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Sexuality and reproductive health

• Sexual health
• Reproductive health
• More information on sexuality and reproductive health

Women with illnesses and disabilities have the same needs for love, sex, and family as everyone else. But, in some cases, having an illness or disability can affect your sexual life, choice of birth control method, and pregnancy. There are ways around many of the problems that can come up. To solve these problems, it helps greatly if you can discuss them freely with your sexual partner and doctor.

Sexual health

Many women with disabilities have active and satisfying sex lives. Their bodies may not respond in quite the same way as those without disabilities. For instance, a woman with a spinal cord injury may have no feeling in her vagina. But she can respond with pleasure to touch on upper parts of the body and may even feel pleasure like orgasms.

If you have a disability, talk with your partner about any limitations you have and about ways in which you may respond to sexual stimulation. Good things to talk about are:

• Where it is easiest to have sex — for instance, on the bed, in your wheelchair, or on the floor
• Which positions are most comfortable and least likely to hurt
• How your disability affects how your body works
• How you can give each other pleasure
• What times of the day or week you are likely to have the most energy for sex (if you tire easily or use medicines that can lower your desire for sex)

People with an intellectual disability also have a right to have a healthy sex life and have children if they want. They might not always understand what agreeing to have sex involves or what sexual behaviors are appropriate. But through education and guidance, many adults with intellectual disabilities can have meaningful sexual relationships. Laws about sexual consent and sexual limits for people with intellectual disabilities vary from state to state. For more information on these issues in your state, please contact your state government.

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Reproductive health

Women with disabilities have the same reproductive health concerns as all women. This includes:

• Cervical cancer prevention and early detection
• Breast cancer screening, early detection, and treatment
• Menstruation
• Birth control
• Sexually transmitted infections
• Pregnancy and preconception health
• Menopause

Still, some doctors overlook the reproductive health care needs of women with disabilities. Or, they don't have the knowledge or training to provide care, such as knowing how to do a Pap test or pelvic exam using other positions or instruments.

If your doctor does not talk to you about your reproductive health, make sure you bring it up!

Pregnancy

There is no good reason why most women with disabilities cannot have safe pregnancies and give birth to healthy babies. Still, having a disability may affect some parts of pregnancy and birth. If you have a disability and want to become pregnant, you should discuss these things with your doctor:

• What are your chances of having a child with a disability? Most disabilities are not inherited (passed on through genes that you give to your child), but a few are. One example of an inherited disease is cystic fibrosis. If your doctor suspects that a genetic disorder might run in your family, he or she might suggest you speak with a genetic counselor. This person can help you understand your own personal risk, as well as your children's risk.

• Will your disability affect your health while you are pregnant or the health or development of your baby?

• If you use medicines regularly, will they affect your developing baby? For instance, some antiseizure medicines used to treat epilepsy increase the risk of birth defects when taken by a pregnant woman. Your doctor may want to switch you to another type of antiseizure medicine that poses less risk to your developing baby.

• Is your disability likely to cause problems during labor or delivery? For instance, during the birth, you may need to keep your legs open wide for many hours. Women with cerebral palsy cannot do this and so their babies need to be delivered by cesarean section.

• What should you do before pregnancy to boost your chances of a healthy pregnancy? For example, find out how much folic acid you need each day. This is called preconception health.

If you don't want to become pregnant, you will need to use birth control. Your birth control options might also be affected by your disability. For instance, diaphragms and cervical caps may not be suitable for women who have limited use of their hands or who cannot open their legs very wide. Talk with your doctor about which birth control method would be best for you.

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More information on sexuality and reproductive health

Read more from womenshealth.gov

• Pregnancy and Medicines Fact Sheet — This fact sheet provides information on the safety of using medicines while pregnant.
  http://www.womenshealth.gov/publications/our-publications/fact-sheet/pregnancy-medicines.cfm

