I met Pamela Foster at a writer’s conference a few years ago, after the organization had to switch venues because I and another sex-positive author, Velda Brotherton, were slated to speak. Pamela reached out to me recently with a show topic in mind, one that would shed light on more sex-related cultural problems—specifically, our broad lack of understanding and education around painful intercourse and aging.
She briefed me on her personal experience, which involved layers of complexities I suspect many people can relate to, and I knew we had to connect. Her desire to help others by sharing her experience is inspiring as she is.
We chatted by Skype and I wove her insight into a special narrated episode of Girl Boner Radio, which you can stream on Apple Podcasts, iHeart Radio, Spotify or below! Read on for lightly edited transcripts from the episode.
Pamela and Jack met at a credit union, where she was working. She was a loan officer, he was a counselor and the face of the Vietnam Combat vet in Humboldt County. Throughout their over three decades together, they often joked about the fact that she had seen his tax returns and two letters of recommendation before agreeing to go out with him.
Jack was a hero, she said, and as a woman who dealt with her own traumas, they just fit. She found his intelligence – not the math-and-science type, but verbal smarts – irresistible — that and his honesty. He could be selfish, but he never lied to her.
She struggled to come up with an answer when I asked her what she thought drew him to her, but she landed at this: She needed him. She was very pretty then (and still is, in my opinion). She’s gentle, nurturing and the proverbial good-hearted woman.
Jack needed to be in control of every detail of his life in order to feel safe, she told me, and she was okay with that. They bonded through their intellect, their shared love of adventure and their general zest for life. They lived in foreign lands, backpacked through Asia for months at a time and enjoyed thousands of scuba dives together.
And like all couples, they met challenges. You’ll hear about some of them today: the kind of complexities that can arise in our sex and intimate lives when our bodies change and no one prepared us for those changes, even a little.
I think we can all learn from this story, regardless of our age, stage of life, gender or relationship status. I’m excited to share it with you. Afterward, if you’re inspired to take pleasure into your own hands, or you want to bring more playfulness and connection into your stay-home life, hop over to thepleasurechest.com to check out some of their most powerful toys, such as the We-Vibe Melt, which stimulates around the clit with pulsating waves and gentle suction—sort of like oral sex— and can be used with a partner for mutual fun. You can also order, The Crave Vesper, a beautiful, fully functioning vibrator necklace. I wear mine all the time. Stick around to the end of the episode for thoughts from Dr. Megan Fleming for a listener who’s curious how often to schedule sex, now that his wife’s libido is higher than his.
Let’s dive in, starting with a bit about Pamela in her own words.
Pamela:
Well, I guess let’s start with my age. I’m 69. I was married for about 30 years and traveled all around the world with my husband, who was a combat vet with post-traumatic stress disorder. The way he dealt with his post-traumatic stress was every five years, we moved. That worked really well… In that same kind of timeframe, I was writing. I have eight published books, none of which really have anything to do with the topic we’re going to be talking about today. But I was writing. About the time that I went through menopause is when he became ill.
So now currently, I am 69. And my husband died on the 27th of October… So a fairly recent widow, but his illness was so prolonged and he was not able to live in the home for the last almost two years of his life. So I’ve actually been alone in dealing with that for closer to about two-and-a-half years.
August:
Their path has been unique, but Pamela and Jack are aren’t alone in that changed dynamic. Most people either need in-depth care or become a caregiver at some point. And according to the National Alliance for Caregiving, those who work 21 hours or more per week are 4 times most likely to be caring for a spouse or partner. When the person you’re taking care of lives with residual effects of trauma, the road can become especially rocky – as Pamela knows well. She knew they would face difficulties throughout their lives and marriage, but this was more than she had imagined.
