Sex & Relationships

Ask Joan: Painful sex

Every month in Sex at Our Age, award-winning senior sexpert Joan Price answers your questions about everything from loss of desire to solo sex and partner issues. Nothing is out of bounds! If you’re over 60, submit your questions to this column by emailing Joan directly at

A reader asks:

I am 65 and my husband is 73, married for 35 years. I no longer desire to have sexual intercourse. I had a hysterectomy by age 40 and had radiation treatments to my cervix to treat dysplasia in my early fifties. I have no libido, and intercourse is extremely painful even with lubricant. Even touching my breast is irritating because it is not sexually stimulating anymore.

Even when I try, I cannot tolerate the pain of intercourse. My husband knows this, but he wants me to do it anyway. He wants me to endure the pain long enough for him to have an orgasm.

I have suggested to my husband that he should masturbate or have sex outside the home if he cannot live without it. We have had this conversation for well over ten years. Sometimes I have said it lovingly, sometimes angrily. He always said that he will, but he does not. I do not believe he is interested in having sex outside of our marriage. He wants to have sex with me.

We have been through many years of marriage counseling on and off. We haven’t seen a sex therapist because it’s not covered by insurance and we’re living on retirement income. I have discussed my painful intercourse with my primary doctor and my oncologist. Both have suggested lubricants, but they do not prevent pain.

When I hear stories of how older adults are having the best sex of theirs lives into their 80s and even 90s, I have a hard time imagining these scenarios. Don’t women struggle with lack of libido and painful dry intercourse even if they have not had radiation and surgeries as I have? 

I do not believe this situation is going to change at this point in our lives. I just want us to live out the rest of our married lives enjoying the things we both like doing together and leave behind anything that we don’t — like sexual intercourse.  I wonder if there are many couples out there in similar situations who are finding ways to be happy together even though they are no longer having sex.

—In Pain

Joan replies:

Your husband keeps insisting on the kind of sex that you find unbearably painful, even though he knows how much it hurts you. You do not need to tolerate this. “Aw, honey, just endure the pain while I thrust inside you until I reach orgasm” is not an acceptable request, let alone demand. He has a right to his sexual desires, but he does not have the right to inflict pain on you to get those desires met. There are plenty of other ways he can reach orgasm.  

We do need lubricant at our age, but that is not enough of a solution for you because of your past medical issues. A free self-help program to decrease the pain of penetration is the Vaginal Renewal Program from A Woman’s Touch, and a pelvic floor therapist would be helpful, also. But the bigger issue in your letter is your relationship: your husband wants intercourse with you, although you find it intolerably painful. 

Would you be willing to have non-penetrative sex together, or are you so turned off by his demands and your own lack of pleasure that you’d rather not have sex at all? It sounds as if you’re asking for a “companionate marriage,” which means that you love each other, you’re bonded, you want to stay together, but sex is not a part of your relationship. If that’s what you want, and your husband wants sex with you, how do you resolve that?  

I’m not expecting your husband to do without sex, and to your credit, neither do you. You’ve encouraged masturbation and offered him a “free pass” to go outside the marriage. I commend you on your openness to that solution. That might not be his first choice, but he can’t have his first choice because it’s too painful for you. 

You’ve been having this discussion for ten years without resolution. You need to involve a therapist or counselor who accepts your insurance and will help the two of you discuss what you need, what he needs, and what alternatives would let your marriage continue. 

Please show this column to your husband and to your therapist if he won’t hear it from you. I suggest you also show it to your doctor, who does not realize the severity of your vaginal pain. 

For others experiencing pain with intercourse, here are some past Senior Planet articles and other resources that you’ll find helpful:


Readers: If you’ve had to negotiate sexual boundaries due to pain, what are your tips for talking to a partner? Let us know in the comments!

Send Joan your questions by emailing All information is confidential. Joan can only answer questions that are chosen for publication from readers age 60+ 

Naked at Our Age” and her newest, “Sex after Grief: Navigating Your Sexuality after Losing Your Beloved,” coming August 2019. Visit Joan’s website, blog “Naked at Our Age,” and Facebook page. For senior sex news, tips, event and webinar announcements, and special offers, subscribe to Joan’s free newsletter.



9 responses to “Ask Joan: Painful sex

  1. This is a question for Joan or anyone feeling capable of answering the question. My wife developed extreme vaginal sensitivity shortly after bearing children. So much so that we were unable to enjoy intercourse together anymore. The pain sensitivity was so great that she did not enjoy oral or hands either. She is unable to pleasure herself. She let me masturbate on her breasts a couple of times but it was so one sided (in my favor) that I didn’t even enjoy it. She spoke with her doctor and he prescribed her some sort of hormonal cream which was ineffective. Our sex life stopped and we just went on working and raising two children in a loving family environment. A couple of years ago my doctor told me my prostate was extra full of fluid and that a recent medical study recommended me to ejaculate at least 21 times per month to maintain good prostate health. My wife and I spoke about this and it was agreed that intercourse was out of the question but that I should masturbate to control the build up of sperm.
    For visual stimulation I have used porn to obtain an erection and during the course of viewing I came across several videos when a man was penetrating a woman anus. I was kind of surprised by the enjoyment the women were experiencing and how surprisingly clean it appeared. I honestly though it would be messier. I began wondering if this could be an answer to my wife sensitivity to vaginal intercourse. I don’t know if this is just an act or real enjoyment takes place, so I am looking for help understanding if this is a real solution or just bad porn.

