Ask the Doctors: Pacemakers & Vibrators
My friend has an InterStim pacemaker and can’t use a vibrator because of the magnets in the batteries or motor. Any ideas?–Anti-Magnetic
Your friend’s pacemaker isn’t a heart device, as most pacemakers are; the InterStim is a small implanted machine that uses wires to deliver electrical pulses to nerves in the pelvic area. Usually it’s used for bladder control, though there are other conditions for which it is sometimes prescribed. To confound things in an interesting way, there is a similar device that is sometimes called the “orgasmatron” and which is purported to give women orgasms electronically. I am guessing the InterStim could also be used this way; when a medical device is dragooned for this sort of experimental or “off label” purpose, it’s often not easy to find conclusive info about it. (If you are curious about this, it’s one of the supposed medical female orgasm enhancers explored in the movie “Orgasm, Inc.” — I’m one of the many commentators interviewed about the problems with a medical model of female sexuality. To cut to the chase, I do NOT recommend this method of becoming orgasmic.)
(FYI to Bay Area residents: This film will play in April at the Roxie Cinema — on April 4 I’ll be there with a panel of experts talking about orgasm meds, machines, and such. Out-of-towners might wish to visit http://orgasminc.org/ to order the film or find out more.)
Dr. Myrtle Wilhite, co-founder of A Woman’s Touch Sexuality Resource Center in Madison, WI, with whom I discussed your question, was very firm in saying, “Only ‘off label’ use [in which a medical device or drug is used for a purpose other than its FDA-approved function] would qualify [the InterStim for use as] an Orgasm Machine. Believe me, no one is going to have this pacemaker-like machine implanted into their spine just for giggles or occasional paroxysms, since the surgical revision rate (oops, it moved, or oops, it’s infected) is 33%–incredibly high. Basically this [device] is for people who, due to trauma (surgical, car accident, etc.), have completely lost the cognitive control of their skeletal pelvic floor muscles. This device, when calibrated correctly, is usually not detected by the person when it fires off, since it’s only supplying routine contractions with a little neural jolt.”
So back to your specific question about the InterStim. The danger of using a vibe with this device would first of all be that the vibrator’s magnetic field could affect the machine’s operation and mess up the InterStim-implanted person’s control of urination timing and ability (this could lead to urine leakage) or, more simply, increase the risk of the machine getting screwed up. Dr. Myrtle thinks that if the machine does get turned off or its pulse pattern altered, it can be re-set. “If the machine stops because of an interfering magnetic pulse, it would simply stop. Stopping would mean that the pelvic floor muscles would completely relax, and the person would lose urine.”
Now as to leakage as the primary “danger”: This is an inconvenience which could be minimized by voiding the bladder before sex and/or vibe use, and putting a disposable pad under oneself. If there’s quite a bit of leakage, a waterproof vibe should be used. I’m aware many people wouldn’t even consider doing anything that would allow for the possibility of such leakage — but others would consider it as akin to the inconvenience of female ejaculation, and just deal with it in order to experience the pleasure they’d get from vibrator stimulation and/or orgasm. As Dr. Myrtle said, unlike the risk of an impaired heart pacemaker, urine loss is “not critical.” (And of course, having said all this, I’d be remiss if I didn’t mention that for some people, just as ejaculation is not an inconvenience at all but a big thrill, so is pee. So many mammals involve urine in their mating rituals, it’d be surprising if no humans at all got into it.)
Dr. Myrtle goes further in her analysis of the question, however. “Now, having said that, I think that vibrator use in this circumstance is warranted whether the InterStim kicks off line or not (as long as it doesn’t permanently damage the InterStim for some reason). Why? Well, I think orgasms contract the pelvic floor muscles more effectively and in different regional patterns than the InterStim will–it will only contract those muscles in the range of the leads [that is, the wires that connect the box to the nerves]. No one is going to die if their InterStim stops, so the risk of harm involves displacement of the leads ([which I] suppose could be a big issue if you had to go back in for surgery). I think I’d ask the physical therapist involved whether it was OK for me to have orgasms while the InterStim is in place, period. If it is safe to have an orgasm (barring some surgical/placement complication), then I say vibrate on…”
OK, back to the war of the gizmos. Depending on where the InterStim unit was positioned, there could also be some danger of the actual mechanical vibration getting too near to it, separate from the magnetic issue, and causing damage not only to the machine but to the body. It is usually implanted on the low back/buttock, but particularly if it were in front, this would be the most serious issue of the lot. The actual vibration, the pressure of a nearby vibe close to the implantation site, or a very strong orgasm accompanied by lots of body movement could result in shifting or other device-to-tissue contact and irritation. As it is, as Dr. Myrtle notes above, these things have about a 33% failure rate — that is, the body cannot tolerate having the device implanted and it never heals right. So this WOULD be a true medical concern, far worse than urinary leakage.)
Finally (and I may be stretching here — but maybe not) if the person is in fact using it off label for sexual enhancement purposes, it seems perfectly possible that the doctor who installed it warned against vibrators because those would change the experience of using the device — that is, would override or confuse the neural signals the InterStim was putting out that supposedly result in erotic sensations.
Now then, let’s turn to the question of what to do next. Was the person warned specifically NOT to use a vibrator when the Interstim was installed? Ordinarily if no direction was given, I’d either have them check with their doctor or physical therapist, or with the device manufacturer to get the official word on it. However, having actually reached out to the company myself to ask about this (the official website seems to give no info at all about vibe use in its many FAQ pages, and other Interwebs research is pretty inconclusive), I learned that the company doesn’t actually answer that question when you pose it — instead, they deferred right back to the prescribing physician.
This, however, leads to a dilemma, in that so many doctors get very little information about sexual functioning (apart from learning all about how babies are made) in their medical school curricula. When a doctor warns against some sort of sexual act, always ask that the prohibition be explained clearly to you. This will give you some idea, frequently, of the doctor’s own understanding of the facts and issues; in many cases, patients will have information about the relevant sexual behavior that the doctor doesn’t have.
So I’m going to second the company’s advice, and recommend that your friend get back to the original doc who installed the gizmo. First, s/he should ask whether a vibrator can be used with the InterStim — if the answer is no, then ask WHY. This allows your friend to decide whether, for example, the possibility of leakage is worth the chance of a nice orgasm — or whether the prohibition is more serious and has to do with the positioning of the device or something else that risks actual physical damage.
And if your friend is none too keen on the idea of a sexually-related chat with the doctor, recommend Dr. Charles Moser’s very useful book Health Care Without Shame.
By the way, in case any readers saw the word “pacemaker” and hoped that the Q&A was about cardiac pacemakers — I’ve done some research about that too, which I’ll write up and share soon.
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