women may have difficulty in performing functional tasks that were previously completed independently. Transfers may require the assistance of a caregiver and a power wheelchair may be necessary for mobility. Locating an obstetrician and anesthesiologist with a supportive attitude, an accessible office and experience in SCI are additional inconveniences.

Spinal Cord Injury does not interfere with a woman's ability to become pregnant. The menstrual cycle is controlled by the hormonal systems inside a woman's body and these are unchanged after SCI. The decision to have a child is a serious one no matter whether you are able-bodied or disabled. Women should be counseled to accept difficulties, inconveniences and lifestyle changes during pregnancies. Achieving closure and rationalizing the disability is the best way to approach pregnancy. One cannot expect to recapture pregnancy features of an able-bodied person. (Melnyk, Montgomery, & Over, 1979) Therefore, women who do not wish to become pregnant must also ensure that they use proper birth-control techniques.

Would be mothers with SCI have to keep important consideration in mind: Women need to have the right information and a good understanding before, during and after the pregnancy. A pregnancy support team (doctor, obstetrician, nurse, or midwife) that are also trained in spinal cord injuries and the special considerations for pregnancy, labor and delivery with an SCI. In every aspect of the pregnancy, the partner or labor support person has to be well informed about SCI and labor and delivery, and should be able to provide comfort and act as an advocate when necessary.

Mobility is significantly impaired. As the pregnancy progresses it has implications for many aspects of your personal care and mobility. Washing, dressing, transferring and driving are affected. Planning for any additional care and carrying out day-to-day activities is essential. Increased size and weight can make weight shifts more difficult and increase the pressure on your skin at the same time. (Schurch, Curt, & Rossier, 1997) Difficulty with transfers also adversely affects the skin. Good skin care and good nutrition are very important. Constant weight shifts and transfers are important to prevent sores.

Many women get more frequent bladder infections when they are pregnant because the growing uterus puts increased pressure on the whole urinary system. This causes increased frequency… [END OF PREVIEW]

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