  2. I can empathize with this situation because my wife of 30+ Years has not had sex with me in 25 years because it hurts her. But we have come to an agreement of sorts. It was hardly a turn on for me to attempt penetration when my wife would tense up and cringe in pain at the mere touch of my penis head to her vagina. So I stopped. I felt more bad for her because she was trying for me, even though it was not something she wanted. Thats love.
    My doctor told me that fluid was building up in my prostate and could result in problems. He told me of a study that recommended men to ejaculate at least 21 times a month to maintain good prostate health. I did not inform him that my wife and I don’t have sex because he is her doctor too. Privacy consideration: if she wants to bring that up with him, she will. Not my place to tell him that.
    Anyway, I told my wife about the discussion with the doctor. Followed by what I felt was a pretty good compromise. I told her that If she was ok with me openly masturbating, that I would have no expectation for her to attempt sex with me. This worked for both of us and that is how it is for us. No anger, no accusations, no messy affairs, just good communication and plain masterbation. I don’t want to be crude about it so when I am going to masturbate I tell her Im doing a “prostate workout” – and she knows what I mean.
    There has only been one drawback which turned out to be physical. After regularly masturbating, my prostate has gone into super production and instead of masturbating 21 times a month as recommended, I have to masterbate at least twice a day to keep the volume of sperm buildup under control. But we worked it out as responsible loving adults, and we are both good with the situation.

  3. One can only imagine what other psychological abuse this woman has endured for 35 years. She needs to divorce him only because he is an insensitive selfish sadist. There are many men who would be more than happy to make love to her without demanding PIV intercourse.

  4. Dear Joan,

    Hmm…this was difficult to comprehend such selfishness. I’d like to see how her husband would handle this if the shoe was on the other foot. What. A. Pr*ck.

    I can’t help but feel that this is teetering over the line of abuse, if not torture – inflicting pain on another. I do not know how she has put up with his behaviour. If I was with a partner who was so insensitive to my needs I certainly would not feel any desire to give him a blow job or even a hand job for that matter (I’d probably want to kick him in the balls too). What a way to crush warmth and intimacy between two people.

    Joan, I hope your response gives her the courage to speak up and find support. Personally, I reckon he should go sleep in the shed.

    And…this post makes me feel even more grateful for the love, kindness and tenderness of my partner. I have painful sex too sometimes, not my pelvis thankfully, just bad knees. He will massage and stroke them to help relieve pain and when penetrative sex isn’t on the table (when sometimes it is…oh yes, there’s an innuendo in there) he’s okay with that. We adapt to our situation and mood each time. I wish this lady had what I have: deep love, respect and consideration.

    Susan, The Maven
    The Spicy Boudoir

    1. this post just gnawed at me

      I’ve always thought of sex as a mutual activity.

      There are so many other ways / places for this man and this woman to get him off.
      On a scale of 1-10, his empathy is at negative four.

      on the other hand, she could find out from what are his driving considerations, opinions and attitudes about masturbation and a side relationship.

      They may be religious or guilt driven from family – it would be good to know.

      it just seems plain to me, that if both wanted to fix the issues, they could talk about all of the alternative methods of getting him off.

  5. Does he not understand that this is PAINFUL for her? Perhaps he needs to be evaluated for Alzheimers. Otherwise he is just a selfish jerk with the attitude of a caveman and she is well within her rights to refuse him. His actions are abusive, coercive, and could arguably be called rape. I hope she will have the strength to Just Say NO! I can’t believe we’re still fighting these fights more than 50 years after the “sexual revolution,” the pill, and the women’s movement!

  6. This person says that they have gone to marriage therapy. If they have only gone to one person, I would suggest “shopping around” if that person has not been able to guide them to any resolution. Not all therapists are created equal and each therapist has their own approach. One of the first sets of questions that I ask a therapist is what their training is, what approaches or methods they use, and if they are knowledgeable about (insert specific concern here – disabilities, LGBTQ issues, PoC, etc…). I have left a therapist because she was too agreeable. I wasn’t going to hear someone tell me I was right. I was going to have help finding a path or solution. With the internet, it is really easy now to read therapist profiles online, see reviews, research acronyms in their specialties, etc… Even though therapy can be challenging, there is a difference between hard work and a bad fit. Learning how to suss that out is a great skill.

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