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Psychosexual problems for men

Supporting a partner with ED


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Let's assume you have been in a relationship for quite a number of years. You love each other very much despite the usual, day-to-day difficulties. You feel settled and would never consider breaking up. You both are reaching middle age or have already done so. Overall, you feel very content with each other. Sex is still very important to you, but maybe not as much as it used to be.


As the months go by you notice that your sex life seems to be fading a bit, although you don't quite know why. Somehow your partner seems less interested in sex than he used to be and you are left wondering why. Or maybe it is very obvious to you that your male partner is having problems getting or maintaining an erection. Or maybe he has been to see a medical doctor for one of the normal middle age-related health concerns such as high blood pressure and since he has started taking medication for it his erections are notably softer. Of course you want to support your partner as best as you can. But what exactly can you do?


Firstly, it is really important that you don't take his problem with his erections personally. Some degree of ED is a normal sign of aging in men. Just like a male partner wouldn't think of taking a woman's onset of the menopause as a personal failure or insult, so women need to stand back from their partner's ED and not take it personally. ED is not a sign that he loves his partner any less. Also, ED does not mean you will never have sex again or that he has lost interest in you. But it will mean that the two of you need to re-negotiate what kind of sex you will have with each other. This could be a very good thing as most people get stuck in routines even with sex and a shake-up of settled ways could bring renewed romance and passion into your relationship.


Secondly, it is important that you inform yourself about ED. ED often has multiple causes. It can be due to physiological or psychological reasons or both. The more you know about the condition the better you will be able to understand what is happening for your man. For more information on ED click here.


Next, you will need to talk with your partner about what is happening. Such a conversation may be extremely emotional and delicate for both of you, but it essential for managing the issue. Only if you ask him will you be able to find out what is going for him and how he feels about it. Also, it makes sense to deal with ED as a team as it impacts both of you. To manage ED together you will need to find out what sex means to both of you, how you feel about his ED, what your usual roles are during sex and how they might have to change to adapt to his new limitations. Click here for more information on how to talk about difficult issues. Once you have started talking with each other, continue to do so. ED is an issue which will need many conversations not just one.


If your partner is not initiating a conversation about ED it is really important that you do. ED can be a sign of high cholesterol and serious damage to blood vessels. Therefore, it is essential that a man with ED consults a medical doctor for a thorough medical check up. It may be possible to prevent a heart attack at this point so please make your partner see a doctor! As men have a tendency to neglect their health and may put off seeing a medical doctor until it is too late, it is important that you talk about the issue with him.

Sidebar: there is plenty of reliable information on the subject of male sexual dysfunction available on the internet, including ways to last longer during sexual intercourse and how to overcome a lack of sexual desire.

Try initiating a conversation when you are feeling grounded and not too worried, in a matter-of-fact tone of voice. You could mention that you have noticed that he seems to be having problems having or maintaining his erections lately (statement of fact, spoken without value judgment). It may help to reassure him by saying that you love him very much (reassurance) and that you are concerned for him (information about your motivation/feelings) as you have read that ED could be a sign of high cholesterol and damage to blood vessels (giving him information). Follow this up by requesting him to see a doctor for a general health check up and to discuss his ED (clear request for behavioral change), because you are worried about him (information about your motivation/feelings). You do not have to follow the above recipe in any strict order, but try and cover all of the different areas suggested above to give your communication maximum clarity.


Fourthly, I would suggest that you take some time to reflect on your relationship without attaching any blame to him or yourself. ED is often caused by psychological factors such as lack of trust in a relationship, anxiety, stress or performance anxiety in connection with sex. ED in rare cases can also be a sign that a man does not find his partner attractive any more (or in very, very rare cases, was never attracted to women or aroused by shared sexual practices in the first place). It is really important not to panic about these possibilities, but to step back and reflect on them dispassionately, with a degree of detached curiosity.


Be curious about your relationship, but don't blame yourself for what you might find.


You will have both tried your best to love each other, but maybe life got in the way a bit over the years despite both of your best intentions. Also, just because he may feel a lack of trust doesn't mean you gave him any reason to feel this way. He may have already felt like this before he even met you or it could be due to factors, which had nothing to do with you.


To summarize, give yourself time to reflect in your relationship, maybe a few days or weeks, don't attach any value judgments or blame to what you are considering, but be curious and open minded in your musings.


