Needing to use a catheter to empty your bladder can feel like an extra hurdle when thinking about having sex again. But intermittent catheterisation can actually be a positive for patients, as it puts you much more in control of your bladder than you might be without it! Sex is an important part of a healthy relationship, and with a few simple steps you can return to enjoying being intimate with your partner.
Sex after a spinal cord injury
After a spinal cord injury sexual function is inevitably affected to some degree. The exact nature of the impact of the injury on your sexual response depends on many things, including the site of the injury. Most women will find that they have reduced or even no sensation in their genital area, and may also find that they have less vaginal lubrication. We know however that about half of women with a spinal cord injury can still orgasm although it may take a little longer than before. Remember that most women (not just women with spinal cord injuries) do not orgasm from intercourse alone, but need clitoral stimulation as well or instead1. How you feel about yourself, your partner, and your relationship is also a big factor; after all many would argue the most important sexual organ is the brain.
It is normal to worry about how needing to use an intermittent catheter will impact on your sex life and your relationship. This may be a concern about anything from leakage of urine during sex through to how to tell a new partner. There are some very practical steps you can take to address some of these anxieties, and feeling more secure about managing your bladder will mean that you are better able to focus on yourself and your partner.
Will planning kill the passion?
Whilst spontaneity and sex often go hand in hand, some forward planning can make things easier – certainly at first whilst you are regaining your confidence and understanding your capabilities. Aim to use your catheter to empty your bladder fully before you relax with your partner. Some women find that a warm bath or shower can help them relax and ease any worries about personal hygiene. If there is room for you and your partner to be in the bath or shower together, this can be a very pleasurable way to explore each other’s bodies and begin to learn what works and what doesn’t.
As well as making sure you empty your bladder fully before sex, restricting the amount you drink for a couple of hours beforehand can also help. Avoiding drinks that have the potential to irritate the bladder such as caffeine, alcohol, and carbonated drinks is also a good idea. With these precautions the chances of you leaking any urine are small – there shouldn’t be very much in your bladder to leak out! However, if you are still worried you can place some soft towels underneath you both and make sure you have some tissues and wet wipes handy just in case. You will find that your confidence grows with experience and you may not feel you need to take these precautions every time.
Putting comfort first
Where you have sex depends to a large extent on where you are comfortable. Finding a position that means you are at ease and which allows you and your partner to touch each other and explore new areas of your bodies can take some working out together. A shared sense of humour can certainly help.
Some women who use intermittent catheters regularly worry that the catheter will affect the shape, function, or feel of their vagina. The catheter that you use passes into the bladder via the urethra which is next to but separate from your vagina. Using a catheter will not affect the way your vagina looks or feels. You may find that your vagina is much drier than it used to be and this can make intercourse more difficult or even a little painful – it also increases the chances of chafing. Using some artificial lubrication such as KY jelly can be very helpful, and you can talk to your partner about how you might integrate this into your foreplay.
Conversation is key
The most important thing is to talk to your partner. Share with them how you are feeling and what you are worried about – remember they may have some concerns as well. Often partners may be worried that they will hurt you when having sex. Make time to explore your body together (as well as on your own). People often find that whilst some areas of the body that used to give pleasure no longer respond in the same way after a spinal cord injury, other areas become much more sensitive and feel very good when touched. Working out which parts of your body feel good when touched and which parts to avoid with your partner can help reassure them that they are not going to hurt you, and that you are still very able to give and receive pleasure!
For more advice and support on using intermittent catheters, or how to return to intimacy with your partner, get in touch with one of our nurses, or explore our Learn centre.
1 "People with disabilities still have sex lives BootsWebMD." (2011) Accessed on: 12 Jul. 2016 <http://www.webmd.boots.com/sexrelationships/features/peoplewithdisabilitiesstillhavesexlives>