Ask Beastly: When Your Sex Life Feels Over

Medical issues can profoundly change your sex life, but they never have to end it.

My name is Alexander. My nickname is Beastly. I write about sex.

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I'm beginning to feel my sex life is over. First, I'm getting up there in years - I'm 64. I've fought ED for 15+ years and finally got a penile implant a year ago. I can now get really hard but lost over an inch from shrinkage from the ED. Also, I was a lifelong bottom until I got anal cancer nearly 4 years ago. Chemo and radiation. Radiation caused scar tissue so getting fucked now is nearly impossible and painful. I became a Dom/Top in BDSM. Now I am on a heart pill that's killed my libido. And I developed a lung condition that leaves me short of breath with exertion.

Is my sex life over? Any ideas, tips, or suggestions? Sex and BDSM remain very important to me.

If I no longer have that I may as well be 6 feet under.

Hi sir,

I'm sorry. It sounds like you're going through a lot. It also sounds like you've evolved continuously and always fought for an exciting sex life, which is more than most people do, even those without the health struggles you have faced and still face.

Good sex is a fight. Since you're willing to adapt — from bottom to top, to stay in the game even after cancer and chemo — then it sounds like you still have some fight in you. If you didn't, you wouldn't have sent me this email.

I'm not a doctor, so I can't offer suggestions for the medical struggles you're experiencing. You must have an honest talk with your doctor about your sex life and ask what you can do to keep it active and fun. But I can talk about the last sentence you wrote.

I'm a fisting bottom, and for the past several years, I've enjoyed the reputation of being a pretty great hole. But this year I've faced a gauntlet of issues, from addiction to colitis (intestinal inflammation, if you want to get gross), that have put me on a bottoming freeze. A few weeks ago, I was severely depressed. And if I'm being honest, if I think too long about my current sexual slump — the longest of my life, so far — I still get pretty depressed. At the height of my blues, I told my therapist that bottoming was one of my life's great joys and if I couldn't have it, I was not sure life was worth living. And he said I really, really need to think about that.

What I essentially said is that life's other pleasures — food, intimacy, travel, reading, friends — are rendered worthless when bottoming is taken away. What if all anal sex — topping and bottoming — was on the chopping block? Would that be my departure from the world?

It's a question worth asking, since many gay men are, in fact, unable to participate in the kind of sex that is assumed and expected of us. Gay culture doesn't help; rather than create space for people with different abilities, we shut them out, and erotic media all but ignores those whose bodies don't work the same way that standard porn bodies work. We are pressured and expected to engage in anal sex, even though many of us are unable to do so.

So, ask yourself the question again. Is losing all sex tantamount to losing your life? Are the other riches of living crossed out by losing anal sex? I had to really think about that question, and I've arrived again at the same answer I came to when I first tested positive for HIV — a time when I regularly asked myself if I wanted to keep living. I decided then — as I have decided every time I've asked the question since — that the moments of wonder and joy are worth more than nothing, and nothing is what I'd be choosing by giving up. Death is just nothing. Moments of wonder will come again. They always do. And that is worth more than nothing.

Sex and BDSM are important to you, so you must know that many kinks and fetishes don't involve anal sex. I'm sure you've participated in some of these. And if you're willing to expand your definition of sex to everything other than anal sex, it's not hard to see a massive buffet table of pleasures to experience. So, no, your sex life isn't over. No one's sex life ever has to end as long as they allow it to evolve and change. But you do have to decide what definition of sex you'll take and what place anal sex holds in the list of things you value. It may help to actually write this list down and put it somewhere you can see it every day — that's what I did.

You will have to decide if pleasure, intimacy, friendship, and connection are worth carrying on for, even with the possibility that anal sex might not be easily attainable going forward. That's a decision only you can make.

There's no right or wrong answer, and I've never shamed anyone for deciding to go when they want to go. We are fully in control of our lives and can decide when we've had enough. In theory, I don't want to keep going after the pleasure is gone. But here's the thing: I got pleasure today from hugging my boyfriend. I got pleasure last night from reading a book. Even in a pandemic, when many people's sex lives are in lockdown, pleasure appears in unexpected places and never ceases to make life worth keeping.

Love, Beastly