8.5. Sexual Aids
Content in this section is intended for adult (age 18+) educational purposes. United Spinal Association bears no responsibility for the accuracy, legality, or content of the external site or for that of subsequent links. Contact the external site for answers to questions regarding its content. Information about a therapy, service, product, or treatment does not imply endorsement and is not intended to replace advice or directives from your healthcare provider. There is always a risk with any type of sexual activity, speak with your healthcare provider about options to maximize your safety.
General Information on Sexual Aids
A spinal cord injury does not mean the end of your sex life. Sensation and function may have changed, but there are numerous ways to enhance and rediscover your abilities during sexual activity. Sexual aids (also known as sex toys) and adapted devices can facilitate sexual activity and the ways people can express themselves sexually, as individuals and partners. Some sexual aids have features such as larger button controls, switches, remotes, handles, etc. Consult an occupational therapist for alternatives or adaptations you can make to your devices for ease of use. See 8.3 Medical Considerations page for information about Continence aids, and Skin and Sensation aids.
When shopping for sexual aids, ask yourself…
- How do you plan to use it? By yourself or with a partner?
- Will you need assistance? Does it require set-up?
- What functional abilities are required to use this device?
- What is required for charging the device? Does it plug in or use batteries?
- Is the device waterproof?
- Would it require modifications?
- How do you clean it?
- How much sensation do you have?
If you have any questions related to a sexual aid and any special health concerns for you, please consult your healthcare professional.
Using Sexual Aids
Before purchase, check what type of material the aid is made of, taking into consideration any material allergies you may have and what kind of lubricant you might be using. Choosing and using an aid compatible with all of your senses can increase the overall pleasure of the experience. Please see the Resource list below.
Do NOT transfer sexual devices/aids between bodily orifices on self or others. Doing so can lead to bacterial infections or illnesses. Cleaning your toy will depend on the material, components, and other factors.
Ample lubrication is essential to prevent injury to sensitive tissues (vaginal, anal) during sexual activity including while using penetrative devices, it is important to use ample lubrication to aid in comfort and safety. Women with spinal cord injury often experience decreased natural vaginal lubrication during arousal. There are a variety of lubricants that can be used during sexual activity to increase sensation, comfort, and pleasure. Any fragrances and dyes added to lubricants disrupt the natural pH of the vagina and can lead to infections. Oil-based lubricants are not recommended as they are harmful to the vagina, and cause breakdown of materials such as latex and staining to materials.
- Safe to use with condoms, both latex, and non-latex
- Can be used safely with silicone toys
- Washes off easily
- Safe to use with condoms, both latex, and non-latex
- Warming lubricants are often silicone-based
- Silicone lubricant will break down silicone toys
Proper positioning during sexual activity can improve access, stability, comfort, and pressure relief for those with limited strength and mobility. Some sexual positions may cause pain, discomfort, or fatigue for those with SCI/D but can be adjusted with adaptive devices or positioning aids. Experimentation to find the positions that are most comfortable for you is encouraged. Positioning aids should have cushioning or protective aspects so as to minimize any friction or pressure during sexual activities. You’ll also want to be aware of prolonged positioning or activities that cause friction which can have a negative impact on your skin integrity.
There are a variety of straps and harnesses that can be utilized for positioning for those with limited mobility. If using these items look for padding that can protect skin in areas lacking sensation. Harnesses are available in many types that allow the user to modify the position of sexual aids during intimacy. There are harnesses that you can affix a toy to an object or person allowing for hands-free options during play.
Sex furniture is specifically designed to facilitate positioning and sexual activity. If you are looking for something more cost-effective, getting creative using positioning aids or adaptive equipment that you may already own can be an excellent place to start. Check the restrictions for weight and functionality before using for sexual activity. Sex stools and chairs are a creative way to increase mobility during sexual activity. Some stools allow bouncing motion requiring less effort in a variety of positions. Stools require the user to have trunk and some pelvic control. The Intimate Rider is a sex chair with gliding action, created by a man with a C6-7 SCI, to improve mobility during sexual activity. Some arm movement is necessary to stabilize yourself and to set the Intimate Rider into motion.
