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Q: Last year my wife, who is functionally blind, came down with the edict of no more touching. She says she still loves me. She does have physical problems, slight incontinence and, she says, just no more hormones left. Her doctor says there are easy fixes. She refuses all of his solutions, some with good reason. Artificial hormones could possibly damage her vision. She has had previous surgery that did not go well. The doctors labeled it chemical shock. She told me to go get a lover. After 35 years of loving monogamy, I find that just ugly. I'm feeling trapped. -- Charles, 65

Dr. Susan: I hate it when the "for better or worse" part of a marriage finally moves into the "worse" part. You're trying to solve this quandary by thinking through all sorts of rational options, but what your wife is saying is that physical intimacy is not comfortable for her. Thus, she wants nothing to do with it. Getting a lover would be messy in so many ways. I assume she won't allow touching because, in your marriage, that always leads to sex. Some women who no longer desire intercourse are happy to allow some kind of accommodation to their mates.

I see two issues here: you want sex, and she doesn't. And perhaps you want affectionate closeness, and you don't say if she is against that altogether. For the former, that's what porn is for. It's safe and would keep you in the marriage. (Maybe she could lend an occasional hand?) The latter, plain old affectionate hugging, shouldn't be ruled out. Discuss both issues with her. Keep in mind that what you're going through is an exaggeration of what many couples go through. Keep talking until you find a way to satisfy both your needs, even if imperfectly.