I am my wife’s carer, but she can’t have sex and I need to satisfy my libido

I am a man aged 65 and my wife is 69. We have been married for nearly 25 years. As young people, we were both shy and found it difficult to make relationships, but then we got together and shared many activities, including a happy sex life. Recently, my wife has developed chronic back pain, which has been very debilitating for her. Many activities that we used to enjoy together, including sex, have fallen by the wayside. She finds any form of sex, even stimulation by hand, too painful. We have not had sex for several years, but I still feel the need for some sexual pleasure in my life. I have come to rely on fantasy and masturbation. My wife may need assistance at any time, day or night, so it is difficult to fit in a relaxed session. Soon, however, my wife is getting respite care and I will be able to take a holiday. With the prospect of having whole days and nights to myself, I am excited by the thought of calling a sex line or getting a sex doll. My superego tells me not to, but my libido insists. I feel I have to keep this secret from my wife, as I don’t want to upset her.

All couples keep secrets from each other. In some cases, these could be considered by an outsider to be harmless and inconsequential, while other cases might be judged to be harmful betrayals. I try to be nonjudgmental and can’t advise you regarding the morality of the choices before you. Let me say that you are not alone. There are many people struggling with the kind of situation you are facing – trying to meet your needs while protecting your spouse’s feelings, but frightened by the secrecy that would be necessary to achieve the former. There are ways to help people living with chronic pain enjoy sex, but your wife may not wish to explore these options. People who have lost all interest in sex do not usually value eroticism. However, they tend to desire a different kind of intimacy – which you are probably providing already as her carer. Could you reframe your different physical needs as natural consequences of your physiological realities? In order to be a willing and energetic caregiver, you must look after yourself. Be cautious, but be kind to yourself – and recognise that the secret, low-risk, self-pleasuring activities you are considering may be beneficial to both of you.

Pamela Stephenson Connolly is a US-based psychotherapist who specialises in treating sexual disorders.

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