My husband and I have been together fifteen years and been through pretty much all of the ups and downs sexually that a monogamous relationship offers. Two years ago, my husband was in an accident and broke his back. The accident resulted in some mild-to-moderate nerve damage to his legs and a newfound case of premature ejaculation. I adore my husband and while toys normally help finish the job for me, I’m left wanting for our old sex life. I’m also worried about his satisfaction. His lack of endurance stresses him out and I end up feeling like it’s more important for me to fake an orgasm, so he doesn’t feel bad and worry about his performance. 

He’s tried Cialis but it causes more nerve spasms than it’s worth. I’m at a loss. I’ve found very little in my research on back injuries and the effects on sexual functions and don’t know what else to do or where to look. I want to be satisfied like I used to be, but I also don’t want to broach the subject with my husband without having an action plan in place. He’s not as open about discussing things and definitely a sensitive soul. I just want to ride my husband like I used to and selfishly not worry about holding back for his sake. I know he wants the same. How the fuck do we get back there?

Back Where We Belong

“Sexual dysfunction due to back and spinal cord injuries are very common,” said Dr. Rachel Gelman, a physical therapist who lives and works in the Bay Area. “There are reports of premature or rapid ejaculation after back injuries, which makes sense: erections and ejaculation require a lot of systems to be working together well, one of which is the nervous system.”

So, if the nerves running to and from your husband’s cock were damaged or compromised during his accident, BWWB, is there anything that can be done?

“There are many treatment options available,” said Dr. Gelman. “I would strongly recommend having him consult a sexual medicine provider. The Sexual Medicine Society of North America (SMSNA) and The International Sexual Medicine Society (ISSM) are great options to get resources and find a local provider. There are also sex therapists and counselors that can discuss exercises or strategies to address his PE.”

Dr. Gelman also had a few recommendations — a few sex sex tips — while your husband waits for his first appointment with a specialist.

“She could try having him wear a condom,” said Dr. Gelman, “the theory being that a condom can help reduce sensitivity and delay ejaculation. And if they want to spice things up — and justify the condom — they could pretend they’re meeting for the first time and recreate their first few weeks of dating. Another option might be one of the various desensitizing ointments and creams that contain lidocaine available over the counter.”

Zooming out for a second: I’ve been on the receiving end of one or two of those desensitizing creams in my time, BWWB, and I strongly recommend very carefully applying it only to the last couple of inches of his hard dick before carefully rolling a condom over the whole thing. You wanna numb his dick, not your hole.

Zooming right back in: Even if your husband agrees to seek treatment, BWWB, and even if that treatment proves effective, the process is gonna take some time. So, this is how your husband’s dick works — at least for the time being — and both Dr. Gelman and I think you should make the best of it.

“This could be an opportunity to play around with new routines and sexual activities,” said Dr. Gelman. “Try more toys — BWWB mentioned that toys are usually a win for her — and go slow and take more time to build things up. And sex doesn’t have to end just because he climaxed. Depending on how long his refractory period is, they could take a break, have a snack, and then go for round two. Or he could just focus on BWWB’s pleasure after his climax.

“And while I fully support BWWB’s desire to ride her husband to her heart’s content like she used to,” said Dr. Gelman, “it’s important to remember that our bodies do change over time.”

Ideally, this process — we age, things change — is a gradual one, and we discover new tricks, new pleasures, and fun new ways of getting off. But when changes come fast, BWWB, their very swiftness can make it hard to adjust.

“I hear the distress this issue is causing for BWWB and her husband,” said Dr. Gelman, “and those feelings are perfectly understandable. But a reminder that stress and anxiety can be mood killers.”

So, in addition to asking your husband to see the doctors and do the work so he can maybe last longer again someday, you should invite your husband to do things he can nail right now: oral sex, mutual masturbation, internal and external vibrators, big and small strap-ons, etc. To build up his confidence again, BWWB, you need to put the focus on joy and pleasure — both of you do — and take the focus off penetration and endurance. And if you approach other routes to pleasure as good and possibly great sex and not as sad consolation prizes, BWWB, you can start having great sex again tonight.

Dr. Rachel Gelman is a pelvic floor specialist and a sexuality counselor. You can follow her on Instagram and Threads @pelvichealthsf and learn more about her work — and pelvic health in general — at her website pelvicwellpt.com.

 

 

Read the rest of this week's column HERE! And this week on the Lovecast: A woman used to be a sex worker when she was younger. She has since built a new career, and loves her life. She got into BDSM, and when she told her new dom about her past, he lost his mind. He feels her sex worker history takes away his power. He demanded that she fill out a questionnaire spelling out her entire sexual history. The list goes on and on and on. Why does her past matter to him? What should she do about it?

On the Magnum, take a sexy, sexy journey back to medieval times, to hear about the origins of Christmas, St. Valentine’s Day and the Feast of the Ass. Basically, the medieval church knew how to party. Those of you who are horny to hear about the counter reformation are going to GET OFF on this convo. Dr. Janega is a hoot, and she and Dan belong together. LISTEN HERE!