Here are some pointers as to what could result in a man feeling the following to help you with your reflections:


Lack of trust

  • Reasons for a man feeling like this could be frequent arguments, which he feels he can't win and he still ends up apologizing for, whether he feels he was in the wrong or not;

  • A perceived lack of respect from your side, e.g. ongoing critical remarks, ironic comments or attempts at belittling or humiliating him;

  • Angry outbursts from you, where you seem to lose control and that are unpredictable;

  • Sulkiness, silence and withdrawing on your part as a way of controlling what is happening in the relationship;

  • Affairs or flirting with other men (or women);

  • Emotional attacks, moodiness or general unpredictability



  • General anxiety about work, home life, money or other issues beyond your relationship;

  • Anxiety about how the two of you are getting on together and the state of your relationship;

  • Anxiety about being sexual with you if he feels you dislike sex or he feels he is hurting you through sexual contact, e.g. if the female partner struggles with vaginismus or dyspareunia



  • General stress about work, money and other responsibilities. Maybe he feels overworked and burdened by too much responsibility;

  • Stress created through arguments or emotional disharmony in the relationship


Performance anxiety related to sex

  • Placing too much emphasis on penetrative sex, e.g. believing that this is the only way to have ‘real' or ‘good' sex (and all the other pleasant things one could do in bed, which don't require an erection just don't count).

  • Being very serious or tense about sex and for both of you not to be able to laugh together when things don't go as planned in bed;

  • For the male partner to feel responsible for his partner's orgasm and sexual satisfaction (It's a common sexual myth that men feel as if it is their responsibility to ‘give' their female partner an orgasm and if possible through penetration alone – this belief places an enormous amount of pressure on the man and his ability to have an erection).

  • If the female partner is not willing to masturbate herself to orgasm should she want one so that the responsibility for her sexual satisfaction doesn't have to rest with the male partner.


And a few words on attractiveness


Let's face it – we are all getting older and are probably not as attractive as we used to be. That is really ok and something that we all need to accept in good humor and as gracefully as possible. However, another thing altogether is to let oneself go and not to make any effort for one's health and physical attractiveness. If you feel this might apply to you it could help if you start taking much more pride in your own body and appearance. Also, you will be attractive to your partner if you find yourself attractive, no matter your weight or state of wrinkles. It will impact your partner if you feel unattractive to yourself or really dislike your own body. Please consider working on yourself in this area so that you feel more comfortable in your own skin as a way of promoting playfulness and enjoyment between the two of you.


Finally, we are coming to the more hands on part of helping your partner with ED. When I say hands on I mean hands on: It will greatly help your partner in gaining or maintaining an erection if you are willing to gently or quite firmly use your hand to stroke, rub, squeeze and in any other way you can think of massage his penis. The older a man gets the less sensitive his penis becomes and most men past 40 will need some manual stimulation to help their erections along. If his erection softens during intercourse give both of you a bit of time, relax, continue with foreplay and manual stimulation of his penis. It is quite likely that his erection will become firm again and you can continue either with what you are doing right there and then, or go back to where you were before. It's OK not to use his erection for penetrative sex the minute he is able to do so. Erections come and go and they become more reliable the less pressure there is for him to use them. Also, most women enjoy this part of sex, which could be classified as foreplay, a lot - so why rush?


If you are finding that his ED continues to be a problem the two of you may want to consider the available treatment options. There are a range of behavioral as well as pharmaceutical options available, most notably Viagra. All of these options do require for both of you to want to implement them and to work together in using them. You will need to reflect on what it might mean to you if your partner takes Viagra for example and how you might best go about it. Although Viagra is very reliable in giving men erections it does not automatically lead to both of you having a satisfying sexual experience with each other. Again, it is essential that you talk about the issues involved and that both of you want to use Viagra, or any other treatment option available. Often men stop using Viagra or one of the behavioral treatments not because they don't work, but because it seems to create more problems in their relationship in some way or they don't feel they can be open about it with their partner.


The next important step will be for you to explore sex again with each other in new ways. What does each of you enjoy now about being sexual with each other even if it does not involve penetrative sex? This part may be very awkward at first if you got used to a set routine, but experimentation and shared exploration could open the door to new vitality, romance and enjoyment in your relationship. I believe that women especially can benefit from this situation as we often want more closeness, emotional connectedness and touching. Men are more conditioned to express all of these needs via their penises and ED may result in a man having to rethink some of his basic assumptions about sex and love. This can be an opportunity,  even though it might be challenging.


Finally, it can only help your man if you allow yourself to explore and experience your own sexuality more fully. There is probably nothing as sexually exciting as seeing your partner feel very turned on. It's OK that you allow yourself to be with your own sensations and desires however small, noisy, lazy or lustful they may be. If you allow yourself to be sexual and to enjoy your own sexuality in whichever way suits you best it will help your partner in his own enjoyment. However, enjoying sexuality is only something you can do for yourself, because you are connected to the pleasure your body is giving you not for somebody else. So please see this suggestion as a permission to go with your own sexuality first and foremost. And your partner may benefit enormously.


Further reading:

Bernie Zilbergeld, 1999, The New Male Sexuality, Bantam Press

Sandra Pertot, 2005, Perfectly Normal. A Woman's Guide to Living with Low Libido. Rodale

If you have difficulty with premature ejaculation - see


Written by Anna 29.08.09


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