Ask your husband what he fears the most, and you may hear answers like “heights,” “loneliness,” or even “your mother.” What you probably won’t hear is the truth about one of men’s greatest fears: being unable to obtain or maintain an erection. Yes, men can be afraid of erectile difficulties because often their sense of masculinity is linked to their penis. This sets them up for future trouble because, you guessed it, most men will experience erectile difficulties at some point in their life. In fact, by age 40, almost all men have experienced at least one time where they had trouble getting or maintaining an erection sufficient for intercourse, and by age 50, over 50% of men say that they experience mild to moderate erectile difficulties.
While most erectile difficulties for men under 40 are due to psychological issues or relationship problems, physical factors or medical conditions need to also be considered, particularly as a man ages. According to Rekindling Desire, common physical causes of erectile dysfunction include:
- Alcohol abuse
- Drug abuse
- Medication side effects (especially high blood pressure and psychiatric medications, like anti-depressants)
- Spinal conditions
- Prostate surgery
- Chronic illness
- Poorly controlled diabetes
- Vascular insufficiency (inadequate blood flow)
Common psychological and relational causes include:
- Anticipatory anxiety (discussed in this blog http://www.cwives.com/?p=1366 )
- Performance anxiety (discussed in this blog http://www.cwives.com/?p=1396)
- Viewing intercourse as a pass—fail test
- A reluctance to request stimulation from his wife
- Anger at his wife
When a husband has erection difficulties that last for at least six months, it’s likely that he will begin to avoid sex unless you have a frank and compassionate conversation about what’s happening in the bedroom. He needs to consult with his physician (possibly a urologist) to treat any physical causes. His doctor may suggest lifestyle changes, including diet and exercise, a change to medications without sexual side effects, drug/alcohol addiction treatment, smoking cessation, and/or medical interventions such as Viagra, injections, or external pumps.
A couple’s consultation with a sex therapist for treatment of psychological causes is also helpful. A sex therapist will help you as a couple to have accurate sexual expectations and also to increase intimacy, eroticism, and the use of caressing without the expectation of intercourse. This last technique is called “nondemand pleasuring” and helps men learn that erections will wax and wane during sexual activity. I tell couples “erections are like the sun. They will rise again. The trick is to not panic when they temporarily fade.” (Sometimes I even break out into a chorus of “The sun’ll come out tomorrow, bet your bottom dollar, that tomorrow, there’ll be sun…”). 😉
So, if your husband has lost interest in sex, search your memory for episodes of erectile difficulties. They may have been the start of his current lack of interest in sex. The Part Five blog will cover another male sexual dysfunction that can lead to inhibited sexual desire: premature ejaculation.
What suggestions do you have for what to say or do if a husband has trouble getting or maintaining an erection?