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WARNING!! This question and answer is of a mature nature. Parental discretion is advised.

Dear Larry:

Congratulations. I have answered 1000s of questions and untold number of them have been about marital intimacy, and I thought I had answered just about everything there was to answer -- until now. :)

Your questions are a first. They are good questions.

I must preface my response, since this is the first time I have answered these particular issues, that my answers are conditional upon any learning of further information from definitive sources that would require a change in my answers.

With that said let us begin:

Q1: Aware that foreplay is a preparation for the sacredness of the marriage act, what if one is unable to have intercourse due to ED? Is “foreplay” still permitted? Is the man morally obligated to get medical help such as Cialis, Viagra, etc to help him complete the act?

A. There are four things to consider:

• First, all sexual activity beyond what used to be called "first base" is reserved to married couples.
• Second, the act of coitus must be open to life.
• Third, any act of caress of the man may not result in his ejaculation anywhere other than his wife's vagina.
• Fourth, the woman may orgasm as often as she wills at any time before, during, or after coitus.

While "masturbating" one's partner is not proper since it is removed from the mutual self-giving of proper marital embrace, foreplay is a mutual caressing of mutual self-giving.

Married couples may engage in intimate caresses without the intention of coitus as an act of intimacy that is appropriate for the moment as long as their is no intention or attempt to avoid coitus on purpose to avoid pregnancy. Otherwise, the couple may enjoy each other in an mutual self-giving intimate non-coital experience.

I and others have often reminded married couples that intimacy is a lot more then coitus. A couple can be intimate with each other in many other ways from a simple holding of hands to caresses in what use to be called second and third base. The Church does not to my knowledge require that every act of intimacy culminate in coitus that is open to life, but that coitus itself always be open to life. The only exception to this, as I understand it, is what I mentioned earlier -- when a couple is engaged in non-coitus sexual intimacy as an intention to avoid life.

Thus, my answer to the question, barring learning additional information on the matter, is that a man who has erectile dysfunction for whatever reasons and thus unable to complete coitus may embrace his wife in intimate acts of mutual self-giving as long as he does not ejaculate outside of his wife's vagina.

As with any medical problem, seeking medical advice is prudent. I would say that the man does have an obligation to talk with his doctor about his options. Whether or not he actually takes medication will depend on his doctor's evaluation of his suitability for the medication, whether or not he wishes to risk any side-effects, and practical matter such as whether or not he can afford the medication. If the answer to medication possibility is no, then he may proceed with marital intimacy as described above.

Q2: Can a married couple in their late fifties/early sixties still engage in intimate relations, genital stimulation if the man is not able to maintain an erection for intercourse – due to ED or age? Would medical help be morally required here?

A. The answer to this question is the same as for question #1

Q3: What if ejaculation is not intended but is inevitable, due to physical or psychological issues, in a couple’s intimate relations? Must they abstain from sexual arousal with each other - unintended consequences? Are they obligated to seek medical help? One of our priests suggested that this ejaculation problem could also be a factor of age.

A. The deciding factor here is the intention of the man. Does he intend to ejaculate outside of his wife's vagina? If that is not his intention, and he is trying not to prematurely ejaculate, then I believe that he is not culpable for this unintended consequence.

As with the first question, I do believe that the man has an obligation to talk to his doctor about his options and then make an informed decision based upon all the factors and considerations involved. He may also benefit from talking with a wise and orthodox confessor as this problem may easily cause feelings of unnecessary guilt.

Q4: One TOB presenter stated that if a woman has difficulty with intercourse (e.g. painful) that the couple must abstain from sexual stimulation with each other.

A. If a woman has pain during intercourse the loving and compassionate thing to do is to avoid coitus. It would be an act of abuse to force a woman to have intercourse that causes her pain. In this event, the marital intimacy described in previous answers applies.

Q5: And how would these problems affect the bond of their marriage? Can they enjoy each other in mutual self-giving even though the conjugal act is not doable?

A. There are many couples who do not have intercourse because of illness, infirmity, or age. The bond between them need not suffer. Love, that is, true love, is not based upon sex. Sexual expression is a bonding experience, but not the only one. Genuine love is more bonding than any sexual expression. That will be a hard one to convince to today's generation. Sex has become a kind of god, and end all to end all. That is perverted. Love transcends the bodily desires.

If a couple finds themselves in a place where intercourse is no longer possible, other forms of intimacy may still be performed, as described above. That, too, can have its bonding fabric. If the couple chooses not to do that by mutual agreement, or cannot do it for whatever reason, love transcends that desire, and the bonding of the man and woman remain intact.

At any time, regardless of circumstances or age, if a spouse cannot handle the lack of sexual intimacy when sexual intimacy is not possible, then I would question their maturity and whether or not their love is genuine.

Otherwise, when the couple is healthy and able to be intimate with each other, except for a space of time by mutual agreement, the Bible tells us a married couple has an obligation to each other to express their love in sexual intimacy  (1 Cor 7:3-5).

I hope this helps,

God Bless,
Bro. Ignatius Mary