Pamela:
I remember there was an interview with Kris Kristofferson right after June Carter Cash’s death. And he said June Carter Cash’s biggest contribution was that she kept Johnny Cash alive. And at the moment, when he said that—I love Kris Kristofferson—but I remember thinking, well, that’s just rude. The Carter family is this huge musical family. But I get it. I understand what he was saying. And that’s kind of how I felt for 30 years. My job was to keep Jack, to keep my husband, alive and well and as happy as I could make him, given the trauma that he was dealing with… Due to exposure to Agent Orange, he died of something called progressive supranuclear palsy, which is an especially fast-moving and horrid form of Parkinson’s… I always expected no matter what came up, he and I would be partners and we would deal with it together.
August:
Instead, Pamela eventually became more of a caregiver than a wife. And leading up to that, she was dealing with changes in her own body that so many people experience, which would greatly impact her sexuality and her marriage. All of that was a stark change from how they began. Around age 40, when first she met Jack, she said, sex seemed “just really easy.” Like this:
Pamela:
I mean, everything works. It’s fun. It can be very spontaneous. And most importantly, for me at any rate, it’s a way of cementing the relationship. It’s a way of building the intimacy… When I went through menopause, Jack was already beginning to show symptoms of this neurological illness. But, of course, we did not know that. We didn’t know that that’s what was happening.
August:
Pamela was just entering menopause and dealing with symptoms like hot flashes when her mother was diagnosed with estrogen-triggered breast cancer. Because of that, the oncologist told her and her sister they couldn’t use any type of estrogen – that it would be too dangerous, given their own breast cancer risk.
Pamela:
We had a very interesting time in my family where my sister, my mother…all of us went through menopause at the same time. And I have no idea what we were thinking, but we took trip together to Canada during that time. Very very interesting trip. I guess we thought it was cold, it would help with the hot flashes…. My mother’s husband was the only man on that trip and I don’t know how the poor man survived, but he managed.
I had a period where the biggest concern with menopause was hot flashes and mood swings and almost like a panic attack kind of feeling. But that went away over time. Within two or three years, that had all gone. And I thought, “Well, this is good. I’m kind of settling into the good part. No more cramps every month. This is all good.” But at about that time is when intercourse became really very painful.
And it wasn’t sudden… I just assumed, okay, we need lubricant now. I’ve come to the age where we’re going to we need lubricant. And that did help for a time. But the fact is, without estrogen, the vagina itself changes and so what happened is that we had this where, for 25 years or 22 years…sex had been something that was kind of a way that no matter how difficult the day or the week or whatever had been, we could kind of come together. And suddenly, I was backing away in pain. And that quickly escalated to where I really was not interested in intercourse.
August:
It took 4 or 5 years, Pamela said, for the pain to go from mild discomfort to an inability to have intercourse at all. Any attempt left the area bloody and raw by the end. The medical term for what she was experiencing is vaginal atrophy, a common condition that’s often typically preventable or treatable, especially if you address it early. Staying sexually active — yes, masturbation counts — and using a quality lubricant consistently can really help. A little side note/PSA: If you have sex ever, you should probably have lube on your nightstand.
Sadly, vaginal atrophy often goes untreated – it’s chalked up to normal aging, because people haven’t learned otherwise or it’s downplayed, even by some doctors, many of whom learn very little about sexuality beyond things like STIs. How can we do better if we don’t know better?
Pamela:
If we had known what was happening if I had known so that I could have shared with my husband… I mean, we weren’t children. There are other ways to have sex. We could have simply said, “Oh, it’s sad that that won’t be an option for us anymore. But look, there’s lots of other things that we can do that will continue the intimacy,” but because we really didn’t know, I think he took it as a personal rejection… And that changed the dynamic, in a marriage where for a great many years, that was a way for me to kind of comfort and nurture him. That was not possible anymore.
August:
Communicating about these issues can bring a whole additional layer of complexities. When one partner has a sexual pain condition, it’s part of the entire sexual relationship—you’re in it together, yet it’s not uncommon to feel pretty far apart.
