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Sexuality and reproductive health

a smiling, preganant African-American woman watching a medical staff member pointing out something on screen during a sonogram

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

Did you know?

Women with functional limitations are less likely to have regular mammograms or Pap tests to screen for breast and cervical cancers.

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

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!


Know your family health history

Many disabling conditions can run in families. Some inherited diseases, like Huntington's disease and cystic fibrosis, are caused by a mutated gene. Even though the mutated gene is passed down from parent to child, not all family members are affected. More often, people can inherit genes that put them at higher risk of certain chronic illnesses, such as heart disease or depression. You can help your doctor assess your risk of disease by sharing your family's health history. This includes your grandparents, aunts, uncles, and cousins. Make sure to share any information you learn that could affect other family members. The MyFamily Health Portrait will help you to create and record your family health history.

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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Content last updated: September 22, 2009.

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