The 60-year-old woman came to my office with her husband. She wanted to have a gynecological checkup. It had been very unpleasant last time she saw a gynecologist – her vagina was very dry and tender.
I asked if that was a problem for their sex life. Yes, it was, she answered. Actually, they did not have sex at all. It was impossible, even if they used a lubricant. She looked straight at me and answered in a matter-of-fact, direct way. She didn’t look at her husband, but he looked at her, concerned, mumbling that it had worked out well earlier, also after her menopause. She didn’t comment on that.
When I examined her it was obvious that her vagina was very dry and irritated. But that was not all. She squeezed her pelvic muscles so hard that it was impossible to do a gynecological examination and visualize the vaginal mucosa, the lining of the vaginal walls. There was just too little space. If she squeezed around her vagina like that when they were trying to have intercourse, it certainly wasn’t possible for him to enter her. And I think the reason with her seeing me was to tell the husband that they could not have sex.
Her sex life was over, but what about his?
When I told her what I had found, she actually seemed content. As I had just given her an alibi to finally drop all ideas about having sex. She clearly didn’t want that anymore. But he did. He asked a bit timidly if there wasn’t anything to do, lubricants, medicine? And yes, there was, so I gave her a prescription of vaginal estradiol tablets, the best remedy against postmenopausal vaginal dryness. But I don’t think she will pick them up at the pharmacy. She has decided that her sex life is over.
Then what about her marriage? I don’t know anything about that. Maybe they had lots of other ways of being intimate than sex. But it was clear that her husband was unhappy with the situation. What about his desire? Will he satisfy himself by masturbating in front of the computer late at night, or will he find another woman, a mistress? That is a dangerous solution. Has she thought that through?
Of course you should not have sex if you don’t want to. And it certainly can be a problem, when the parts in a relation differ a lot with regard to desire. But marriage is about willingness to compromise, more often than not. And desire can be turned on, if you allow it. How – that’s something you must talk about.