Pamela:
We did try to talk about it. You should know that he was a psychologist. We were both educated people that should have known how to add communication skills. But nonetheless, both of you take it personally. I take it personally that he’s insisting on intercourse, which is causing me pain. He takes it personally that this person who was very welcoming of him into my body is vehemently pushing him away and saying no… Of course, over time, we switched to other types of sex. We switched to oral sex, essentially. And that was okay, but—I don’t think this is that unusual, either—I was better at bringing him to satisfaction than he was at bringing me to satisfaction.
August:
Those weren’t the only challenges they were experiencing. Jack had physical limitations— a bad neck, back and knee —all of which can make sex and certain positions uncomfortable. And without better understanding around all of this—given wonky societal messaging, lack of sex ed and more—it was pretty easy for Pamela to take matters personally.
Pamela:
I began to question myself, as it’s hard to sort those emotions out. Pain is not nice. You scurry away from that and you scurry away from the person who is is causing that pain.
August:
Over the years that followed, Jack’s illness became a much higher priority. Sex wasn’t possible for him either and the couple had other concerns to watch out for — like him not falling or choking. At some point, Pamela went to see her gynecologist for a routine checkup. During that appointment, she asked Pamela a question that would set her on a path of self-discovery and send her mind, initially, reeling.
Pamela:
She said, “Do you think that at some point, you will want to resume sex?” Now at that point, we have about no estrogen at all for about 12 years and about a seven- or eight- year period of abstinence from vaginal intercourse. So this is the part that I really did not know and was completely unprepared for.
August:
Her vagina had changed so much that the gynecologist had trouble inserting even the smallest speculum. If Pamela wanted to have vaginal intercourse again, she would have to go on estrogen—starting with the smallest possible dose. Then she would need to use dilator dildos, starting with one that’s smaller than a pencil, inserting them until the vaginal muscles relax, three or four times a week — working her way up in size. Understandably, Pamela had mixed feelings about that.
Pamela:
So first of all, I honest to God don’t know if it’s important enough for me to have vaginal intercourse to go through that. And secondly, it doesn’t work unless I would be willing to take the estrogen.
I asked the gynecologist point blank. I said, “My mother’s oncologist said no estrogen of any kind, not given the kind of family history of breast cancer that I have.” And she said, “Every oncologist will tell you the same thing.” So the gynecologist’s view was look. You can come up with something where you kind of weigh the risk with the benefit. And a person might decide, all right, the lowest dose possible estrogen and, over time, working with dilator dildos and maybe you will be able to have that [intercourse] again, but I am not willing. Every female in my family has had breast cancer. I am not willing to use estrogen.
Since then, I have talked to several other women friends my age who are kind of going through the same thing. No one ever told us that without estrogen and with abstinence that essentially the vagina will atrophy.
August:
Hear that again: No one ever told Pamela or her friends that a lack of estrogen paired with abstinence causes the vagina to atrophy. How many times have you heard that someone with a penis has to have sex for health reasons? Or that guys need to masturbate? How many Viagra commercials have you seen on TV? If you have a vulva, your sexual health and your pleasure matter just as much. These are quality of life issues, health issues, important issues. I wouldn’t be surprised if this is the first time you’ve even heard anything about vaginal atrophy.
Pamela said she might have a different opinion about her options if she were involved with someone who really prioritized intercourse — and that all of this makes getting back out there in the dating pool feel complicated.
Thankfully, Pamela has embraced other means of Girl Boner bliss on her own.
Pamela Foster:
The way it has always worked for me is that masturbation has always been about clitoral stimulation. And so that works fine… So for me that’s that’s a that’s kind of a no brainer… Clitoral masturbation works absolutely great. And there’s even lubrication… All of that works fine, but the vagina does not.
And men my age have their own baggage physically. They’re dealing with their own physical stuff. So yes, I would hope that it might be possible that down the road I would be able to be with somebody…but especially at my age, the physical touch and the closeness is really at least as important as the actual orgasm.
