Q: I am a 57-year-old woman, married to a 58-year-old man. We have sex usually twice a day. In the 3.5 years we've been together, I have never had an orgasm during sex with this wonderful man. I feel aroused and well lubricated, but the instant his penis enters my vagina, all feelings of arousal stop. When he stops moving, I can feel my vagina pulsating, but when he moves again, this feeling ceases. I can have an orgasm from manual stimulation (his or mine), and had orgasms every time during sex with my first husband, so I know it can happen. My new husband's penis seems very large, both in length and girth. I am post-menopausal, and am using replens and vagifem twice a week. My doctor says there is nothing physically wrong with me, and she has no answer for this problem. Can you help us?
A: Dear Heather,
This is a perfect case to refer to a certified sex therapist in your area. The answer to your problem probably lies in the meaning of penetration between you and your wonderful man. As odd as this may sound, its often easier to orgasm when we're able to focus deeply on our own pleasure without concern about how our orgasm/or lack of orgasm affects our partner. I've had many patients say they're easily orgasmic with some partners but not with others. I'm sure your therapist will also explore what actually happens to your arousal when his penis enters and whether you have the same experience during manual penetration of other kinds of insertion, tongue, etc. The good news is that you sound as though you enjoy your partner and are a responsive woman. Find someone you trust and explore this issue carefully.