Lifestyle modifications and pharmacological approaches to improve sexual function and satisfaction in men with spinal cord injury: a narrative review

Research output: Contribution to journalReview articlepeer-review


External organisations

  • International Collaboration On Repair Discoveries (ICORD)
  • University of British Columbia
  • BC Centre for Sexual Medicine, Vancouver Coastal Health
  • GF Strong Rehabilitation Centre, Vancouver Coastal Health, Vancouver


Study design: A narrative review describing various components of sexual dysfunction in men with spinal cord injury (SCI), as well as addressing potential therapeutic approaches.

Objectives: Restoration of sexual function is considered one of the most important health priorities for individuals with SCI. The purpose of this review is to provide information regarding the factors that are less appreciated when considering changes to sexual function in men with SCI. We also propose therapeutic approaches, with a focus on lifestyle modifications, which have been shown to improve sexual function.

Methods: A literature search was performed and limited evidence for therapeutic approaches in individuals with SCI was supplemented by consistent findings from the able-bodied population.

Results: We evaluated the less addressed factors known to contribute to sexual dysfunction in men with SCI, including hormonal influences (i.e., testosterone deficiency, thyroid hormone, and cortisol), psychological factors (i.e., pain, fatigue, depression, and body image), and secondary SCI complications (i.e., urinary tract infection, pressure sores, and autonomic dysreflexia). To address these factors beyond standard medical treatments for sexual dysfunction, options include physical activity/exercise, diet, and specific medications for symptom relief (i.e., testosterone replacement therapy and selective serotonin reuptake inhibitors for depression).

Conclusions: Physical activity’s potential application, efficacy across multiple aspects of sexuality, and the lack of side effects, suggests that long-term exercise is a viable solution to directly or indirectly improve sexual function in males with SCI. Diet and supplemental medications may further promote body composition changes, which more broadly affect sexuality.


Original languageEnglish
Pages (from-to)391-401
Number of pages11
JournalSpinal Cord
Issue number4
Early online date19 Dec 2019
Publication statusPublished - Apr 2020
Externally publishedYes

ASJC Scopus subject areas