Goel Meenakshi, Mazzia Claire, Kosa Sarah Daisy, Harris Anne, Berndl Anne
Department of Obstetrics and Gynecology, Division of Maternal- Fetal Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, ON M4N 3M5, Canada.
Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, ON M5S 3K3, Canada.
J Sex Med. 2025 Apr 15;22(4):562-569. doi: 10.1093/jsxmed/qdaf024.
Spinal Cord Injury (SCI) can impact sexual function negatively, and although most people continue to be sexually active post-injury, they often report decreased satisfaction in various aspects of sexual life.
To gain insight into the sexual experience and functioning of people assigned female at birth (AFAB) with a SCI.
This study is part of an international observational questionnaire examining the reproductive health outcomes of individuals AFAB with SCI. The questionnaire was distributed to SCI organizations and support groups in 33 countries in four languages between 2019 and 2021. A total of 557 individuals AFAB with SCI, between the ages of 18 and 50, who completed the sexual health questions were included in this analysis.
Scores of Female Sexual Function Index (FSFI-6) in relation to the severity of the SCI based on the American Spinal Injury Association (ASIA) impairment scale, level, and duration of SCI.
Nearly 65% (170/263) of the study population within 10 years of injury had sexual dysfunction (SD) (FSFI-6 score less than or equal to 19), and participants with ASIA A had the most dysfunction (Mean score 15.95 + 7.52). Interestingly, although half of the study population scores as experiencing SD, only one-third describe SD as a concern associated with SCI. Though most of the changes were of a physical nature (inability to orgasm, pain during penetration, spasticity, barriers related to bowel/bladder problems and episodes of autonomic dysreflexia), psychosocial factors like the presence of concomitant anxiety/depression and sexual violence from a partner affected their sexual lives adversely. We attempt to elucidate the strategies adopted to improve sexual satisfaction that can help professionals involved in the SCI rehabilitative process.
Our results provide insight into the degree of SD, factors impacting sexual satisfaction and areas which need to be emphasized during the rehabilitation process of people AFAB with SCI.
This study is one of the largest of its kind, attempting to understand sexual functioning and factors impacting the sexual life of people AFAB post-SCI using a standardized tool, the FSFI score. As a voluntary survey, those who responded may not be fully representative of the population.
Sexual health is an essential component of rehabilitation for individuals AFAB with SCI. Enhancing their sexual satisfaction requires a comprehensive approach that considers their physical, psychological and interpersonal circumstances.
脊髓损伤（SCI）会对性功能产生负面影响，尽管大多数人在受伤后仍保持性活跃，但他们常报告性生活各方面的满意度下降。
深入了解出生时被认定为女性（AFAB）的脊髓损伤患者的性经历和性功能。
本研究是一项国际观察性问卷调查的一部分，该调查旨在研究AFAB脊髓损伤患者的生殖健康结果。2019年至2021年期间，问卷以四种语言分发给33个国家的脊髓损伤组织和支持团体。本分析纳入了557名年龄在18至50岁之间、完成了性健康问题的AFAB脊髓损伤患者。
根据美国脊髓损伤协会（ASIA）损伤量表、损伤水平和损伤持续时间，女性性功能指数（FSFI-6）得分与脊髓损伤严重程度的关系。
在受伤10年内的研究人群中，近65%（170/263）存在性功能障碍（SD）（FSFI-6得分小于或等于19），ASIA A级患者的性功能障碍最为严重（平均得分15.95±7.52）。有趣的是，尽管一半的研究人群得分显示存在性功能障碍，但只有三分之一的人将性功能障碍视为与脊髓损伤相关的问题。虽然大多数变化是身体方面的（无法达到性高潮、性交时疼痛、痉挛、与肠道/膀胱问题相关的障碍以及自主神经反射异常发作），但诸如伴有焦虑/抑郁以及来自伴侣的性暴力等心理社会因素也对他们的性生活产生了不利影响。我们试图阐明为提高性满意度而采取的策略，这有助于参与脊髓损伤康复过程的专业人员。
我们的研究结果揭示了性功能障碍的程度、影响性满意度的因素以及在AFAB脊髓损伤患者康复过程中需要重点关注的领域。
本研究是同类研究中规模较大的之一，试图使用标准化工具FSFI评分来了解AFAB脊髓损伤患者的性功能以及影响其性生活的因素。作为一项自愿调查，做出回应的人可能并不完全代表总体人群。
性健康是AFAB脊髓损伤患者康复的重要组成部分。提高他们的性满意度需要一种综合方法，考虑到他们的身体、心理和人际关系情况。
