Thelma Louise… and Josh: Marriage May Not Be Forever But Sex Is

Thelma (not her real name), a 52 year old corporate attorney, came to see me in my clinical practice because she had just recently split up with her husband, Josh, of 20 years after learning that he was having an affair with her best friend, Louise.

First, I asked her how long it had been since she and Josh had sex. She said it had been about five years mainly because of vaginal dryness; she said it had become increasingly difficult for her to have sex with her husband due to the associated discomfort of pain during sex (dyspareunia) and boredom in the bedroom.

Josh, an attorney himself, was 10 years older and Thelma thought (had hoped, really) that by the age of 62 he would no longer have an interest in sex. Boy, was she wrong. At 52 she was no longer interested in sex and wondered when it might end for him. Quite possibly never, I told her.

From cradle to grave, we are all sexual beings and there is no magic age when sex stops. There are, however, circumstances which may alter a person’s ability to engage in sexual intercourse; medications, medical conditions and injuries to name a few. Men in particular though have sexual urges and cravings that are different from most women due to biological need and socialization.

Thelma felt betrayed by both her friend and her husband. Her immediate response, after learning about the affair, was to end her marriage and run away. She told her husband that he had 2 weeks to move out of the home they shared and then she left on a road trip to visit her parents, her best friend, and her sister in an effort to process her pain.

Thelma realized that her vaginal dryness had so many consequences on her personal life as she grieved the loss of her marriage and her best friend. I explained to her that vaginal dryness could also affect her physical health. Estrogen receptors decrease in the vaginal walls during peri-menopause (the years leading up to menopause), which leads to vaginal dryness.

Lubricants and personal moisturizers like RepaGyn® (hormone free) vaginal suppositories will help her to get relief from her vaginal dryness. If vaginal dryness is left untreated it may advance into vaginal atrophy, a condition associated with additional symptoms such as urgency, leakage of urine and recurrent urinary tract infections. Vaginal atrophy may require low dose localized estrogen treatment.

Thelma decided to carry on with her plans to divorce Josh and I could not help but think that had she dealt with her vaginal dryness early on, she may be headed back to the bedroom with a bag of tricks to spice things up instead of to the courthouse to split things up.