By Colleen Dawson

Being a woman means that sex is inextricably linked to careful preparation. Spontaneity happens when the planning allows it. While many men are averse to anything “artificial” in their own sexual performance, I have always had to deal with paraphernalia and medical interventions to live a “natural” sexual life.

Here are my reflections on my fifty years of sexual activity, forty of them with Mish.

Addressing ED and penile rehab doesn’t feel natural to him

Mish recovered well from the operation itself, but inevitably was suffering from ED. We cuddled, touched and were intimate to some extent. Having erections is important in recovery, and he found the Vacurect pump, cock rings, and Cialis/Viagra to help. But he felt these were not ‘natural’ and he was upset that he couldn’t often get or maintain an erection.

His response to using the equipment and drugs to help overcome ED got me thinking about how things have changed sexually for me over the years. I’m a heterosexual woman who has been sexually active since the age of 19, and I’ve been with Mish since I was 29.

“Natural” sex is not so simple for me as a woman

Sex for me has generally been a very enjoyable activity in good relationships. With the changes in my body and libido through menstrual cycles, pregnancies, miscarriages, childbirth, menopause, and post-menopause, it has always been combined with using equipment and/or medical drugs (painkillers and birth control preparations).

Through every menstrual cycle there were concerns for me and/or my partner about having sex while bleeding, making a mess, and how my libido waxed and waned throughout every cycle. Never mind just dealing with the bleeding, pains and PMT every 4 weeks.

Before my first serious relationship, I started taking birth control pills. From then, efforts to avoid pregnancy were a constant companion to sexual activity. After a few years I started getting headaches and other unpleasant side effects from the pill. I started using a diaphragm with spermicidal gel. This needs to be inserted not long before penetration, so needs a willing partner with a sense of humour – these slippery things are hard to manage! At times we used condoms – these also need a willing partner. I thought an IUD might be easier, as it’s meant to always stay in place. But mine fell out after 3 days – my uterus didn’t like this strange object in it.

Some of the paraphernalia I’ve needed, to be sexual without getting pregnant

Sex, paraphernalia, drugs – they’re linked for me. No sex without the rest. This must be true for many women, of all ages. I took a while to realise why Mish was talking about all the paraphernalia and drugs he was using after the prostatectomy. For me such things are a normal regular part of life. For him the paraphernalia had always been more peripheral, although he was extremely responsible and helpful about condom or diaphragm use.

Impact of childbirth on body and sexuality

At age 32, surprising myself and Mish, my biological clock woke up and told me, loudly, that it was time to get pregnant. I got pregnant quickly, but miscarried, twice. Each time I had a D&C in hospital under anaesthetic and was told not to get pregnant again for at least 3 months. More drugs and recovery, followed by condoms.

Then at last I completed a full term pregnancy. Once again I experienced a radically changing body. Sometimes I was extremely horny; most of the time I was disinterested in sex. Childbirth involved a twelve hour induction, ending with a suction pump on the baby’s head to pull him out. Then there were more body changes through breast feeding and sleep deprivation. And I felt such a strong connection to the baby, it left me disinterested in nearly everything else.

When we started sexual activity again, my body was still healing, breasts leaking milk. It was not sexual or sensual for me, and the fear of getting pregnant again soon after the birth was very strong. Eventually an equilibrium was somewhat restored. But that was followed by another miscarriage, D&C, a fifth pregnancy and at last another birth.

From childbearing to menopause

I had our second child when I was 38. By the time I was 41 I was sure, for many reasons, that I didn’t want to have another child. After discussing birth control means with Mish, I decided to have my tubes tied. This was a day procedure in hospital, with anaesthetic and keyhole surgery.

With another pregnancy unlikely, we had a number of years without needing any birth control measures. Menstrual cycles were fairly light and painless. In my early 50s my periods dried up altogether and the practical issues around sexual activity were all gone!

Impact of hormone decline and aging

After a few relatively easy years, I began to experience low energy and low libido, combined with drying of the vaginal tissues. Bone density scans showed a significant drop in my bone density, more than the usual slow decline with age. To combat this, I started on low dose hormone replacement creams. Even though I had always viewed hormone replacement with suspicion, the thought of a crumbling spine at an early age seemed far worse.

In less than two months of using the bio-identical hormone cream I had more energy of all sorts and more libido than I’d had for years! While I started the hormones to deal with declining bone density, the benefit to our sex life and my life in general has been very positive.

We had another few months of adjustment to the hormones. Several times I got thrush and it seemed to go back and forth between Mish and me. The hormones also didn’t bring an end to the vulnerability of my vaginal walls that came with age and reduced natural lubrication. Things got much better when we discovered a vaginal moisturising gel that worked for me during penetration, to ensure no damage to the delicate vaginal tissues. It also has the correct pH – this is important and not guaranteed with all sexual lubricants.

From then, until Mish was diagnosed with cancer, the only practical intervention needed for sex was the moisturising gel. It felt remarkably simple – just a specialised skin cream on a special type of dry skin – a bit like we do on any other skin on the body.

The lengths I am prepared to go for satisfying safe sex

Sex is a powerful driver. Looking back on my story, I see the lengths I’m prepared to go to so I can have satisfying safe sex. My experience has undoubtedly helped me understand some of what Mish has been going through since the prostatectomy, and be able to find ways to be sensual and sexual with his changing body.

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