Barriers:

• May have difficulty sustaining positions due to muscular fatigue
• Difficulty getting into or maintaining traditional sex positions
• May have difficulty doffing clothing
• May have difficulty with manual stimulation during sex
• Muscle weakness from chronic disease may adversely affect sexual relations (Bhadauria et al., 1995)
• Orgasm and ejaculation strength may be lessened if there is weakness pelvic area (Muscular Dystrophy New Zealand, n.d.)

Strategies:

• Use supports like pillows and wedges to increase stability during sexual activity
• If client is a wheelchair user, incorporate the wheelchair into sexual activity. For example, the partner can sit on top of the client.
• Position yourself so that the weak or paralyzed limb does not have to support the body during sexual activity. For example, it would be difficult for someone with weak upper extremities to sustain a quadruped position. Instead, try a position where the limb is supported by a surface (eg. supine).

References

Bhadauria, S., Moser, D. K., Clements, P. J., Singh, R. R., Lachenbruch, P. A., Pitkin, R. M., & Weiner, S.R. (1995). Genital tract abnormalities and female sexual function impairment in systemic sclerosis. American Journal of Obstetrics & Gynecology, 172(2 Pt 1). doi:10.1016/0002-9378(95)90576-6

Muscular Dystrophy New Zealand (n. d.). Sex and neuromuscular conditions [PDF file]. Retrieved from https://www.mda.org.nz/media/776ee85c-c16c-4622-a631-c78fb4786612/iPzAJg/MDA%20Services/Resource%20Library/Sexuality.pdf