My husband’s … package is completely different now. He’s embarrassed, but I’m not ready to give up this part of our life.

How to Do It is Slate’s sex advice column. Have a question? Send it to Stoya and Rich here. It’s anonymous!

Dear How to Do It, 

My 65-year-old husband (I am a 45-year-old woman) got a prostatectomy two months ago. Luckily, the cancer was confined, and he will be fine. He has recovered from surgery remarkably well.

Despite the wonderful penile rehabilitation resources we have (he has the injections, the pump, the pills), he has not been able to maintain an erection for penetrative sex. It also takes him much longer to orgasm with manual or oral stimulation, and I can tell he feels bad that he doesn’t get hard during this time. (He also pees while ejaculating, but I do not care about this, and we end up laughing about it after, although I can tell it’s embarrassing for him.) We’ve always had a loving and active sex life during our 15 years together, and we don’t want that to change.

How do I support him emotionally and mentally in his rehab journey? We have a young child and both work full-time. Weeknight sex takes ages, and I need my sleep—some nights he will just do me, and after 45 minutes of playing with him, I’ll end up giving up, and we’ll fall asleep. Scheduled sex on the weekends doesn’t feel sexy, but it is our only option at the moment. I’m not the most patient of people, but I do really want to make sure he feels desired and sexy (because he is to me!). How do I show up for him in this tricky moment, when we also have real-world things to deal with?

—Supportive Wife

Dear Supportive Wife,

Two months isn’t that far out from surgery. According to Cleveland Clinic, “Most people won’t experience erections for several months after a prostatectomy.” Erectile function can gradually improve by the six-month mark, but it could take up to two years to fully recover. Your husband is ahead of the curve, here, and I’m wondering whether one or both of you are forcing things to some degree.

Has he explained any of the reasons why he’s jumped back into sex and is attempting penis-in-vagina penetration so quickly? If he hasn’t volunteered any information around that, gently ask him. Sometimes, the mere act of talking things out with a partner whom we trust and love can help us untangle our emotions and thoughts around a subject. Starting conversations about sexual hiccups brings things out into the light where you can work together to navigate them with an eye towards everyone’s needs. If the bounty of resources you describe includes access to counseling from someone with experience in prostatectomy recovery, utilize that—a trained professional can boost efficiency in these types of discussions.

I truly hope the two of you will be able to maintain a loving and active sex life for the duration of your relationship. The reality, though, is that the details of what that looks like absolutely will change. If it weren’t his prostatectomy, it would be your perimenopause, someone’s aching joints, or some other byproduct of aging, which is an ongoing process that affects both our desires and the ways we can comfortably use our bodies. I expect that the ways you two related to each other shifted during your pregnancy and have been affected by the fact of a young child in the home. Try to think of your husband’s recovery as similar—another natural accommodation of the various ways life happens to all of us.

Have a big talk about what sex means to each of you, and what aspects of it are important. Get a sense of which physical activities check the important boxes, and, crucially, are feasible at this time. Then focus on those. Help your husband feel sexy (and alleviate some of your own frustration) by engaging in the sex acts that actually work for where the two of you are at right now. You’ll likely be able to get back to old-fashioned tab A in slot B at some point, but the more you push for penetration right now, the greater your risk of increasing both your feelings of shame, inadequacy, and frustration.

Dear How to Do It, 

I’m a sex positive queer person who has discovered vaginal fisting and enjoyed it for about a year with various partners. Sometimes I feel discomfort because of a change of position or pressure on my cervix. Too much rotation isn’t good either. How do I communicate before pulling out when it’s uncomfortable (especially when I immediately want to re-engage)?

—Terrible at Communicating Kinky

Dear Terrible at Communicating Kinky,

To me, solid communication skills are a prerequisite for fisting. You’re an adult, and you get to make your own choices, but my recommendation would be to go back to basics until you have the hang of three crucial components: communicating preferences before the act, noticing slight discomfort early, and speaking up immediately. Fisting hardly ever involves the kind of violence that the name evokes for the uninitiated, and still, you can cause some extreme damage if everyone’s communication is not up to par.

Are you able to state, up front, that you don’t enjoy cervical pressure? Can you look someone in the eye and give a broad description of which positions and motions work for you? If so, that’s wonderful. If not, start practicing. Some people have an easier time rehearsing alone, in front of a mirror, at first. Get to a point where you can give folks the lay of the land before they start their adventure.

When it comes to noticing slight discomfort, anything that strengthens your connection to and awareness of your body will help. This can look like balance exercises; physical movement classes such as dance, yoga, or martial arts; or simple breathing practices that encourage focus on the breath as it moves through the body. You can also do specific practice. Start with your hand—touch it in different ways, tickling, stroking, petting, pinching, squeezing, and rubbing. Draw your attention to every detail of each sensation. When you’re used to that, do the same with your genitals (and consider enlisting a supportive partner). If pleasure is part of this experience, feel free to enjoy that, but remember that your goal is to develop a deeper awareness of what you’re feeling in a given moment to nurture that nuanced understanding.

If you’re doing that last exercise with a partner, or the next time you have partnered sex, aim to voice everything out loud. This includes, of course, the “oh yes, right there” moments, but can also be “a smidge to the left,” “Can we try something different?”, and any other neutral or critical feedback. Eventually, you’ll get to the point where finding your own phrasing, such as “I need a break and then I want to keep going,” can happen spontaneously and accurately in the moment.

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Dear How to Do It,

I’ve been with my girlfriend (we’re both women) for about seven years now, and I’m really feeling the passage of time this year. Namely, I feel like our sex life has begun to bore me. It’s pretty routine, either mornings or nights on the weekends, the occasional weeknight if we’re feeling wild. I’m just uninspired by the things we might’ve once liked, and I wish that weren’t the case. I don’t want to hurt her feelings and make her think I’m not attracted to her anymore. But how do I get over this hump? Does everyone get here eventually? It’s keeping me from wanting to have regular sex if I’m being honest.

—Seven Year Itch

Dear Seven Year Itch,

Lots of people get to a point in their relationship where the sexual connection starts to feel boring. This is not the case for everyone, though, and that boredom doesn’t have to be permanent.

Make a thorough list of everything you value about the relationship, that you appreciate about your girlfriend, and find attractive—in a broader sense, not just the sexual or erotic—about her. No matter how small the detail, write it down. Next, consider what your interactions have been like lately. Is most of your time together spent handling logistics? Do you do a lot of parallel media consumption, whether that’s sitting next to each other watching the same show or scrolling independently on your phones? Where’s the room for casual connection (eye contact, relatively mundane conversations about your days and feelings), for playfulness and silliness, and for flirtation? Can you arrange for more time actually engaging with each other? And do you have lives away from each other, outside of work, which allow you to have independent recreational experiences and then come back together? Lastly, is there anything in particular as far as sexual activities that piques your interest now?

Whether you’re tackling the whole issue head-on or suggesting small changes to address individual parts of the rut you’re in, come from a stance of wanting to add to what the two of you do have—everything that was on that list I suggested at the beginning. Emphasize the things you love and appreciate about your girlfriend before you suggest changes. Invite her to collaborate on how to add more genuine togetherness and space for spontaneity to your relationship. (For further reading and ideas, I recommend you check out Esther Perel’s Mating in Captivity.)

—Jessica

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