How to have painless sex after spinal surgery

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People having undergone surgeries for the treatment of spinal cord injuries are often concerned about their sex life post-surgery. Back pain may interfere with intimacy, decrease sex drive (libido) and interfere with sexual enjoyment. Patients with pelvic numbness or nerve dysfunction may feel less stimulation and pleasure or have difficulties developing or sustaining an erection or orgasm.

Even worse, sex might aggravate the back injury, causing a great deal of pain and ultimately, making sex an unpleasant and unwanted experience. While there’s no denying that spinal cord injuries do impact an individual’s sex life, there are several factors that determine the extent of the impact.

Since all patients and surgeries are different, it’s advisable to discuss the return to sexual activity with the consulting doctor. Though the patients feel awkward bringing it up, there’s no cause for worry. It’s a very normal and healthy concern. The impact of a spinal cord injury on an individual’s sex life is largely dependent on the extent and level of the injury. A patient’s sex life can stay nearly normal if the spine injury does not involve any nerve damage or paralysis. There could be some pain during the act, but an individual’s ability to perform typically remains unaffected.

However, the good news is that sex is safe even after a spinal surgery. For patients undergoing traditional back surgery, doctors commonly recommended waiting for 6 to 12 weeks before resuming sexual activity. The advancements that have been made in minimally invasive back surgery means that patients treated endoscopically can start having sex again after only 2 weeks if their incision is healing well, their pain has resolved or significantly improved, and their sex drive has returned.

The healing time could be little longer for other more invasive surgeries or surgeries involving spinal instrumentation. As with all activity, the patient should approach sex in a safe, gentle manner and take on a passive role initially. The patient should avoid heavy lifting, bending and twisting. They should stop if pain develops.

The patient may benefit from placing a small pillow under their lower back, stacked pillows under their knees to bend the hips and support the legs, and taking a well-supported position.  They may also benefit from taking pain medication prior to sex. Their partner should avoid putting their full weight on them.  The patient may have less pain starting with missionary position, lying down on their side or standing and bending over a chair.

For women, this may mean lack of sensation in the vagina and clitoris, which could impact the ability to reach orgasm. For men, pelvic nerve involvement may affect their ability to get and maintain an erection. If any of these issues are a problem for you, consult your surgeon for help.

It’s always a good idea to talk to your surgeon during the pre-surgical consultation about what to expect after your surgery. The most important thing you can do to help your body recover after surgery is to follow your doctor’s post-op instructions. Your surgeon has your best interests in mind, so listen to their directions.

Waiting for the time period advised by the surgeon to resume sex life after spinal surgery has several advantages; the patient’s incision will be healed sufficiently so it will be less sensitive to touch. Muscle spasms would have subsided. The muscles and soft tissues will be stronger and better able to stabilize the spine, which may result in better performance. Resumption of sexual activity should be gradual to minimize recurrent symptoms and enhance comfort and pleasure.

Important points to keep in mind:

  • Patient should approach sex in a safe, gentle manner and take on a passive role initially
  • Patient should avoid heavy lifting, bending and twisting. They should stop if pain develops
  • It may be beneficial to place a small pillow under the lower back, stacked pillows under knees to bend the hips and support the legs, and taking a well-supported position
  • Patients may also benefit from taking pain medication prior to sex
  • Partner should avoid putting their full weight on them
  • The patient may have less pain starting with missionary position, lying down on their side or standing and bending over a chair
  • For women, there may be lack of sensation in the vagina and clitoris, which could impact the ability to reach orgasm
  • For men, pelvic nerve involvement may affect their ability to get and maintain an erection.
  • If any of these issues are a problem for you, consult your surgeon for help.
  • It’s always a good idea to talk to your surgeon during the pre-surgical consultation about what to expect after your surgery
  • The most important thing you can do to help your body recover after surgery is to follow your doctor’s post-op instructions
  • Your surgeon has your best interests in mind, so listen to their directions

The author is an orthopaedic surgeon at Fortis Hospital in Mumbai