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A Reader asks:

I am a woman of 75 and have not been able to reach orgasm for about seven years. I really miss it. I am happily single and have always had great success with vibrators, using them solo and with partners as well. Vibrators never used to fail me – but now they do. I even bought a more powerful vibrator, still no orgasm.

I went for a pap exam and summoned the courage to ask the gynecologist, a woman of about 60, about this. She fulfilled my greatest fears by immediately putting up a wall, saying, “You need to talk to a sex therapist.”

I told her that I’ve never had any issue about sex, never thought it was dirty or wrong. I told her it must be a physical issue. I had been hearing about all this sex going on with older people, so maybe it wasn’t age that prevented my orgasms as I had thought. I wanted help figuring this out.

This doctor made me feel that I was an old fool asking about something that I was no longer entitled to.

After she recovered from my question, she said my medications could be affecting me sexually. I take Prozac and blood pressure medication. But she said she did not need to do an exam on anyone over 65 who was not active with a partner.

She finally went ahead with the exam, but told me nothing. I learned later – only because I saw it on a computer screen at an appointment with a different doctor – that she wrote in my chart that I have vulvar atrophy. She didn’t tell me that. No tests of any kind were ordered. In fact, she said I never needed to see her again unless I met up with “tall, dark, and handsome.”

I have a physical next month with my female GP and I’d like to bring this up. After the GYN’s reaction, though, I am very nervous. This doctor made me feel that I was an old fool asking about something that I was no longer entitled to. As we age, we do have to give up things, and perhaps that’s one of them. I just want to know for sure and to be treated compassionately.

After that reaction from my GYN, I have been reluctant to ask for any help from anyone. Thank you for any assistance you can provide.

–  No Orgasm for 7 Years

Joan responds:

I am enraged on your behalf. You were treated incompetently and insultingly. Despite being a woman in her sixties herself, your gynecologist demonstrated ageism, sexism, and unprofessionalism.

…your gynecologist demonstrated ageism, sexism, and unprofessionalism.

Vulvovaginal atrophy is a condition that affects the majority of postmenopausal women, with symptoms of vaginal dryness and difficult or painful intercourse (dyspareunia). This is not the problem you presented, though. That she would dismiss your actual complaint of inability to orgasm (anorgasmia) is unconscionable.

..I am incensed that your gynecologist thought you were undeserving of sexual pleasure unless you had a male partner.

Anorgasmia, particularly if you used to be able to orgasm, can have a medical cause that needs to be investigated. For example:

• Medications including blood pressure medications, antipsychotic drugs, antihistamines and antidepressants, particularly selective serotonin reuptake inhibitors (SSRIs).
• Heart disease
• Diabetes
• Overactive bladder
• Hormonal changes
• Multiple sclerosis
• Tissue damage from gynecologic surgeries, such as hysterectomy or cancer surgery.

Yes, talk to your GP and ask all your questions. You might start this way:

1. I value my sexual pleasure. I am very concerned because I can no longer reach orgasm, although I used to do so easily with my vibrator. This started about seven years ago, but I thought this was part of aging and was embarrassed to ask about it. Now I’m learning that we don’t “age out” of the ability to orgasm, and I need your help.
2. Should we consider hormone replacement therapy?
3. I am on Prozac and blood pressure medication, and I’ve learned that both can affect sexual response. Can we try different medications?
4. I didn’t realize that inability to reach orgasm may be a sign of an underlying medical issue. Can we run some tests to figure out what’s going on?
5. If you want me to see a gynecologist, please refer me to a different one. The one I saw last time dismissed my concerns, did not try to help me, and told me I didn’t need to come back unless I’m in a relationship. This was unhelpful and insulting.

About that last point: I am incensed that your gynecologist thought you were undeserving of sexual pleasure unless you had a male partner. You know, and I know, and our Senior Planet readers know that our orgasms do not depend on having “tall, dark, and handsome” in our lives.

This categorization of women’s sexuality sounds like a bad movie from the 1950s. I’m astounded that a gynecologist would display such an anti-sex, anti-pleasure, anti-woman sentiment and practice gynecology with these antiquated notions.

I hope you’ll update us after your appointment with your GP. You might print out this column to take to your appointment!

Resources:

• “What can cause orgasm problems in women?” NHS UK
• “Anorgasmia in Women,” Mayo Clinic
• “Addressing Vulvovaginal Atrophy (VVA)/Genitourinary Syndrome of Menopause (GSM) for Healthy Aging in Women,” Frontiers in Endocrinology. (Show this one to your doctor.)

Have you experienced ageism in your doctor’s office? take this informal poll and let us know, and we’ll run a follow up post on how to complain effectively.

Before submitting your question to Joan: 

• Check https://seniorplanet.org/author/joan-price/ in case Joan has already addressed your topic.
• Joan can only answer questions from people age 60 and above.
• Selected questions will be answered in this public column, not privately. If you want a private answer, you can book Joan for a personal consultation.
• If your question is under consideration for Joan’s column, she will email you directly and will only select your question if you respond to her email. If you submit your question, please check your spam/junk folder in case your overzealous spam filter captures her email.
• Ready to submit your question? Email sexpert@seniorplanet.org.

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: “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.