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  • Title: Sexual issues of women with spinal cord injuries.
    Author: Charlifue SW, Gerhart KA, Menter RR, Whiteneck GG, Manley MS.
    Journal: Paraplegia; 1992 Mar; 30(3):192-9. PubMed ID: 1630847.
    Abstract:
    The need for research addressing problems unique to women with spinal cord injuries is well documented. Consequently, 231 such women, ages 18 to 45, were surveyed. Demographic characteristics and data relating to physician usage, female hygiene, pregnancy, contraception and sexuality were collected. Analysis revealed that 60% of the respondents had post injury amenorrhea; the average time until menses resumption was 5 months. The group's post injury pregnancy rate was one-third its pre injury rate, but women with incomplete paraplegia had significantly more pregnancies than those with complete quadriplegia. Of 47 women who did carry babies to delivery, one-half had vaginal deliveries; 49% used no anesthesia. Problems during pregnancy included autonomic hyperreflexia, decubitus ulcers, urinary tract infections, water retention, bladder and bowel problems, anemia, spotting, fatigue, cardiac irregularity and toxemia. Many of these problems plagued the women during labor and delivery and in the post partum period as well. Sixty-nine percent of the women were satisfied with their post injury sexual experiences, although self confidence, spasticity, and lack of spontaneity were issues. Although satisfied with care received from physicians, many women were not content with the information provided during rehabilitation, and felt a need for more literature, counselling, and peer support. In 1984, researchers analyzed data on 231 18-45 year old women with a spinal cord injury who underwent initial rehabilitation at Craig Hospital in Englewood, Colorado to examine sexual issues. More than 50% of the women reported that health workers did not provide them sufficient sexuality information during rehabilitation, but those who underwent rehabilitation after 1977 were more satisfied with it than those before 1977. They tended to be satisfied with the care they received from their physicians after the injury. Most women were comfortable talking about sexuality with family, friends, and/or other women with spinal cord injuries. Some women were concerned with increases in vaginal discharges (53%) and perspiration (27%) after the injury. Clinicians must realize that the needs of women with spinal cord injuries are different than those of men. Spasticity during sexual relations, pregnancy, childbirth, and the postpartum period troubled some women, e.g., it interfered with sexual intercourse in 21% of the women. Yet 2 newborns were addicted to valium which is used to control spasticity. Other issues were self-confidence and lack of spontaneity. Nevertheless 69% of all women were satisfied with sexual experiences. 60% of the women had amenorrhea after their injury and the mean time for menses resumption was 5 months. The preinjury pregnancy rate was 1.3/person compared with only .34 after the injury. Women with incomplete paraplegia had a higher postinjury pregnancy rate than those with complete quadriplegia (.63 vs. .15; p.001). 50% of the 47 women who had full-term infants delivered vaginally. 49% did not use any anesthesia. Pregnancy complications and complications during labor and delivery were bladder and bowel problems, autonomic hyperreflexia, decubitus ulcers, urinary tract infections, edema, anemia, spotting, fatigue, cardiac irregularity, and preeclampsia.
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