“I am 45 and a T10 paraplegic .While I was in rehab my wife and I discussed the future . Our sons are married and I told my wife sex was not important to me any more as we have had a good innings, pardon the pun ! She says she won’t love me less just because we won’t be having sex any more . Am I being selfish ?”

I cannot speak on behalf of your wife; you would be the better judge of whether she is being genuine when she tells you that she will still love you without intercourse. Many non spinalcord injured couples have made the same choice for reasons such as morbidobesity, terminal illness, arthritis and chronic fatigue and pain syndrome toname but a few.

Sexual intercourse, also known as copulation or coitus, usually refers to the physical act of the penis penetrating the vagina and I presume this is what you are referring to in your letter. Coitus is only one component; others include intimacy and touch.

You and your wife can discovera different connection when you extend your intimate relationship to includethe whole body, mind and spirit. This has been practiced for centuries in theEast as Tantric Lovemaking and can include, or exclude, coitus.

Non-penetrative sex oroutercourse plays an important role in human bonding. It is often used solelyfor pleasure and leads to strong emotional bonds without the complications ofcontraception and the risk of pregnancy or contracting sexually transmitteddiseases. There is no rule that says lovemaking has to end in an ejaculatoryorgasm. Outercourse includes seduction, eye gazing, erotic energy exchange,touching, soothing massage, kissing all over the body and the honoring of eachother’s bodies.

When touching happensOxytocin, the Feel Good hormone, is released. Being touched (anywhere on thebody) causes a rise in oxytocin levels, initiating a series of events that leadto arousal, including a rush of endorphins (the body’s natural pain relievers)as well as a spike in testosterone levels – and all this without sex!! Oxytocinheightens that warm and fuzzy bonding feeling, increasing sexual receptivenessand intimacy. Considered by many to be the key lubricant in the machinery ofsex, oxytocin also increases the desire to be touched more, reinforcing thecycle of sex hormone escalation.

The release of oxytocin can beconditioned by repeatedly making love with the same partner. You have alreadydone this in your relationship and now, just seeing that person could releasemore oxytocin, making you want to be with that person more and more. Researchshows that people in committed relationships respond to positive emotions withgreater oxytocin levels than single persons, leading to speculation that aclose, regular relationship may influence the responsiveness of the hormone.

You have an existing historyof lovemaking, orgasms and intimate moments that no one can take away from you.Hopefully you are still that man whose presence, personality and attributesattracted your wife in the first place. You two have created and moulded yourrelationship and, by now, you should be comfortable with each other as, withtime, puppy love deepens to companionship and affection with less emphasis ontraditional male female gender expectations.

You don’t have to prove thatyou are virile – your sons are tangible proof of that! Lift your relationshipto a higher level of understanding and mutual respect where intimacy can stillplay a part but without penovaginal intercourse. This is not selfish or a copout but a mutual understanding and life choice exercised after discussions and- quite frankly – it is nobody else’s business! I wish you many years ofintimacy and bonding on a higher level - without the sexual complicationspresented by your condition!