August:
As far as who that person might be, Pamela said she knows one thing for sure: it’ll be someone respectful who practices consent, which she considers especially important while navigating sexual function issues. That sounds like a wonderful kind of person to me. Also wonderful is the person Pamela has been evolving into, through this journey. I asked her how all of this has impacted her sexuality.
Pamela Foster:
I’m really coming to like who I am sexually now. I think of it as crone power and the crone is an incredibly powerful, invigorating, rejuvenating figure. She’s kind of the wise woman goddess. It’s taken a long time… Things change so gradually…the boobs aren’t so perky anymore…and it doesn’t matter what you weigh, the body is not going to look the same at 69 as it did at 50, but I’m okay with that… Now the big question is, in the culture that we have, whether or not I ever find somebody who is also delighted with who I am right now. Because I have no real interest in being with somebody who isn’t delighted with me.
August:
I love the certainty and strength in her words — so crone-esque. ‘Crone’ means the elder holy one, someone who holds the power of age and time, retribution and transformation. I think we can all benefit from embracing that archetype, either as our own now or one to deeply admire and aspire to. A study conducted at the College of St. Catherine showed that when women resonate with or activate crone archetypal images — photos that honor older women — they’re more likely to cultivate a positive sense of self and a purpose that can benefit society and integrate them into the culture as they age.
When Pamela reached out to me, offering to share her story, she mentioned that doing so didn’t feel easy; this isn’t a topic she’s spoken about publicly before, certainly not for thousands of listeners. Yet she felt compelled to do so now.
Pamela Foster:
When I found out that essentially I could no longer have vaginal intercourse, there was a period of grief… I’m pretty open about being able to talk to other women and so it was amazing to me how most women said, “That’s not possible. That’s not true.” And I was like, “Yes, that is the case.” And then I talked to a couple of friends who are kind of going through the same thing – both of them are a little younger than I am, so they’re they’re not quite at the point that I am physically – but they’re having the same symptoms and the same problems within the relationship and doctors who say to them, “Oh, you just need better lubricant.”
If a woman doesn’t understand what’s going on with her body, there is no possible way that she can accept it first of all, and secondly, explain it to anybody else. So yes, this is a private subject matter for me and it’s not easy to go public with it. But women need to know this. This is really important… People live to be 100-years-old now. I have a lot of good years left. And there’s lots of women out there who have a lot to offer and I think they need this information.
August:
Can you please join me in a virtual round of applause for Pamela? I love what she shared there and I’m so grateful that she opted to speak from a vulnerable place, with hopes that others will hear about her experience and find their own way to healing sooner—or even prevent pain and struggle to begin with. She wanted to leave you all with this piece of advice:
Pamela:
I would talk to my gynecologist but the other thing is, I would talk to a sex therapist. They seem to be the people who really do understand and have really positive suggestions on how to deal with things. Absolutely. I would not just accept it, say nothing and push onward. That’s probably the worst thing that we can do.
August:
When I followed up with Pamela after our interview, she told me what she appreciates most in her life now is the freedom to reinvent herself—or, more accurately, reacquaint herself with the parts of herself that were necessarily neglected during the years she cared for Jack as his health declined. She continues to embrace her inner-crone, imaging herself living in the woods, investigating her powers and allowing herself to travel darker paths of knowing, with the crone’s hand in hers, to emerge in this whole new world.
Pamela also noted that crones are highly sexual and have zero regard for cultural norms that so many women and femmes feel restrained by. Many cheers for that. She’s going back to college to earn a masters in psychology this fall, with the goal of specializing in geriatric psychology – with an emphasis not on the limits of aging but on the Jungian concept of wisdom and freedom of aging.
Learn more about Pamela Foster on her blog, pamelafosterspeakerwriter.wordpress.com, or click the link in the show notes. Find her novels and her essay collection, My Life with a Wounded Warrior, on Amazon or barnesandnoble.com.
For more Girl Boner fun, including thoughts from Dr. Megan Fleming for a listener who wants to know how long he and his wife should schedule sex, stream the episode up above or on your favorite podcast app!
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