I’m a woman in my 50s and have been with my husband for decades. We have always had a wonderful sex life and I used to be able to climax vaginally very easily, often without clitoral stimulation. During an eventful time for the family a couple of years ago, my libido and ability to climax disappeared, though they did eventually return. A few months ago, I had a health crisis, which has slightly impaired my coordination on one side. Although I have recovered very well, I am again experiencing a loss of libido and sexual sensation.
We continue to have sex regularly and I enjoy the intimacy. I can climax with clitoral stimulation but it takes a long time and can be almost physically painful. I really miss vaginal orgasms and the release they brought. Although I am of perimenopausal age, I have no obvious symptoms and a hormone test came back normal.
I have felt very emotionally vulnerable and frustrated during my convalescence, so I’m wondering whether stress is the problem. My self-esteem has been affected by my physical disability, but my kind, patient husband always makes me feel desired.
Stress is known to affect a person’s sexuality at various stages, including desire, orgasmic ability and physical arousal. Fatigue and pain can also be culprits, as can many types of physical illnesses or conditions. Psychological issues or mood disorders such as depression and anxiety may also affect a person’s ability to experience pleasure in sex, interrupt the lovemaking process and even lead to sexual disorders.
The health issues you have been experiencing could have affected your ability to orgasm as you used to, so it would be worth asking a doctor to check for factors such as nerve damage – and also help you understand the possible sexual side-effects of any medications you may be taking. I can understand your sadness and sense of loss at being unable to experience your preferred type of climax, but if you can find and address the specific reason, that may become possible again.
Since the clitoris is the most important pleasure centre in most women’s bodies – and “vaginal orgasms” tend to occur when positioning allows for optimum clitoral connection – it would be worth trying different positions to engage your clitoris for maximum effect. But first, prioritise finding tools to handle your stress and start implementing them.
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If you would like advice from Pamela on sexual matters, send us a brief description of your concerns to private.lives@theguardian.com (please don’t send attachments). Each week, Pamela chooses one problem to answer, which will be published online. She regrets that she cannot enter into personal correspondence. Submissions are subject to our terms and conditions.
