概述
脊髓损伤（SCI）可能会影响性功能，还可能会影响与性行为或性健康相关的心理健康、生理健康和社会幸福感以及与伴侣的关系。性行为和生育能力管理相关咨询和教育可能有助于您在发生脊髓损伤后，适应自己身体的变化。
SCI 可能会影响您对生殖器和性结构的控制。实现并保持勃起和射精的能力可能会受到 SCI 的影响。阴道口血流和阴道润滑可能会受到 SCI 的影响。您可能会注意到性欲和性高潮能力发生了变化。
发生 SCI 后，针对性行为和生育能力管理的疗法可能包括：
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心理治疗。脊髓损伤发生后性健康的心理健康和社会幸福感方面与生理健康同等重要。SCI 发生后感觉自己身体状况良好的能力，以及在建立和维持亲密关系方面重拾信心的能力，是 SCI 发生后性健康的一个至关重要但通常未得到解决的方面。
训练有素且经验丰富的医生、护士和康复心理学家组成团队，提供性健康的心理健康和社会幸福感方面的教育和咨询服务。
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性功能障碍的治疗。脊髓损伤患者在 SCI 发生后可能会注意到生理变化，并且可能需要治疗以帮助恢复性行为。
有多种可能的治疗方案，包括阴茎假体、辅助器具和药物治疗。
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生育能力咨询。训练有素的医务人员会与您和您的伴侣讨论有关性健康和生育能力的问题，并为您提供性教育和咨询服务。
脊髓损伤发生后，通常可以怀孕，也可以进行阴道分娩。SCI 发生后月经周期暂停的情况很常见。但月经周期恢复后，则有可能怀孕。如果您希望怀孕，则应做好计划并与治疗团队讨论任何潜在问题。
来自朋友以及教育和互助组的支持能够提供专业知识和应对技巧。为伴侣提供支持和教育也是 SCI 发生后恢复性行为的重要一环。
目的
Sexuality and fertility management after a spinal cord injury (SCI) is done because an SCI can affect the genitals and sexual function. After a spinal cord injury, it may be hard to achieve and maintain an erection and to ejaculate. Blood flow to the vagina and vaginal lubrication can change. You may notice changes in sex drive and in the ability to orgasm after an SCI. The ability to have children, known as fertility, also may be affected after a spinal cord injury.
Sexual activity and sexuality are important to many people after spinal cord injuries. Treatments, psychological therapy, fertility counseling and education can address these issues.
风险
The risks of sexuality and fertility management after a spinal cord injury depend on the specific type of treatment. There are no risks associated with psychological therapy or fertility counseling.
If you take a medicine for sexual symptoms, there may be side effects. The most common medicine to treat erectile dysfunction is sildenafil (Viagra, Revatio). This medicine may cause headaches, flushing and mild low blood pressure. Flushing may cause patches of darker skin or dusky brown discoloration in people with brown or Black skin. It can cause pink or red skin in people with white skin.
Penile implants can lead to serious complications, including infection.
如何进行准备
As you get ready for an appointment for sexuality and fertility management after a spinal cord injury, it may help to read educational materials. Ask members of your healthcare team for pamphlets or other information.
可能出现的情况
Sexuality and fertility management after a spinal cord injury (SCI) involves creating a comprehensive plan for rehabilitation. How much an SCI affects your sexuality and fertility depends on the level of spinal cord injury. It also depends on whether the SCI is complete or incomplete. Someone with a complete spinal cord injury loses feeling and the ability to move below the spinal cord injury. Someone with an incomplete spinal cord injury has some feeling and control of movement below the affected area.
Your rehabilitation plan can address the range of symptoms you're experiencing related to sexual function.
During sexuality and fertility management
Therapies for sexuality and fertility management after SCI may involve:
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Psychological therapy. The mental aspects of your sexual health after an SCI are as important as the physical aspects. It's important to feel good about your body and regain confidence to establish and maintain intimate relationships.
A team of trained and experienced healthcare professionals such as doctors, nurses and rehabilitation psychologists can offer psychological therapy. They educate and counsel people after spinal cord injuries about the mental and social well-being aspects of their sexual health.
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Treatment for sexual dysfunction. People who have had spinal cord injuries may notice physical changes and may need treatment to help resume sexual activity.
Treatment options include medicines and assistive devices such as vibrators, vacuum erection devices and penile constriction bands. Penile implants also may be an option.
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Fertility counseling. Trained healthcare professionals can discuss issues with you and your partner regarding sexual health and fertility. They can provide sexuality education and counseling.
Pregnancy is usually possible after spinal cord injury, as well as a vaginal delivery. It's common for the menstrual cycle to pause after an SCI. But once it starts again, sexual activity can lead to pregnancy. If you wish to become pregnant, discuss any potential issues with your healthcare team.
Find support from friends. Educational and support groups can provide knowledge and help with coping skills. Support and education for partners also is an important part of sexuality rehabilitation after an SCI.
结果
Sexuality and fertility management after a spinal cord injury can help people continue to experience sexual pleasure and orgasm. Management strategies may help strengthen your relationship with your partner. Therapies and treatments also can help couples get pregnant and give birth.