My wife has little interest in foreplay but I can’t get aroused without it

I am a man in my early 50s, with a wife in her 40s. After 20 years together, she won’t engage in anything more than the most basic foreplay, to the point that I am rarely sufficiently aroused for penetration, which she says she needs to reach orgasm. She recently told me that she is repelled by any kind of wetness on my part and will not touch my penis at the first sign of ejaculate, while oral sex is out of the question. It feels as if we are at an impasse, as I’m unable to get aroused enough for penetrative sex, although I still enjoy pleasuring her with my hands and orally. I have started using a low dose of Viagra, prescribed by my GP, but it is insufficient for a satisfactory erection, kills any spontaneity and has unpleasant side-effects that leave me with a hangover-like sensation in the morning. It isn’t a long-term solution to minimal foreplay. How can we find a way forward that will work for both of us?
Your final question really needs to be addressed directly to your wife. Through discussion and experimentation, it will be necessary to find alternative, palatable methods of increasing your level of arousal. I wonder why she did not reveal her revulsion about penile fluid at some earlier point in your 20 years together? Perhaps she was ashamed about it, but it may be a genuine phobia, which would require treatment. Most men do need more direct genital stimulation as they age, and their partners often need to be educated about this, and reassured that the reason is nothing to do with them. Unfortunately, many partners of middle-aged men start believing they are no longer sufficiently attractive to inspire an instant erection. Not understanding that a man’s body only works that way in his youth, they have unrealistic expectations and, as a result, sometimes suffer from a loss of confidence that can lead to withdrawal from sex. Some couples’ style of foreplay is mutual self-pleasuring, which may be an option in your case. There is also a variety of toys that would be worth exploring together. Either way, it is imperative that, as partners, finding the way forward becomes a fully cooperative venture.