Sexual Matters of Couples with Spinal Cord Injury Attending a Sexual Health Clinic in Tehran, Iran

Background: Couples experiencing spinal cord injury (SCI) usually deal with altered sexual lives. Evaluation of the sexual satisfaction, intimacy, and partnership as well as sexual functioning of the couples with one SCI-affected partner is necessary. Methods: The current cross sectional study was conducted on 28 couples (56 individuals) attending a sexual health clinic at the Brain and Spinal Cord Injury Research Center (BASIR) affiliated to Tehran University of Medical Sciences, Tehran, Iran. Descriptive statistics were employed and data were expressed as frequencies. The chi-square test, the Pearson and Spearman correlation coefficients, and the Student t-test were employed to determine the differences between male and female subjects with SCI as well as their partners. To investigate marital-related outcomes, ENRICH marital satisfaction scale, marital adjustment scale, and the Bagarozzi intimacy questionnaire were used. In addition, female sexual function index (FSFI) and international index erectile function (IIEF), as well as sexual knowledge and attitude, sexual expression (SE), and the Larson sexual satisfaction questionnaires were employed to evaluate sexual-performance-related outcomes. Results: The mean age of male and female subjects with SCI (20 males and eight females) was 39.65 ± 9.483 and 34.88 ± 10.412 years, respectively. Mean age of the partners without SCI, male and female, was 37 ± 9.067 and 41.38 ± 10.155 years, respectively. Partners with and without SCI had low sexual satisfaction by 67.9% and 53.6%, respectively. There was also a poor intimacy and partnership in partners with SCI (46.4%). Gender-based differences in the couples' sexual functioning indicated that females without SCI showed lower scores in sexual functioning than their male counterparts. All female subjects got lower scores in FSFI. A significant mean difference was observed between the SCI and non-SCI groups in ENRICH marital satisfaction (P < 0.02), the Bagarozzi intimacy (P < 0.035), marital adjustment (P = 0.000), and IIEF (P < 0.001). Conclusions: Based on the current study findings, sexuality of people with SCI was far more complex than those of their healthy counterparts, which caused the health providers face with clinical, social, and cultural challenges. Sexual rehabilitation should be effusively addressed in all spinal units and recovery centers, along with other aspects of treatment and rehabilitation.