Sex and relationships - expert Q&A with Trudy Hannington

Would the DFail really take up a story from here?

I am more worried about the DC and what they would say, especially now that I am older. They seem quite sure that I have only had sex the same number of times as the total number of children I have

You could use the different username option.
It doesn't always solve the problem of identifying details, but presumably nobody would know enough about someone's sex life to recognise them?

Granny23

I'll break the ice with a question that comes up often in carers support groups:

a) What to do if the spouse/carer wants to have sex with their longterm partner, but the partner now lacks the capacity to consent?

b) What to do if the partner with Dementia is continually trying to instigate sex but the carer/partner cannot bring themselves to co-operate?

In answer to a) It is very important that consent is agreed when being sexual with anyone. I understand it must be very difficult and sad not to be able to make love to someone who you have been close to for many years, but the distress it could possibly cause to the person it is happening to particularly with a dementia patient as their thought, memories and reactions can change very quickly could be very damaging.

It is important to talk to someone about your feelings around this subject and not to feel guilty about your thoughts and feelings. You can still be loving towards your partner in as gentle a way as possible but to be fully sexual without consent is wrong.

For b) This is a very distressing situation and I have worked with patients over the years in my clinic where this has happened. It is important to speak to your GP or specialist who is treating the person with dementia, as some medication can be introduced to calm the situation down, without necessarily stopping all sexual desire and intimacy altogether.

Silentwitness

Partner and I have been together 25 years. Both early 60s. He had prostate cancer treated with hormones and radiotherapy so sex was not then possible. Since treatment ended we have managed intercourse twice though not very satisfactorily for either of us. For the last few months neither of us has raised the subject or apparently had the urge - I definitely haven't. He's retired early and the combination of us being together a lot more and little intimacy is causing us to drift apart. I suffer from vaginal dryness and he was using Viagra even before the cancer. How do we restore things? Clearly we need to talk but I'm quite happy without sex though I do miss the closeness we once had. A trip to GP? (Have name changed in case anyone wonders who this new person is)

Prostate cancer treatment is very damaging for sexual function, however, there are some very good treatments now available. Viagra is unlikely to work on its own but there are other treatments available such as injection therapy. This can sound gruesome but we use it a lot in our clinic with excellent results. The name of the injection is Invicorp if you would like to read about it or ask your GP if you can be referred to a specialist in sexual medicine or an Urologist to discuss these options. It is available on the NHS too. It is a very small needle and does not cause pain. Normally you are taught together as a couple how to use it. There is also a vacuum device and rings that can be used and again one of these can be prescribed on the NHS. Do remember though that it isn't always necessary to focus on penetrative sex. Foreplay can be just as enjoyable and an erection isn't necessary for this, enjoyment, intimacy and closeness can still be achieved.

For the vaginal dryness there are some wonderful lubricants on the market. One of the best ones is YES YES, it is natural and organic. They do a water based and an oil based lubricant and theses can be mixed together to give what we call a double glide technique! If you contact the company they will send you a sample to try. The website is yesyesyes.org.uk They also do a vaginal moisturiser that you can use every few days that can also help with just general day to day comfort. We do now also know that localised oestrogen cream or pessary can be used very safely at any age. You can read more about this on menopausematters.co.uk

As it has been a long time since you have been sexual, it can be very scary starting your sex life again, this is where a sex therapist can really help. You may have someone available locally on the NHS or to see someone privately look on the COSRT website (college for sex and relationship therapists) you will find a list of accredited therapists who are highly trained in this area. You have to start slowly, dating again, kissing and cuddling until you feel more relaxed before progressing to anything more sexual.

notreallyme

My question is this. We are both in our mid 60s and happy in our relationship but our sex life is dwindling greatly. When it happens we both enjoy it. I think we would both like it to happen a bit more. But life, tiredness, family stress gets in the way. Do you have any suggestions? We are not ready to give up

This is such a common problem, sometimes the mind's willing but the body is not quite there!!

Basic tips would be to try to change the routine, so if you are now retired or working part time don't wait until 11pm to be sexual, try to have a lazy Sunday morning instead!
Plan and book "dates" with each other. This does not have to mean spending lots of money and going out but a dine in from M&S can work just as well.

Get back to basics with cuddles and kisses that don't have to mean sex, have a cut off time in the evenings where no matter what isn't done is left to the next day, try this at least 2 evenings a week and then sit on the same sofa, cuddle up and spend quality time together.

Sometimes it is nice to forget penetrative sex and explore each others bodies and experiment with foreplay to enhance sexual activity. Once again seeing a sex therapist can really help with this kind of problem.

newnameforthis

Hello Trudy. I am in my mid 50s and my husband is ten years older. I really enjoy sex but increasingly he is becoming less interested. Our relationship is good aside from this and I don't want this to damage it. But what can we do when one wants it and one doesn't? One of us is going to end up frustrated or pressurised which is not good.

Q4. Age difference can be an issue but I would be keen to run a few blood tests and just rule out testosterone deficiency which is much more common than you may think. This can be easily treated and treatment is available on the NHS. Other symptoms of this condition are tiredness, low mood, loss of "mojo" you can read more about this on our clinic website legerclinic.co.uk.

