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Do we have to resign ourselves to no more sex?

A few years ago, my husband had a major accident which has left him with a permanent back injury and in chronic pain. Among the many repercussions of this is that sex is now very painful and awkward for him. We can’t seem to find any positions to make love in without it hurting his back and he doesn’t enjoy it because he is constantly tensing up from the pain, and then if we do push through he can’t seem to get a firm enough erection. As a result, we are giving up on sex, but he feels bad and low about his inability to please me and, to be honest, I am feeling sexually frustrated and unloved. Can you offer any advice?

I am so glad you have written in, as these situations can gradually deteriorate and cause a lot of relational pain if we don’t take decisive action.

You may not be able to fix the physical pain and the erection difficulties if there is a permanent blockage of the neurological pathway through the spinal chord, but you can fix the emotional pain and potential division, and find ways to stay sexually close.

Do encourage your husband to get specialist advice if he hasn’t done so already, to ensure everything possible is being done from a medical point of view as erections can be aided with medication such as Cialis, Viagra, Muse or a physical aid such as a vacuum constriction device. He should also check whether any medication he is already on could be affecting his sexual functioning as a side effect.

However, my recommendation from a psychological point of view is that you focus on your intimacy together rather than on sexual intercourse. Better to accept a compromise and enjoy sexual touch without a full erection and penetration than throw the baby out with the bath water and have nothing. Although this takes some readjusting, even grieving, it will be a journey well worth taking.

Reassure your husband that you still find him gorgeous and that he can satisfy you even without a firm erection! Did you know that two-thirds of women who have orgasms don’t do so during penetrative sex. It is far easier to have an orgasm through direct stimulation of the clitoris.

I suggest you agree to enjoy some ‘fore-play’ times together. Let your husband get in whatever is the most pain free position for him, which might include lying in the bath, laying on a warm electric blanket or whatever is best for him. He should also take a good dose of pain killers in advance.

You should both let the other know what sort of touch you might most enjoy, be that a massage, an all-over body kiss or just letting your hands wander. Wear some clothes that make you feel sexy and go very slowly in taking them off. Use it as a time to express verbally your feelings towards each other: what you appreciate and admire about your partner, as well as what you find sexy. Remember you can make love with words – emotionally and physically.

I don’t know how easy or not you found it to have an orgasm before your husband’s injury. If this is something that hasn’t come easily anyway, I would recommend a book called Becoming Orgasmic, which guides us as women through some very practical steps, as well as emotional understanding, that will prepare us for letting go and focusing on our sexual feelings to the level that an orgasm can be enjoyed.

Even if this wasn’t a problem before, you may have conflicting feelings about it now, knowing that your husband is not so readily able to get to this point. It is easy to hold back out of not wanting to reinforce ‘leaving him behind’. However, this is false logic or ‘wonky thinking’ as in fact it adds to his sense of impotence in also not being able to satisfy you.

I would encourage you to embrace your own sexual pleasure in your love making times, understanding that this will give him great pleasure back as much of the joy of sex is in seeing the other person aroused. Remember that God has given you sexual feelings as a gift to bond you together in love and he wants you to continue to celebrate your sexuality in as much as you are able.

As for your husband, continue to pleasure him in whatever ways he can enjoy. This is where you will have to grow together in communication and be free to experiment. The Holy Trinity Brompton Church Marriage Course (see has a lovely exercise in the manual (which goes with session six) that might enable you to talk at a deeper level about some of these things.

Depending on what help can be gained or not from medical interventions, he may have to come to terms with accepting the current loss of a reliable erection. This is a profound thing for a man to face and your love and encouragement will make a huge difference to helping him make peace with this and find his sexual identity the other side of it. If it is any encouragement to know: a third of men face some form of sexual dysfunction at some stage in their lives so this is not at all uncommon.

When conversations are fragile and volatile, it is easy to retract from them, but he needs you to be affirming him within this problem and facing it openly together. Do continue to caress and kiss him intimately when you are having your fore-play times, reassuring him that it is about him simply enjoying that touch. The truth is that the less he feels under pressure to gain or keep an erection, the more likely he is to actually achieve that anyway!

Remember that God has given us sexual intimacy to be a blessing “in sickness and in health”. There is no performance standard. Pursue the positives you can enjoy, be real in grieving and letting go of what is not possible, and delight in learning new ways of making love to each other.

* Becoming Orgasmic . . . a Sexual and Personal Growth Programme for Women  by Julia R Heiman and Joseph LoPiccolo is published by Piatkus ISBN: 0-86188-803-0

Meet our expert

We put this question to Maggie Ellis, a psychosexual therapist and founder of Lifecentre in Chichester, which supports people who have been raped and sexually abused, and their families and loved ones.

Maggie worked as a history teacher before deciding on a radical career change after trying to support a friend who had been raped. She trained as a counselor before specializing in psychosexual therapy, learning how to support people with any sort of sexual problem from sexual dysfunction to sex addiction. Maggie led an open question seminar at the recent Radiant conference and writes a regular column in Christianity magazine.