Sexual identity is a significant and encompassing aspect of one’s personality. Paralysis often changes physical functioning, sensation and response, and self-image can be shaken — but it does not have to change a woman’s ability to feel attractive, intimate, or fulfilled.

Sex After Paralysis

Women wonder if they can have sex again, whether they can attract a partner, whether the partner will stay, and whether having children is possible. Paralysis itself doesn’t affect a woman’s libido or her need to express herself sexually, nor does it affect her ability to conceive a child. Generally speaking, sexuality in women living with paralysis is less affected than in men — it is physically easier for a woman to adapt her sexual role, even though it may be more passive than that of a non-disabled woman.

The key to successfully redefining one’s sexual identity is experimentation and open communication. It helps to understand the anatomy and physiology of sexual function and response, and to connect with knowledgeable health care professionals or counselors who can review the available options.

Physical & Emotional Changes in Sexuality

There are no physiological changes after paralysis that prevent women from engaging in sexual activity, but a number of internal shifts occur across the body:

Low sex drive is common among women with paralysis. In one clinical study, Viagra was tested in women with spinal cord injuries and almost all reported that it stimulated arousal, and in some cases enhanced lubrication and sensation during intercourse.

Managing Intimacy: Bladder & Bowel

Women living with paralysis often fear bowel and bladder accidents during intimacy. A few simple habits reduce that risk considerably. Note: the urethra is separate from the vagina, so a Foley catheter can be left in place during intercourse.

With good communication, an occasional bladder or bowel accident won’t destroy a rewarding sex life.

Intimacy & Orgasm

A woman with paralysis, like men with similar levels of function, can achieve what is described as a normal orgasm if there is some residual pelvic innervation. Researchers and clinicians point to three notable findings and tools:

Pregnancy & Childbirth

Women with paraplegia or tetraplegia who are of childbearing age usually regain their menstrual cycle — nearly 50 percent do not miss a single period following injury. Pregnancy is possible and generally not a health risk, and most paralyzed women can have normal vaginal deliveries. Still, certain complications warrant close monitoring:

Women living with disabilities often do not receive adequate reproductive healthcare — routine pelvic exams may be skipped and providers may wrongly assume women with disabilities aren’t sexually active, leading to missed STD screening. Some providers have even (incorrectly) suggested abstaining from sex or childbearing altogether.

Breast Health

In the clinic, getting a wheelchair through the door is often the easy part — many medical offices and exam equipment remain inaccessible. Services and programs provided to patients with disabilities must be equal to those provided to patients without disabilities.

Birth Control

Since paralysis does not usually affect fertility, contraception remains important — with a few special considerations for each method:

📚 SEXUAL HEALTH SERIES — 3-Part Series

Source: Christopher & Dana Reeve Foundation, National Paralysis Resource Center · Supported by the Administration for Community Living (ACL), U.S. Dept. of Health and Human Services · © 2026 AccessLife