I am 45 and was recently involved in a car accident. I am now a T4 paraplegic. While I was in rehab, I told my wife that sex was not as important to me as it was a few years ago. She agreed and says she won’t love me less just because we won’t be having sex any more.

The rehab team reassured me that a sex therapist could help rehabilitate my sexual functioning, but I just couldn’t be bothered. Am I being selfish?

Please rest assured that many middle-aged couples have the same conversation, even in instances when a spinal cord injury is not involved. Reasons for ending sexual intercourse include, morbid obesity, terminal illness and debilitating conditions such as arthritis, chronic fatigue syndrome and chronic pain syndrome, to only mention a few.

‘Sexual intercourse’ also known as ‘copulation’ or ‘coitus’ usually refers to the physical act of peno-vaginal penetration, and I presume this is what you are referring to. However, sexual intercourse can include a range of things such as mutual satisfaction, intimacy and touch.

You and your partner can discover a different connection when you extend your intimate relationship to include your bodies, minds and spirits. This is not a new concept and has been practiced for centuries in the East as Tantric love-making and can include or exclude coitus.

Some very prominent writers have described non-penetrative sex or “outercourse” in various books throughout the ages. It plays an important role in human bonding without the complications of contraception regimes, pregnancy, and the risk of contracting sexually transmitted diseases.

It includes the seduction, eye gazing, erotic energy exchange, touching, soothing massage, kissing all over the body and the honouring of one anothers’ bodies.
A very important factor associated with touch is a hormone our bodies produce called oxytocin or the "feel good" hormone. Studies have shown that oxytocin is associated with our ability to mediate emotional experiences in close relationships and maintain healthy psychological boundaries.

Being touched (anywhere on the body) causes a rise in oxytocin levels, initiating a series of events that can lead to biological and psychological 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!

Oxytocin heightens that warm and fuzzy feeling, increasing sexual receptiveness and intimacy. Considered by many to be the ‘key lubricant’ in the machinery of sex, oxytocin increases the desire to be touched.

Since the release of oxytocin can be conditioned, after repeatedly having sex with the same partner, just seeing your partner could release oxytocin, making you want to be with that person all the time.

Research has shown that men or women who are currently involved in a committed relationship experienced greater oxytocin levels in response to positive emotions than single people. Leading researchers speculate that a close, regular relationship may influence the responsiveness of the hormone. So consider this, oxytocin:

  • is produced by touch
  • causes feelings of intimacy and closeness
  • triggers powerful orgasms
  • production is enhanced in men and women in committed relationships.

It is important for you and your wife to recognise that you have an existing history of lovemaking, orgasms and memories together that no one can take away from you. Your spinal cord injury has not left you unable. You (hopefully) still have the presence, personality and attraction that got your wife interested in you many years ago. Together you have moulded your own relationship of trial and tribulation, and by now you should be very comfortable in one another’s company. You don’t have to prove that you are virile – your children are tangible proof of that! Treat this as a time to lift your relationship to a higher level of intimacy, without physical peno-vaginal intercourse. This is not selfish nor is it a cop out, but a mutual understanding and a choice exercised after in-depth discussion. And quite frankly, it is nobody else’s business!