Joan advises a reader about handling intimacy after a prostate procedure.

I’m 72, married to my wife for more than 50 years. Through 40 of those years, we had sex almost always daily if not more. I ended up having prostate issues and had a “roto rooter” job done not only once, but twice! The worst part about this procedure is that I no longer ejaculate through my penis. Instead, it goes back up into the bladder.

Changes

Neither if us knew how much this would bother us. My wife misses the power of the ejaculate in her vagina and I miss the feeling of it coming out of my penis. It wore on both of us until I now can barely even get hard. Now when we’re intimate, I have to give her oral sex. If I’m lucky enough to ejaculate, I can feel it happen, but knowing I’m not in her just makes me feel like less of a man, and she doesn’t enjoy sex like she used to.

I’m trying to figure out why she doesn’t want to have sex more often. She tells me she’s just too tired or isn’t feeling well. I miss the closeness that we used to enjoy and the feel of her vagina around my penis. What can I do to help get her back to making love at least once a day if not more?

– Too Much Loss

Joan responds:

It seems to me there are two questions here:

1. The question you asked: “What can I do to help get her back to making love at least once a day if not more?” This is about quantity of sex.
2. The question you didn’t ask: “Given our current reality, how can we make sex more enjoyable and satisfying?” This is about the quality of sex — the most essential part.

Roto Rooter?

First, to help readers understand what you mean by “roto rooter” procedure, the Mayo Clinic explains it this way:

Transurethral resection of the prostate (TURP) is a common surgery that’s used to treat urinary problems that are caused by an enlarged prostate. An instrument called a resectoscope is placed through the tip of the penis. It is then passed through the tube that carries urine from your bladder, called the urethra. The resectoscope helps a surgeon see and trim away extra prostate tissue that’s blocking urine flow.

A common risk of TURP is “dry orgasm,” also known as “retrograde ejaculation,” the release of semen into the bladder rather than out of the penis during orgasm. This is what you’re experiencing. It feels like orgasm — it is orgasm! — there’s just no visible ejaculate. This doesn’t affect sexual pleasure.

The Challenges

I feel your distress, and I understand the many challenges here:

• Physical: You can’t depend on erections and you no longer ejaculate through your penis.
• Emotional: Both of you miss the kind of sex you used to enjoy.
• Relationship: Your wife no longer wants daily sex and seems to evade telling you the real reason.

Physical:  All of us experience physical changes of aging and medical issues that make us alter how we have sex. For you, the changes are stark and tangible in the lack of ejaculate and undependable erections. But there are many other ways to enjoy sex that don’t require either erections or ejaculate.

Emotional: It’s normal to mourn the loss of what you used to enjoy most about sex. But I encourage you to embrace the ways that you and your wife can still enjoy sex and intimacy. You’re still capable of orgasm without intercourse — that doesn’t make you less of a man or less of a lover.  Non-penetrative sex is not a lowly substitute for the real thing. It is the real thing!

Relationship: I suspect that your wife has withdrawn from frequent sex because the anxiety that you bring to your sex play interferes with her pleasure. You say that you “have to give her oral sex.” Surely your wife can tell that you see oral as a chore. If instead you delighted in giving her oral pleasure, don’t you think she’d enjoy it more? Likewise, if she helps you orgasm without intercourse, whether you’re hard or not, practice staying in the moment with her.

Where to go from here

You can’t go back, but you can go forward. Both quantity and quality of sex will improve if you celebrate the wonderful ways you can give and receive sexual pleasure, rather than wishing it was the old way. Ask your wife what kind of sex she would enjoy, given your realities. Tell her what you would enjoy. Experience the sensations and intimacy. Explore options in my webinar, “Great Sex Without Penetration.”

If you need more help, a sex therapist can assist. Find one in your area through the referral directory from the American Association of Sexuality Educators, Counselors and Therapists (AASECT).

Sex is not over for you, and it can be glorious with the right mindset, clear communication, and focusing on pleasure rather than goals. I wish you both the best.

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Joan Price has been Senior Planet’s “Sex at Our Age” columnist since 2014. She is the author of four self-help books about senior sex, including her award winners, the newly updated and expanded “Naked at Our Age: Talking Out Loud about Senior Sex” and “Sex after Grief: Navigating Your Sexuality after Losing Your Beloved.” Visit Joan’s website and blog for senior sex news, views, tips, and sex toy reviews from a senior perspective. Subscribe to Joan’s free, monthly newsletter.