CONTRACEPTIVE CARE OF THE OLDER PATIENT – CHANGING RELATIONSHIPS (CASE)
Mrs X., an attractive 43-year-old woman, attended her doctor regularly for repeat prescriptions of the progestogen-only Pill. At a recent visit she looked tense and complained that intercourse was painful. She wondered if she should stop the Pill as it seemed to be causing dryness. She had no other menopausal symptoms and physical examination was normal.
While she dressed after the examination she began to talk more about how she had not enjoyed intercourse for the last few months, and how she had to force herself for her husband’s sake. They were both keen church members who believed that sex was an important part of the bond between them. When the doctor asked if there had been any change in her life at the time the pain started there was a long silence, and then amid tears, Mrs X. told how her 20-year-old son had announced that he was a homosexual. Despite a great effort to be understanding, both she and her husband were having difficulty coming to terms with the news.
Until that moment with the doctor Mrs X. had not put the two problems together in her mind. Now she could begin to understand how the shock had effected her ability to get in touch with her own sexual feelings. It seemed that whenever she began to relax sexually, images of her son came into her mind. After discussion she seemed easier and decided to continue with the progestogen-only Pill.
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