Table 1.

Potential for sexual response based on spinal cord injury

	Likely to experience, reflexive arousal: erection/vaginal lubrication	Likely to experience, psychogenic arousal: erection/vaginal lubrication	Orgasm	Recommendations
Complete upper motor neuron injury cephalad to T11	Yes	No	Yes	1 Genital stimulation 2 Stimulation of sensate erotic body parts
Complete upper motor neuron injury caudal to T11–L2 with sparing of sacral spinal segments	Yes	Yes	Yes	1 Genital stimulation 2 Stimulation of sensate erotic body parts 3 Audiovisual, tactile gustatory and imaginative stimuli/ fantasy
Conus injury/lower motor neuron injury (loss of sensation/voluntary control S4–S5, loss of S4–S5 mediated reflexes)	No	Yes	Yes	1 Assisted lubrication (e.g. KY jelly) 2 Stimulation of sensate erotic body parts 3 Audiovisual stimulation/ fantasy
Incomplete injuries	Ability to appreciate pin touch sensation in S2, 3, 4 dermatomes correlates with ability to attain psychogenic arousal and achieve ejaculation Ability to perceive T10–L2 dermatomes correlates with the ability to attain psychogenic erection/lubrication, and the better the response to fantasy Preservation of sacral sensation or voluntary sacral control of S4–5 correlates with ability to attain reflexogenic erection/vaginal lubrication Regardless of level or completeness, approximately 50% SCI individuals experience orgasm

“Reflexogenic arousal” refers to erection/vaginal lubrication that occur as a result of genital stimulation. “Psychogenic arousal” refers to erection/vaginal lubrication that occur as a result of arousal in the brain (e.g. through hearing, seeing, feeling, or fantasy). “Orgasm” refers to the perception of a peak feeling of sexual release or climax.