David Bucks, the U.S. distributor of the FertiCare vibrator, designed for Paraplegic men, inspects each product before it's sent to clients.

Rebecca Rosenberg
Nearly 15 years ago David Bucks was extreme skiing in California when an avalanche knocked him down and threw him from a 200-foot cliff onto a rock face. Three of his Vertebrae broke into 42 pieces. At 33, Bucks was completely paralyzed below the chest. Once he realized he'd live, he feared that he'd never be able to have sex again.

"You're telling me that my other legs won't be able to walk but will little Junior?" Bucks recalled asking the doctors.

Some time after the injury, he started dating his nurse and they discovered FertiCare, a medical vibrator from Denmark that is marketed as a fertility aid.

Although Bucks hadn't ejaculated for seven years, he climaxed three times after a half hour of using the powerful vibrator. The orgasms were so intense that his legs flopped like fish out of water and his stomach contracted into a rock. Two months later his girlfriend was pregnant. Bucks was so enamored with the device that he began importing them to the United States.

He found a ready market. Most people with spinal cord injuries rank improving sexual function as more important than walking, according to a 2006 study published in the medical journal Spinal Cord. With more robust public discussion of erectile dysfunction, thanks to the advent of Viagra, the 250,000 Americans with spinal cord injuries are increasingly sampling products ranging from the blue pills to special sex chairs.

"Things have really picked up," said Dr. Stacy Elliott, a sex specialist for the disabled. "Our medicines are much better and there are more products and sexual aids available."

About two decades ago, the few erection aids included a penile implant or an injection of phenoxybenzamine at the base of the penis, which couldn't be used more than once a week.

Now, however, there are products like FertiCare, which is three and half times more powerful than a regular vibrator and requires a doctor's prescription. Bucks turns a nice profit selling 50 a month for $695 each.

Most sex products for the disabled have been geared toward men, but a vibrator especially designed for paraplegic women is due to hit the market within a year. (It is being developed by the International Collaboration for Repair Discoveries, which is based in British Columbia.)

Vibrators aren't the only aids available. The Dutch company Chique Erotique markets the Dream Love Chair for paraplegics; it is an elaborate apparatus with two adjustable and opposing seats. And there is the Eros Clitoral Therapy Device, which creates a vacuum over the clitoris to stimulate blood flow in women with sexual dysfunction. In 2000, the Food and Drug Administration approved the apparatus, which also requires a prescription.

For many wheelchair users, the Internet provides further ways to explore sexuality. Mypleasure.com is one of a dozen Web sites with columns, reviews and products geared specifically for people with disabilities. Mypleasure's Disability section attracts 50,000 hits a year--more visits than to the rest of the site, according to Dr. Sandor Gardos, owner of the site.

Come As You Are, a store in Toronto, which has a Web site of the same name, has so many paraplegic clients that it employs a full-time sex educator, Cory Silverberg, author of "The Ultimate Guide to Sex and Disability." On a typical week, 30 paraplegics visit the store and he helps them select products. "Our philosophy is that everyone has a right to access sex toys," Silverberg said.

The Internet has been a great source of information for Namel Norris, who raps under the name Tapwaterz. He turned to Web sites to get sexual advice after he was shot in the neck in the Bronx at age 17. "I read about different positions, ways to last longer and how to get orgasms," said Tapwaterz, 26. "It makes things easier knowing other people are going through it."

However, sexual activity can present unique and sometimes messy challenges.

For many paraplegics like April Coughlin, having a bladder or bowel accident is a major concern. Although Coughlin, 27, takes medication to control Incontinence, she has come to accept that mishaps will happen. "The reality is you're going to have embarrassing moments, and if the person you're with can't handle it, that person isn't for you," she said.

A more serious problem is Hyperreflexia--painful spasms caused by the brain's inability to transmit messages below the point of paralysis. If not treated, the condition can lead to dangerously high blood pressure and even strokes. The symptoms--excruciating headaches, sweaty palms and lightheadedness--transpire when the body interprets stimulation in the area of injury as pain. As soon as the stimulus is removed, the symptoms dissipate. Although as many as a third of the 286 patients surveyed in the Spinal Cord study experienced hyperreflexia during sex, a full bladder or bowel is a much more common trigger, according to Dr. Kim Anderson, the lead author.

The complication isn't dangerous enough to deter people from having sex or using vibrators, said Anderson, who is paraplegic herself.

The FDA hasn't received any warning letters or adverse effect reports regarding FertiCare. "It's a Class 2 device, which means it's considered of medium risk like an oxygen monitor," said Karen Riley, an FDA spokeswoman.

The potential dangers certainly didn't discourage Bucks, who said FertiCare and other sex tools helped him achieve a fulfilling sex life again.

"After all," he said, "sex is what keeps marriages together and makes the world go around."