Category Archives: sexual dysfunction in men

Women and men’s sexual problems

The onset of men’s erection problems

First and foremost, women are not usually in any position to judge what a change in male sexuality means. This would be like a man trying to interpret the changes that his partner will go through at the time of her menopause. She would, quite rightly, resent him making judgments and assumptions about her sexuality, and the same is true in reverse.

I think this issue is compounded by the fact that many women may tend to see any change in her man’s sexual expression as being a reflection on her. So, if his penis becomes less hard, or fails to get hard at all, a woman may interpret this as meaning that he finds her less attractive, or perhaps that he is seeing another woman, or that she has done something wrong. You can read about this here.

Video – ED affects women too!

If the relationship happens to be in its early stages, and a woman begins to see a man’s erectile failure as a sign that he is not attracted to her, she may begin to put pressure on him: “What’s the matter?” “What have I done?” “Don’t you find me attractive?”

These questions and others like them may alienate men and make them feel under even more pressure, thereby making it even more likely that they will lose their erection. This compounds the problem  and may lead to further complications such as unexpressed resentment. Such anger can in turn cause delayed ejaculation, a problem which seems to be more common than many physicians recognise.

That’s perhaps because men are reluctant to talk about it, because they see it as a sign of masculine “failure”. (Though it isn’t really a problem if it’s handled in the right way.) 

Sexual Compromises

A lot of couples develop a style of sex which favors the woman, even if it doesn’t look like that. One of the most misleading pieces of advice in recent times has been the suggestion that “Women come first“. Well, yes, it’s true that many women cannot reach orgasm during intercourse, so on the face of it this advice is fair enough. It goes like this: a man must give a woman oral sex or masturbate her until she comes.

Then it’s his turn, and he can enjoy thrusting into her welcoming and wet vagina until he ejaculates; it may not even matter if he reaches orgasm quite quickly, because she is already satisfied, having had her orgasm beforehand. Sounds good? There’s only one small problem: the little matter of his erection, or, rather, the lack of it.

How is he to get erect at this stage of lovemaking? There may be only one answer, and that is for her to give him a helping hand (or mouth). If the woman does not wish to do this, or doesn’t know it is necessary, a couple can very quickly be back to the same old blaming game. This means he becomes the problem: he has a “sexual dysfunction” (in fact he has “erectile dysfunction“), which a woman may interpret as meaning he  doesn’t find her attractive – or so she thinks.

And another issue: this scheme isn’t necessarily going to work for an older man. He might not be able to get an erection without manual stimulation from his partner. A young man can roll around the bed with a naked woman and get an erection pretty much instantly. It’s not like that for an older man.

Start by developing non-sexual intimacy  

One of the major causes of erectile failure (erectile dysfunction) is the fact that a man believes he has to perform to a certain standard during sex: that he must, for example:

  • always please his partner before he pleases himself
  • lead and take control during sex
  • have a full erection and satisfy his partner with vaginal intercourse before he ejaculates.

Although this is not true of all cases of erectile dysfunction, it’s certainly true that in many cases, the pressure which a man puts on himself can contribute to the pressure on his penis to stay erect. This may sound simplistic, so let me explain: such performance pressure causes anxiety, and anxiety is the enemy of confident sexual power.

The nervous system which activates our anxiety responses is the opposing on to the one which activates our sexual responses: you cannot function well at sex if you are nervous or anxious, or indeed, aroused or stressed. (Delayed ejaculation is one of the most sexual issues most affected by emotional influences.)

Therefore, the more anxious a man is about performance in bed, the more likely he is to lose his erection: and once this has happened, the more likely it is to happen again. But this is not the whole story of erectile dysfunction.

The situation is made more complicated by the fact that to some extent, a man can compensate for his anxiety by using practices which boost his sexual system. For example, heavy duty fantasy, or arousal which stems from the sight or sound or scent of one’s partner are methods which many men unconsciously come to use to keep their sexual arousal high. This may work even when they are experiencing high levels of anxiety, anger or resentment during sex.

What this means in practice is that a man may appear to be sexually aroused, with a hard erection, and the ability to make love. However, it’s his own mental processes which are keeping his penis erect, not physical arousal, which is what you actually need to be sexually satisfied.

Sure, for many years this system may keep a man in the saddle, so to speak. But, inevitably, as time goes by and age has  its inevitable effect on a man’s sex drive, he will find that the responses of his body to this fantasy are less than they used to be….

Maybe so much so that the anxiety or other (negative) emotion he feels around sex or towards his partner may actually come to predominate his emotional state. This will almost certainly mean that he cannot keep an erection.

Or, he gradually finds erectile dysfunction is creeping up on his without him realizing it – until the day when his penis refuses to co-operate during sex.

Now, men who are in this situation need to deal with erectile dysfunction by becoming more aroused in their bodies rather than their minds: by not relying on fantasy, but instead on real arousal in their bodies, they can replace the need for fantasy to keep their penis erect. They will also have a real sense of sexual arousal that naturally gives them an erection and comes from intimate interaction with their partner.

Now you have probably realized that this means a man must actually examine the emotional relationship he has with his partner. If it has significant amounts of anger, resentment or is clouded by other negative emotions, he must effectively deal with this before he begins to search out a cure for erectile dysfunction.

As you may imagine, this is not always easy because a lot of this negative emotion is actually unconscious – that is to say, out of the man’s awareness.

On the other hand, men who are in a situation like this, are often terrified by the loss of erection that threatens their whole sexual self-image. So there is little alternative to some kind of therapy which at least addresses the relationship issues. This may prevent the man from finding a new partner with whom he imagines there is less emotional baggage and with whom the same level of negative emotion has not yet developed.

So how can one deal with erectile dysfunction in this context? The first step is probably to get some kind of therapy or counseling for the relationship. Then, the emotional issues can be dealt with. 

Assuming that there are no physical causes for a man’s erectile dysfunction, the nest step may well be sensate focus: a proven and effective method of reestablishing sexual arousal and getting a man back to sexual self-confidence.

Sensate focus works through a gradual series of touching exercises, which are designed so that there is no sexual pressure. With an explicit commitment not to engage in sexual intercourse, the pressure that contributes to the erectile dysfunction is removed, and a man may quickly find that he begins to experience a new and different level of connection with his partner….one where he can appreciate her without the overlay of fear or anger that his (mistaken) belief that he must pleasure her or that her sexual satisfaction depends on him produces.

Essentially you start with an agreement to be intimate and naked, but without genital contact.

After engaging in a series of touching exercises, which in themselves can be a powerful route to understanding or discovering powerful emotions that spring from the depths of your feelings towards each other, you move on to a series of touching exercises where genital contact is permitted, though masturbation or oral sex to reach orgasm is prohibited.

These exercises are designed to remove performance pressure, and allow a man (and his partner) to make contact with their sexual selves, physical arousal, and sexual responses.

The next step is to engage in a series of touching exercises with genital contact and possibly masturbation to orgasm. Once again, the progress towards full sexual intercourse is paced: at every point in the sequence of events, a man must examine how aroused he is and if he finds that he begins to feel anxious, he must reduce his anxiety and bring himself back to a state of relaxation until he is once again calm and back in contact with his sexual and emotional self.

It’s essentially this loss of contact with self that produces erectile dysfunction: In the process of sexual arousal, without the feedback from your body you don’t know how aroused you are. Yet many men who fall into this trap are relying on fantasy to keep their penis erect, not their physical arousal – which is why they often experience what is know as the “numb-come” – the “feeling-less” orgasm: they are simply not aroused. Or, they may not come at all, or they may develop a severe case of erectile dysfunction.