I am a 41(f) married to a 43 (m). We’ve been married for 10 years-not long into our marriage my husband was diagnosed with Bipolar 1 and the next 8 years of marriage was crisis after crisis with his mental health and the loss of our child. During these years, I felt very little desire to be sexually intimate with my husband because I was taking on the caretaker, mother, and crisis support role. If you know anything about Bipolar 1, you know it is a very serious condition and can create a highly chaotic environment. But I loved him and took vows in sickness and in health.

Fast forward to 2 years ago-we finally found a fantastic psychiatrist and she was able to find the right medication to stabilize my husband. He was/is back to the man I love. This return has also reignited my desire for regular sex. But one of the numerous medications he takes is causing a loss of libido and ED and we cannot tinker with these meds since he is finally relatively stable.

I am in the best shape of my life and, if I had it my way, I would have sex daily. Unfortunately, his desire is gone and he now also has ED that is not responding to regular interventions (meds etc). We love each other so much but, quite frankly, now that my life is calm, I am so horny and want it to be my turn to be looked after physically, sexually and emotionally.

He has told me that he would not blame me if I had my needs met elsewhere but he just wants to know. But deep down, I know that knowing that I am having sex with another man would quite possibly trigger another bipolar episode (stress is a huge trigger). I Just don’t know what to do-self pleasure is not the same and, on the rare occasion, I get some intimacy, there is never PIV. He tried a strap on but it is just not the same and I feel like he’s doing it out of duty. Which I know he is.

I feel like I’m dying inside. Even though I’m 41, I’m young looking and get quite a lot of male attention but it is so hard not to move forward with having my physical needs met. I would worry that I’d feel too guilty and/or he would find out and the stress would trigger an episode and I cannot risk that. I’m even worried that I’m putting too much pressure on him by trying to initiate intimacy semi regularly.

I’m open to any advice. He’s talking to a sex therapist and we will eventually go together but no therapist will be able to solve the side effects from one/several of his meds of loss of libido and ED. We’ve done plenty of counselling over the years and communicate well now that he is stable, but we can’t communicate our way out of med side effects and ED.