Explore other publications and websites

• A Health Handbook for Women With Disabilities (Copyright © Hesperian Foundation) — This comprehensive health book for women with disabilities features chapters on understanding and taking care of your body, growing older with a disability, abuse, violence, self-defense, and much more.
  http://www.hesperian.org/publications_download_wwd.php
• Birth Control for Women With Epilepsy (Copyright © Epilepsy Foundation ) — This fact sheet explores the complex interactions between hormonal birth control, such as the pill, and some of the medications used to control seizures. It explores the questions of whether women with epilepsy can use hormonal birth control and whether it is effective.
  http://www.epilepsyfoundation.org/livingwithepilepsy/gendertopics/womenshealthtopics/birth-control-for-women-with-epilepsy.cfm
• Diabetes and Pregnancy (Copyright © American Diabetes Association) — The key to a healthy pregnancy for a woman with diabetes is keeping blood sugar in the target range — both before and during her pregnancy. To do this, you need a diabetes treatment plan that keeps meals, exercise, and insulin in balance. This resource gives women with diabetes the information they need to maintain their health throughout pregnancy.
  http://www.diabetes.org/gestational-diabetes/pregancy.jsp
• Diabetes and Women's Sexual Health (Copyright © American Diabetes Association) — Sex is an important part of life and relationships. But diabetes can affect a woman's sex life. This publication covers what you should know about diabetes and women's sexual health.
  http://www.diabetes.org/type-1-diabetes/women-sexual-health.jsp
• Epilepsy and Sexual Relations (Copyright © Epilepsy Foundation) — This information sheet discusses some common concerns people with epilepsy may have about sex, such as seizures and pain during intercourse, as well as how to talk to your doctor about sexual problems and seek therapy if needed.
  http://www.epilepsyfoundation.org/living/wellness/dating/weisex.cfm
• Female Sexual Problems (Copyright © American Association for Marriage and Family Therapy) — This publication discusses female sexual dysfunction: what it is, what the causes are, and how to seek treatment.
  http://www.aamft.org/imis15/Content/Consumer_Updates/Female_Sexual_Problems.aspx
• HPV Vaccine: What You Need to Know — This fact sheet discusses the benefits and risks of getting the human papillomavirus (HPV) vaccine. It also defines HPV and talks about who should get the vaccination, who should wait, and where you can get more information.
  http://www.cdc.gov/vaccines/pubs/vis/downloads/vis-hpv-gardasil.pdf
• Intimacy (Copyright © National MS Society) — This publication addresses intimacy and sexual concerns for people with multiple sclerosis. It also offers links to other helpful sources of information.
  http://www.nationalmssociety.org/living-with-multiple-sclerosis/relationships/intimacy/index.aspx
• Maternal Illness or Disability (Copyright © La Leche League International) — This website includes a list of links to frequently asked questions, articles, and media releases about mothers with illnesses or disabilities and their ability to breastfeed.
  http://www.lalecheleague.org/NB/NBmaternalillness.html
• My Health Test Reminder (Copyright © Congress of American Pathologists) — This website offers a free e-mail service to remind women when they are due for their next pap test, mammogram, colon cancer screening, and diabetes and cholesterol tests. The site provides information on each test, including why the test is important and necessary for maintaining good health.
  http://www.myhealthtestreminder.org/
• Patient Information Sheet #10: Sexuality and Lupus — This publication gives information on problems some women with lupus may experience with the physical and emotional aspects of sex.
  http://www.niams.nih.gov/hi/topics/lupus/lupusguide/chppis10.htm
• Pregnancy Registries — Pregnancy registries help women make informed and educated decisions about using medicines during pregnancy. If you are pregnant and currently taking medicine — or have been exposed to a medicine during your pregnancy — you may be able to participate and help in the collection of this information. This website provides a list of pregnancy registries that are enrolling pregnant women.
  http://www.fda.gov/ScienceResearch/SpecialTopics/WomensHealthResearch/ucm251314.htm
• Reproductive Health Information — Contraception (Copyright © Center for Research on Women with Disabilities) — This publication briefly explains how different methods of birth control work and discusses the advantages and disadvantages of each method for women with disabilities.
  http://www.bcm.edu/crowd/?pmid=1406
• Reproductive Health Information — Sexually Transmitted Infections (Copyright © Center for Research on Women with Disabilities) — This publication for women with disabilities explains sexually transmitted infections (STIs). It includes information on symptoms and prevention.
  http://www.bcm.edu/crowd/?pmid=1471
• Sexuality and Reproductive Health Following Spinal Cord Injury — This report provides information on the impact of spinal cord injury (SCI) on sexual functioning. It discusses fertility, pregnancy rates, male impotence, and live births in persons with SCI.
  http://www.ahrq.gov/clinic/epcsums/sexlspsum.htm
• Sexuality for Women With Spinal Cord Injury (Copyright © The University of Alabama) — This publication discusses some of the common problems with sexuality that women with a spinal cord injury may experience, including problems with sexual function, arousal, fertility, and orgasm.
  http://www.spinalcord.uab.edu/show.asp?durki=51275

Connect with other organizations

• American Association of Sexuality Educators, Counselors and Therapists
  http://www.aasect.org/
• American College of Obstetricians and Gynecologists
  http://www.acog.org/
• Center for Research on Women With Disabilities
  http://www.bcm.edu/crowd/
• Planned Parenthood Federation of America
  http://www.plannedparenthood.org/

Content last updated September 22, 2009.

Resources last updated September 22, 2009.

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