More than just penetration

You can be sexually active today but you never know about tomorrow. Maybe we should all equip ourselves for any eventuality. These are the thoughts that ran through my mind as Jane narrated the story of how her life had suddenly changed.

Jane and John had been married for 10 years and life was getting more exciting by the day. They both worked hard to keep the fire of marriage burning. 

But as fate would have it, one day while driving John rammed into a lorry which had stalled in the middle of the road. He escaped death by a whisker but got a spinal cord injury which left him paralysed from the waist down.

He was incontinent and was put on a urinary catheter to continuously drain his bladder. Penetrative sex was out of the question.

“Lots of thoughts have crossed my mind,” said Jane when she came to my clinic. “I could get another man to satisfy my needs but still nurse my husband; I could divorce him altogether and remarry; or I could try living without sex, though that is impossible at my age.”

She was 30 years old.

It would be inhumane to divorce a loving husband simply because sex was no longer possible.

“But you can still have sex with your husband even if he is paralysed!” I interrupted. She frowned and shook her head, tears rolling down her cheeks.

“You do not understand, it is not possible, he is dead flat down his waist!”

Then I remembered that Jane, like many of my clients, took sex to mean penetrative intercourse, a definition that has been overtaken by time. There are people who can’t get an erection because of diabetes, hypertension medication or even fatigue.

Satisfying engagement

These men and their partners still need to be involved sexually and that involvement must be satisfying.

There are two myths about sex that must be done away with if everyone is to enjoy sex.

First, penetration is only a small event in sex; it is not the ultimate end. Second, penetration does not have to happen for sex to be complete.

Sex is about pleasuring your spouse. People get pleasure from all manner of intimate acts. For some, just holding each other is good enough. Others enjoy a passionate kiss. Others fondle and stimulate erotic areas of the body with their hands or lips.

There are many women out there who reach orgasm without penetrative sex.

All that is needed is to think out of the box, step back and enjoy the pleasures of other sexual activities and if penetration does the trick, fine; if not, you will still be satisfied anyway.

Whenever I hear of couples separating because the erection is weak or absent, I get the grim reminder of the deficiency of sexual skills that is so prevalent in our communities.

Early studies

Early studies in sexology showed that more women got orgasm through clitoral stimulation by whatever means than through penetrative sex. Penetrative sex has however been promoted and protected because it was thought to be the bane of stable marriages. This belief is, however, only true to the extent that penetration is possible and to the extent that both man and woman enjoy the penetration.

“Well put, doctor. But how do we start these practices that we are not used to?” Jane asked.

Well, as part of treatment of diseases that affect sexual function, there should be sex coaching for couples. As such, Jane and her husband were put in a coaching programme.

Three months later they were back to enjoying intimacy though the man was still paralysed and on a urinary catheter.

“Incidentally, the things we do now are more intimate than before; sorry to say but some misfortunes are a blessing in disguise,” Jane said on her last visit to the clinic as she burst out laughing. “Thank God the divorce did not happen, it wouldn’t be as good with a different man!”