Sometimes men of this age struggle to get or maintain an erection and this can cause performance anxiety. Men then tend to avoid sex as they feel embarrassed or scared that they might fail. over 50% of men over the age of 50 will have some degree of erectile dysfunction. Using something like a small dose of Viagra can really help with this. There is also an alternative to Viagra which is called Cialis, this can be taken as a daily dose which helps couples be much more spontaneous sexually, men often report feeling much more confident with this drug. Both are available on the NHS through your GP.

southernnn

Since my husband had surgery on his back last year he has found it difficult to have sex. Wea re both keen but it just doesn't seem to be happening for him and maybe the more we are worrying about this, the less likely it is to improve. The doctor says there is no reason why we can't resume our sex life so there is no medical problem. We have thought about Viagra but were nervous about it. Can you put our minds at rest? Thank you

Q5.There is really no need to be worried about trying Viagra, as long as our husband is not on any nitrate medication then this is a very safe drug to use but see the answer to No.4. Cialis might be a better option as this can be taken as a daily dose. Both of these drugs are available as a generic drug so quite cheap now and available on an NHS prescription. Don't just buy it off the internet though as you really don't know what you are buying! See your GP first or find a specialist in sexual medicine.

Back problems can interfere with sexual function and can affect a mans erection, once again it is worth ruling out any other possibly underlying physical problems such as cholesterol levels, diabetes, thyroid problems and testosterone deficiency, all of which cause erection difficulties.

It is necessary to try either Viagra or Cialis at least 8 times over a period of a few weeks, as many men try it once and because they are nervous it will fail it then doesn't work! Therefore, a good few goes is important.

Benji3742

We been married for 17 yrs all in our late 60s. DH was diagnosed with heart problems 13 years ago and told by the doctor he will die if he have sex, we have not had sex since. I am very unhappy. Any advice?

Things have changed a lot in the last 13 years! There has been a lot of research and there is good evidence now available that if you can walk up 2 flights of stairs without feeling breathless then you are fit enough to be sexual.

Go back and see your GP and if necessary ask to be referred back to see a cardiologist for a second opinion, as your husband will probably be able to be prescribed Viagra and given permission to attempt to be sexual. It might be that you can't be as energetic as you use to be but maybe if you try different positions where it isn't quite so tiring for your husband that could work well. For example, female on top position or a spoon position where much less energy is exerted.

Once again a sex therapist and a doctor specialising in sexual medicine is who you need to see, you will then know your options and be given guidance on what you can and can't do.

Many thanks for your interesting questions all of which are common things we see in our clinic every day so do not be afraid to seek help.

Southernnn. Viagra isn’t going to help with his back problem but may well help his confidence, you can get it without prescription and it doesn’t cost an arm and a leg, give it a try.
The general response to this thread very depressing, there are plenty of younger grans that do still enjoy sex, eventually we will all stop for one reason or another but if you can keep enjoying intimacy it helps the relationship a lot.

I am 67 and for a few years suffered with virginal dryness. My question is why is it so painful with penatrive sex. Because of this, penatrive sex has not happened for a few years. I know you can get lubricants for this problem but which is the best one. I still feel really nervous about trying again as I am frightened of the pain. Other then that we have a very loving relationship.

I would love to still have a sexual relationship with my husband, but he seems to have lost all interest. He is 65 and I am almost 68. I do not have any problems with vaginal dryness, but we have not made love for over year now, possibly longer. I really miss the intimacy and closeness, but it's almost as if he has decided he is too old for it now.

MooM00 - I find KY Jelly sort of helped for intimacy. On a day to day basis I use Vagasil cream. However, just started on a hormone pessary from the GP which she says will sort matters.
I think it's not only vaginal dryness that is the cause of pain, but also an element of thinning of the skin/membrane that happens as we get older.
If I recall correctly, I think on a thread some time ago I called it 'sandpaper sex'.

MooMoo, the thread included sandpaper sex , and recommended Vatican cream. !!!! Obviously a typo error for Vagisil, it gave us all a laugh, Was it sold in the gift shops around the Vatican ?

I have a feeling no one is going to be able to help with this as I have tried everything/read everything/ everything is being tried medically.. Husband has always suffered on & off from what we now understand is prostatitis- his symptoms are frequent urinary & urethral pain/ discomfort etc. Has been to a specialist repeatedly. Up until recently he was keen to have sex & dealt with the symptoms if/when they occurred. The last couple of years he has been finding reasons not to. We are at crisis point now in him having completely lost interest & refusing to take part in any sexual activity at all, even if we avoid penetration which even if momentary seems to cause a flare up. We get on so well & he says all the right things when we talk about it. Im getting desperate now because I really dont want to stop. Can anyone help me? I worry it comes across as selfish- obviously I want him to be well but even when he is feeling ok he just doesn’t want to know. Please dont suggest a psychosexual counsellor as I have known one in a work setting & know it wouldn’t help him at all.

I think a lot of it is an age thing. If you are still getting on well seems the intimacy is only what you can make of it.The compassion is great and makes it all worthwhile friends to the end is the way to go. The pressure to have sex if one is not able or willing can cause a lot of problems. As long as you agree on this together there is a way forward. Viagra..ky jelly and other methods can help but if one or other have health problems you need to consider all options and how you both want to deal with it.

Thats the trouble- I dont want him to feel hurt but I am really not ready to give it up, whereas I think he would be even though he says that’s not the case.

Sex is a biological need in all of us no matter what your gender. We plan our sessions for mornings only. Always most enjoyable thankfully.