(073) SEXUALITY IN WOMEN WITH TRAUMATIC AND NON-TRAUMATIC SPINAL CORD INJURIES: KEY PREDICTORS AND CHARACTERISTICS
Authors: Mazoni Costa R , Tunes De Paula A , C G Nascimento B , De Bessa Jr. J , Bruschini H , Nahas WC , Mendes Gomes C 
Published: December 2024

Abstract

Introduction
Female sexual response is influenced by numerous biopsychosocial factors. Spinal cord injuries (SCIs) can significantly impact sexual function, activity, and satisfaction. Understanding the various aspects that contribute to sexual dysfunction and overall sexual satisfaction in women with SCI is crucial for improving patient care and outcomes.

Objective
The objective of the present study was to identify characteristics of sexual function, satisfaction, and predictive factors of sexual activity among women with SCI of different etiologies.

Methods
In this cross-sectional study, women over 18 of age with an SCI (traumatic or non-traumatic) with more than one year of evolution were evaluated at an academic referral specialty hospital. Sociodemographic data, including age, marital status, cause of SCI, time since injury or diagnosis, severity of neurological impairment, and self-perceived sexual activity before and after SCI were assessed. Sexual function was evaluated using the Female Sexual Function Index (FSFI) with scores ≤26.55 indicating sexual dysfunction. The NBSS-SF was used to assess bladder management and urinary incontinence. WHOqol-bref Question 21 was used to measure women’s sexual satisfaction regardless of activity level. The study received approval from our hospital’s Research Ethics Committee, and all participants provided informed consent.

Results
The mean age of 98 participants was 42.5 ± 12.1 years with 42.9% married/stable partner. Among the women, 14 (14.3%) had traumatic SCI while 84 (85.7%) had non-traumatic SCI, with a mean duration of neurological condition of 12.6 ± 8.0 years. Thirty-eight (38.8%) participants were ambulatory without assistance, and 21 (21.4%) were wheelchair-bound. Before SCI, 76 (77.5%) women reported being sexually active, and 48 (48.9%) after SCI (p = 0.005). Table 1 illustrates perceived changes in sexual activity before and after SCI. Mean FSFI score was 22.0 ± 10.1, with 28 (58.3%) classified as having sexual dysfunction (≤ 26.55). The most affected domains were desire, arousal, and orgasm (Fig. 1). Of all 98 women, 65 (66.3%) had spontaneous voiding, and 25 (25.5%) performed self-catheterization. Urinary incontinence was reported by 14 (29.2%) of 48 sexually active women and 37 (74.0%) of 50 inactive ones. Being married increased the chance of sexual activity (OR 12.8 [95% CI 4.8-33.9, p &lt; 0.001], while being older, post-menopausal or having urinary incontinence decreased the chance (OR 0.1 [95% CI 0.1-0.4], p = 0.003 and OR 0.12 [95%CI 0.0– 0.3], p &lt; 0.001, respectively). Thirty-seven (37.7%) women reported being moderately to very satisfied with their overall sexual life, with 29 (78.4%) being sexually active and 8 (21.6%) inactive.

Conclusions
Sexual activity declined significantly pos-SCI and sexual dysfunction were highly prevalent among those women. Predictors for sexual activity included younger age, pre-menopausal status, being married and urinary continence. Higher level of satisfaction was reported by those who were sexually active. Our results highlight the need to address sexual health and improve quality of life for women with SCI.

Disclosure
No.