Safe sex

Safe sex

A University of British Columbia researcher helps spinal cord patients safely become parents.
May 1, 2007
Having children is considered one of life’s greatest joys. It’s something that many people wish for, and people with spinal cord injuries are no different. The challenge, however, is that people with spinal cord injuries can have difficulty regulating their blood pressure. This inability is particularly troublesome for some men who wish to become parents. First, the process of impregnating their spouse isn’t easy. For paraplegic and quadriplegic men, the procedure involves a doctor using a vibrator to stimulate ejaculation for in vitro fertilization to be possible. Though it may sound straightforward, the very act of ejaculation can put these men’s lives in jeopardy.

“Any man’s blood pressure goes up during ejaculation,” says Bill Sheel, a kinesiology researcher who works out of the Health and Integrative Physiology Laboratory at the University of British Columbia campus. “But a spinal cord patient’s blood pressure may skyrocket during the procedure.”

Quadriplegics, in particular, have less control over their blood pressure because messages sent to and from the brain to various body parts during stimulation can’t get through. Instead of the brain regulating blood pressure, as it should, the messages increase blood pressure. The higher an injury occurs on the spinal cord, the more problems a patient will have in regulating blood pressure.

The suggested optimal blood pressure for most adults is 120/80mm Hg. During the stimulation procedure, Sheel saw the blood pressure of one of his patients shoot up to 240/130mm Hg while his heart rate dropped, presenting a condition known as autonomic dysreflexia. “It’s very dangerous,” explains Sheel, as it significantly increases the risk of stroke, seizure and death.

With the help of a team of four researchers including a sexual medicine specialist, Sheel became the first to study the reactions to ejaculation stimulation in paraplegics and quadriplegics with and without Viagra (a drug noted for lowering blood pressure). The study led Sheel to conclude that quadriplegics appear more likely to suffer from autonomic dysreflexia.

Sheel, who used to work with elite athletes, aims to understand how the heart, lungs, blood, and muscles work together under stress. And he now uses this expertise to help spinal cord patients safely have children.

“His team is pioneering work in spinal cord research,” says John Steeves, director and founder of Vancouver-based International Collaboration on Repair Discoveries (ICORD), a spinal cord research organization. “This kind of research requires Sheel’s training and his unique perspective on how blood flow changes during exercise.” With a new lab full of instruments that non-invasively monitor the body’s vital signs during exercise, Sheel is equipped for breakthroughs in blood pressure control for spinal cord patients, and in diseases such as sleep apnea and chronic obstructive pulmonary disease (COPD). “There’s really no one else doing work like this,” Steeves says.

With any patient, Sheel uses Doppler ultrasound, microneurography equipment, a beat-by-beat blood pressure monitor, and data acquisition to continuously and repeatedly monitor different body functions and vital signs simultaneously. Instead of the big needles and bulky tools often used in such monitoring, the new equipment allows Sheel to gather all information non-invasively. This makes it possible for him to observe a spinal cord patient undergoing ejaculation stimulation without causing the patient any discomfort. Most importantly, by monitoring so thoroughly, Sheel is able to stop the procedure before the patient suffers any health risks.


Microneurography equipment
Microneurography equipment

Young men take more risks than any other demographic, so it’s no surprise that they also suffer the most spinal cord injuries. Years before thoughts of fatherhood enter their minds, these men are left unable to bear children naturally. But, advances in ejaculatory devices, led by researchers at ICORD, mean becoming a dad isn’t impossible anymore.

Like a proud father, ICORD Director, John Steeves, knows the exact number of spinal cord patients in Vancouver that ICORD has helped in realizing their dream of fatherhood: 100. It may not sound like a lot, but every time the ejaculation stimulation procedure is performed, there are significant risks involved. “We always want to do it in the safest possible manner,” says Steeves. “We don’t want patients going into a medical situation that could prove detrimental to their health or even deadly.”

To meet this goal, ICORD started working with researcher Bill Sheel and his state-of-the-art equipment to make the stimulation procedure safer. Ejaculation is the result of a complex and coordinated effort involving the brain, spinal cord, sympathetic, and parasympathetic nervous systems. In the average man, the lead up to ejaculation causes increased systolic and diastolic blood pressure (25 to 100 mmHg) and increased heart rate (20 to 65 beats per minute) that peak at ejaculation, before quickly returning to normal. In spinal cord patients, the break in the nervous system means messages can’t get through. The body must instead go through a complex feedback system that can cause blood pressure to spike up to 140 mmHg higher than resting, and heart rate to fall by as many as 15 beats per minute below resting. Sheel monitors patients’ vital signs and halts the procedure if blood pressure and heart rate get too far out of sync.

While the Viagra trials did not prove fruitful for lowering blood pressure, Sheel continues to test different supplements to see the effect on blood pressure of spinal cord patients during ejaculation. By performing such research and data collection, Sheel is trying to predict which spinal cord injuries are most likely to result in autonomic dysreflexia. As he works towards finding a surefire answer, he’s also helping to make parenthood a safer venture for spinal cord patients. “Being able to have children does wonders for the psychological well being of the patients,” Steeves says. “It creates a higher quality of living.”


Sheel’s research-devoted lab is rare and therefore in high demand. In addition to his work with the International Collaboration on Repair Discoveries, Sheel collaborates with researchers within UBC’s School of Human Kinetics and other UBC departments, including zoology, rehabilitation sciences, sexual medicine, and general medicine. He has also trained researchers at other universities and hospitals in Quebec and B.C. to use sophisticated equipment like the Doppler ultrasound. The lab is funded through support from organizations, such as the Michael Smith Foundation for Health Research, Natural Sciences and Engineering Research Council of Canada, the World Anti-Doping Agency, and the Canadian Institutes of Health Research.

Learn More

Read the abstract about the Viagra study from the Journal of Applied Physiology. (Site anglophone)

For more information about sleep apnea and COPD, visit the BC Lung Association’s site.