Contraception

The most appropriate contraceptive method will vary based on individual health, injury level, and personal preferences.

It is important to consider potential side effects and interactions with other treatments before using any of the medications or treatment options listed below, and to seek specialist advice when necessary, taking into account the individual’s health status and any concurrent conditions.

Common options include:

  • Condoms: A non-hormonal option with few side effects that also helps prevent sexually transmitted infections (STIs).
  • Intrauterine devices (IUDs): Highly effective, however insertion may trigger autonomic dysreflexia in people with injuries at or above T6. Device monitoring may be difficult for individuals with limited hand function.
  • Oral contraceptive pills: Commonly used, however oestrogen-containing pills can increase the risk of blood clots (venous thromboembolism or VTE).
  • Depo-Provera: An injectable contraceptive option.
  • Implanon: A long-acting implant placed under the skin of the upper arm.

Resources

Sexual and reproductive health following spinal cord injury
SCIRE Professional: Spinal Cord Injury Research Evidence

Fertility following spinal cord injury
New South Wales Government Agency for Clinical Innovation (NSW ACI)

Sexuality and reproductive health in adults with spinal cord injury: what you should know
Consortium for Spinal Cord Medicine

SCI sexual health
Spinal Cord Injury British Colombia (SCI BC)

Sexuality after spinal cord injury
Mount Sinai Hospital

Sexuality and sexual functioning after SCI
Model Systems Knowledge Translation Centre (MSKTC)

Sexuality and fertility following spinal cord injury
Spinal Cord Injuries Australia (SCIA)

References

Agency for Clinical Innovation. (2017). Fertility following spinal cord injury. NSW Government. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0006/600855/ACI-Fertility-following-spinal-injury.pdf

Agency for Clinical Innovation. (2014). Sexuality following spinal cord injury: A guideline for health professionals. NSW Government. https://aci.health.nsw.gov.au/__data/assets/pdf_file/0004/349051/ACI-Spinal-sexuality-guideline.pdf

Alexander, M., Courtois, F., Elliott, S., & Tepper, M. (2017). Improving Sexual Satisfaction in Persons with Spinal Cord Injuries: Collective Wisdom. Topics in spinal cord injury rehabilitation, 23(1), 57-70. https://doi.org/10.1310/sci2301-57

Australian Government Department of Health and Aged Care. (n.d.). About sexual health. Retrieved May 24, 2025, from https://www.health.gov.au/topics/sexual-health/about

Bryant, C., Aplin, T., & Setchell, J. (2022). Sexuality Support After Spinal Cord Injury: What is Provided in Australian Practice Settings? Sexuality and Disability, 40(3), 409-423. https://doi.org/10.1007/s11195-022-09756-w

Bryant, C., Gustafsson, L., Aplin, T., & Setchell, J. (2021). Supporting sexuality after spinal cord injury: A scoping review of non-medical approaches. Disabil Rehabil, 44(19):5669-5682. https://doi.org/10.1080/09638288.2021.1937339 

Earle, S., O’Dell, L., Davies, A., & Williams, R. (2020). Views and experiences of sex, sexuality and relationships following spinal cord injury: A systematic review and narrative synthesis of the qualitative literature. Sexuality and Disability, 38(4), 567–595. https://doi.org/10.1007/s11195-020-09653-0

Elliott, S., Hocaloski, S., & Carlson, M. (2017). A Multidisciplinary Approach to Sexual and Fertility Rehabilitation: The Sexual Rehabilitation Framework. Topics in spinal cord injury rehabilitation, 23(1), 49-56. https://doi.org/10.1310/sci2301-49

Elliott, S., & Querée, M. (2018). Sexual and reproductive health following spinal cord injury. In J. J. Eng, R. W. Teasell, W. C. Miller, D. L. Wolfe, A. F. Townson, J. T. C. Hsieh, S. J. Connolly, V. K. Noonan, E. Loh, S. Sproule, A. McIntyre, & M. Querée (Eds.), Spinal cord injury rehabilitation evidence (Version 6.0, pp. 1–133). SCIRE Project. https://scireproject.com/wp-content/uploads/2022/04/SCIRE-Sexual-Health-Version-6-chapter_Nov.23.18-v.FINAL-2.pdf

Lynch, C., & Fortune, T. (2019). Applying an Occupational Lens to Thinking About and Addressing Sexuality. Sexuality and Disability, 37(2), 145-159. https://doi.org/10.1007/s11195-019-09566-7

Henke, A. M., Billington, Z. J., & Gater, D. R., Jr (2022). Autonomic Dysfunction and Management after Spinal Cord Injury: A Narrative Review. Journal of personalized medicine, 12(7), 1110. https://doi.org/10.3390/jpm12071110

Paralyzed Veterans of America. (2012). Sexuality and reproductive health in adults with spinal cord injury: A clinical practice guideline for health care professionals. https://pva.org/wp-content/uploads/2021/09/sexuality-consumer-cpg-2012.pdf

Parker, M. G., & Yau, M. K. (2012). Sexuality, Identity and Women with Spinal Cord Injury. Sexuality and Disability, 30(1), 15-27. https://doi.org/10.1007/s11195-011-9222-8

Taylor, B., Davis, S. The Extended PLISSIT Model for Addressing the Sexual Wellbeing of Individuals with an Acquired Disability or Chronic Illness. Sex Disabil 25, 135–139 (2007). https://doi.org/10.1007/s11195-007-9044-x

World Health Organization. (n.d.). Sexual health. Retrieved May 24, 2025, from https://www.who.int/health-topics/sexual-health#tab=tab_2