There are a variety of positioning aids designed with sexual activity in mind. Sex ramps, wedges, and customizable sofas and benches are some of the options available. Ramps and wedges are perfect for facilitating positioning for comfort and ease of access during sexual activity. Positioning pillows underneath and around areas of the body can relieve pressure to sensitive areas and improve stability for those with limited trunk strength and sensation. Foam wedges and positioning aids can be used for those with limited balance, providing a firmer surface to perform sexual activities on or against. See “Resources” below for further information on positioning aids and furniture that aids with sexual activity.
Vibrators have been around since the late 19th century, and have been used for various functions. Typically, battery-operated vibrators will be less intense than plug-in or rechargeable options. If using vibrators with a “hands-free” option, be mindful of overheating and areas of sensitivity. The difference between external and internal vibrators depends on the user’s preference, as most toys with internal functions will be able to be used externally. Shape, size, and color are all dependent on the user’s preference and sensation capabilities. For individuals with limited dexterity there are various options including long-handled wand vibrators, tongue vibrators, and finger vibrators. It’s important to note that the risk of autonomic dysreflexia (AD) increases for susceptible people with SCI (those with neurological level of injury at T6 and above) who engage in more intense sexual stimulation, including the use of vibrators. For further information related to AD and sexuality please see section 8.3 “Medical Consideration”.
Exploring your sensation may lead to discovery of new erogenous zones such as ears, nipples, shoulders, nape of the neck and your “transitional zone” ( just below the last region of skin with preinjury levels of sensation that has some altered sensation). Using a little creativity with touch and pressure can open up a world of pleasure to your senses.
For those with decreased or limited sensation, it can be difficult to detect excessive pressure and friction during sexual activity, so it is imperative to follow safety instructions and usage warnings on sexual aids. For those who experience discomfort with deep penetration, bumpers can be used with penetrative devices or on the penis to restrict the depth of penetration. See Resources below.
Devices for Erectile Dysfunction
Penis rings (constriction bands, cock rings) Can be used around the base of the penis to enhance or maintain an erection during sexual activity by keeping blood flow restricted to the penis. Metal rings should not be worn longer than 20-30 minutes at a time.
Penis Pumps (Vacuum Erection Device)
Can be used to increase blood flow to the penis, increasing erection size and used with constriction bands. Contraindications to using penis pumps are peripheral vascular disease (PVD), clotting disorders, diabetes, and skin integrity. Pumps may be manually operated, or battery powered.
For men with difficulty obtaining or maintaining an erection, hollow dildos are also available that can accommodate a penis. Please note that medication options for erectile dysfunction are discussed in Section 8.1, General.
Sexual Aids and Positioning Resources
- PleasureAble - A Sexual Device Manual for People with Disabilities - DHRN/VCH (PDF). This manual was created by a team from the University of British Columbia as a practical resource for persons with disabilities and health care clinicians who work with these clients.
- Sex Position Handbook – SCISEXUALHEALTH.CA. This resource is provided by SCI Sexual Health Canada. The Sexual Health Rehabilitation Service offers specialist clinical services at two sites: Blusson Spinal Cord Centre at Vancouver General Hospital and at the GF Strong Rehabilitation Centre. It is a specialized service that’s unique in Canada, including five Sexual Health Clinicians and a Sexual Medicine Doctor, trained in sexual health, disability and rehabilitation.
- Sex and Love and Intimacy After SCI: Positioning With Partners. This resource is provided by Mount Sinai Hospital (a Spinal Cord Injury Model System Center) through a grant from the Craig H. Neilsen Foundation and support from community partners to provide more educational resources about sex, sexuality and intimacy after spinal cord injury.