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OT: Dear All

Anyone who can answer may help. I have an unusual case of a 61 yr old pt who has severe vaginal atrophy and has used estrogens (both tablets and ring) and cannot achieve vaginal intercourse. Her 62 yr old husband has always had a problem with premature ejaculation but they have worked around it till now. They still desire to engage in marital intimacy but without vaginal intercourse , it is my understanding and theirs that they cannot separate the procreative from the unitive (even though they cannot procreate) and therefore without vaginal intercourse cannot fully enjoy the physical pleasures of the marital embrace. They even feel that it may be tantamount to masturbation even though they do not desire it as such, nor look at it as such. Any comments or suggestions? Their next step is to consult a priest. Any references would be greatly appreciated.

Les Ruppersberger, D.O. FACOOG NFP only Gyn

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