Sexual intercourse has become almost impossible

Kate Holmquist answers your life and relationship problems

Q I’m in my late 40s, deep into menopause and suffering terribly from vaginal dryness and discomfort. Sexual intercourse has been well-nigh impossible for almost a year. My husband and I are both grieving our lost intimacy.

My GP, who has been a great support, has tried me on every solution known to modern medicine, but with little or no joy. Her latest suggestion is to forget about intercourse altogether for a year or two and instead keep things going with oral sex and mutual masturbation. Seems like a very reasonable solution, right?

But here’s the catch: before I met my husband, my previous boyfriend was mainly interested in the many and varied alternatives to intercourse. While I enjoyed all that immensely at the time, I felt it was to the exclusion of the more traditional activity (required if I was to get pregnant). So when I met my husband I decided to stamp my authority on matters sexual from the outset. I told him straight that the thought of oral sex was enough to turn my stomach. If he wanted, or needed, that he would have to look elsewhere. I could sense his disappointment but, shy and gentle as he is, he never once questioned it or complained.

When I was 28, I caught him masturbating and shouted at him that I would “tell his mother”. Looking back, I can’t understand why I did that.

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How can I apply my GP’s advice, given the tight corner that I, for purely selfish reasons, painted myself into all those years ago? Or am I damned to suffer karmic payback for my deceit?

A You're being too hard on yourself, finding reasons to punish yourself by raking over past behaviour. We can only live in the now. Since it's a woman's prerogative to change her mind, you could tell your husband that, considering your current difficulty, you want to try oral sex because physical intimacy with him is so important.

You say that you stamped your authority on the sexual relationship, which you now regret having done. Perhaps you have changed with maturity and it’s time to be non-judgmental, to let go of control and try new things. This fundamental self-questioning is part of menopause for many women.

If you feel you want to relinquish the powerplay, perhaps you could tell your husband that you have changed and now want to try new things. It’s all about opening up communication.

So many couples share a bed without being intimate. Several readers have written to say that once they took the advice (and summoned up the courage) to speak openly to their partners, they rediscovered intimacy and even laughed about how worried and alone they had felt before.

Regarding the vaginal dryness, is a second opinion in order? Irish Family Planning Association medical director Caitriona Henchion advises: "There are very good medical treatments available for treating vaginal dryness. At a women's health clinic, you can speak to a doctor who has experience with management of menopause.

“Local oestrogen cream can be used by almost all women, even those who don’t choose, or cannot use, hormone replacement therapy. Other non-hormonal treatments are also available.”

Vaginal dryness is not only about sex, it can be uncomfortable for other reasons, so treat this as a medical issue that needs to be solved, rather than waiting for “a year or two”.

Your question is wonderful in that it reflects your own realisation that, early in your marriage you set up a pattern, perhaps a power trip, and now with your physical and emotional maturity you want to behave differently. Life is about growing. There’s no need to beat yourself up by dredging up the past. Start afresh from today. Your husband may be delighted.

Q I’ve been feeling upset about the saturation coverage of the new abortion legislation for reasons that I can’t talk to anyone about. It’s a long story. My husband and I have had troubles over the years. We separated, then got back together, separated again, got back together again. I’m hoping that now we are together for good. But why is it that we could have sex when we were apart and now we rarely do?

I am really afraid that it’s my fault that there’s a block between us that cannot be dissolved or even discussed.

Several years ago, I became pregnant unexpectedly by my husband. We were separated at the time. We already had children and hadn’t plans for more. Due to the difficulties in our relationship we hadn’t been having sex for quite some time so I wasn’t using contraception. Then – I can’t explain why really – we had sex spontaneously.

Despite my age, I fell pregnant. I was in a complete panic. It felt so wrong to have another baby as our relationship was in chaos and I couldn’t see myself coping with a new baby while juggling so many personal and financial problems, including dealing with our young children as a single working mother.

My pregnancies were always difficult and on my last pregnancy I was even advised not to have another.

So a new baby would have destroyed me mentally, possibly physically, and my children would have suffered.

So I thought about termination. When, at the time, I tried to discuss it with my (separated) husband, he acted like it had nothing to do with him. I decided to have an abortion in the UK.

Afterwards, I was relieved but also grief-stricken, if you can imagine feeling both at once. I did my best to forget it. But I don’t think our marriage has got over it. It’s as if a bond was broken between my husband and me because I chose for this child not to be born. I even feel guilty for having deprived my children of a sibling they should have had. It’s years ago but still keeps me awake at night.

A You have great strength to have written, but it is still difficult to deal with the consequences of such a choice alone. Sometimes we are so traumatised at a particular point in life that it's years before we are ready to address our feelings. To move forward you need support. Many women don't realise that post-abortion counselling is readily available, whether the abortion was last week, last year or last century.

The Irish Family Planning Association, which offers post-abortion counselling, says in answer to your letter: “Women’s abortion experiences are diverse: each individual woman lives, experiences and interprets her pregnancy and abortion differently.

“The nature of the abortion debate, some of which is deliberately stigmatising, has raised issues for many women. Post-abortion counselling can provide a safe space and support for understanding and resolving emotions that may arise.”

The association’s professional and confidential counselling service is available for women who wish to talk to someone during and after an unplanned pregnancy. The service is free and available regardless of whether you have attended the association’s medical or counselling services in the past. Also, you do not have to have had an unplanned pregnancy recently to avail of the service; it is available to women at any time.

If you would like to bring your husband along, you can. “The service is available to partners and couples. It is not uncommon for one partner to continue to receive counselling, even after the other feels that issues and emotions have been resolved,” says the association.

The lack of sex in your marriage may be about other issues too, but right now you are focusing on the abortion, so you would be wise to address this.

To make an appointment with one of the fully accredited counsellors and psychotherapists at one of 12 centres nationwide, contact the Irish Family Planning Association on 1850-495051.

Send your questions to Kate at tellmeaboutit@irishtimes.com