Q: My doctor asked me during an annual exam if I climax during intercourse. I thought it was a strange question but I couldn't answer because I haven't had sex in more than 25 years. I don't recall any problems before unless I never have climaxed and didn't know it. So why would she think I might not? If I choose to have a relationship at that level, should I see a doctor first? -S.C.
Dr. Pepper Schwartz: I have to agree: That's a strange question. Quite odd. Perhaps she was trying to find out if you were having some kind of sexual outlet, in which case she should have asked you that directly. It may also be that even if she knew you weren't having sex with a partner, she was trying to find out if you masturbated and had orgasms because they do seem to be correlated with overall health and well being.
It's unlikely that you could have climaxed and not know it. A climax is more than a pleasurable feeling: It's an overall build up of erotic energy that is so exciting that eventually it is released in a few seconds of intense pleasure with a total body response (sometimes experienced as jerky spasms of the uterus), a lot of panting or gasping and a resultant "spent" feeling. It's unmistakably what it is! She may have thought you didn't have that experience because of something you said about sex, or the fact that she knew you had not had a partner in a long time.
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Given how long it has been since you've had a sexual relationship, I think it might be a good idea talk to your physician or a sex therapist before you get involved with someone. Your vaginal tissues might need some rehabilitation because they haven't been used in a long time (unless you masturbate with a dildo, in which case you might be fine.) You would also need to think about how to talk to a partner about sex, especially on how to make sure you use a barrier method of contraception (older people can get sexually transmitted diseases, too) but most importantly, to help yourself feel very comfortable about the prospect of being in a sexual relationship again.
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