My husband is sick and impotent. I’m in my 50s and miss sex

Q. My husband has ongoing health problems and is impotent as a result.

He doesn’t want to talk about it and, most nights, sleeps as soon as his head hits the pillow. I’m in my late 50s and, while my sex drive is not what it once was, I miss the intimacy and buzz.

A. Being unable to maintain, or achieve, an erection is the most worrying sexual problem for a man. Impotence is the old-fashioned term, but it accurately describes the feelings such failure produces.

More than likely, your husband is dismayed and unhappy about being unable to ‘perform’ in bed with you.

Resentment can build up and with it an inability to talk about how this difficulty is impacting on the relationship.

At a sexuality conference in Glasgow, a number of years ago, I attended a presentation of a small piece of Canadian research on the effect of ED following prostate cancer. There was little or no knowledge of the impact on the partner. This fits with some couples I have met.

One man commented that men don’t talk about their feelings and suffer in silence. It may well be that your husband is unable to find the words to explain what he is gong through. He is living with, and beyond, his health problems. He probably sees himself in a different light — less masculine — and with this goes his desire.

But as his partner, you are left on the outside. You are rightly distressed about what is happening to your relationship. There is an elephant in the room and it is proving difficult to discuss this sensitive issue.

There is the stereotyping that men are only interested in the restoration of erections. Maybe sex in the past was always about penetration. Now, this is not possible, so he sees it as the end. He may be thinking he can’t satisfy you. Yet many people have pleasurable sexual encounters where they don’t orgasm. Men, too, can orgasm without ejaculation.

For many, following prostate treatment there is dry or retrograde ejaculation — he reaches climax, but no fluid comes out of the penis. It is redirected into the urinary bladder.

You need to find a way that he will hear you and engage in a conversation. You both are grieving the loss of the past sex life. You have to face the changes, the emphasis is to be on pleasure rather than penetration.

This is a chance to tune into new feelings of pleasure. Sensual touching all over the body gives pleasure. Plan to get together and relax. Reconnect emotionally. Talk about where you like to be touched and what it means to you.

One male client told me that once he got through the attachment to penetrative sex, he enjoyed the cuddling, the touching, and was delighted if his wife came to orgasm. He was able to orgasm as well.

Yes, their sexual encounter was without penetration and retrograde, but there were strong feelings of pleasure.

The most important thing for this man and his wife was that they were close and intimate again.

A good book for you both to read is The New Male Sexuality, by Bernie Zilbergeld (Bantam Books).

* Marie Daly is a psychosexual therapist with Relationships Ireland; visit www.relationshipsirleland.com.

* Please send your questions to: [e-mail]