Louise Chang, MD
Never before has erectile dysfunction been so openly discussed in our society. It appears in everything from news reports and comedy sketches to national advertising campaigns. “But ironically, it’s still very difficult for many couples to talk about sex, and especially to talk about erection problems,” says Brian Zamboni, PhD, a clinical psychologist specializing in human sexuality at the University of Minnesota.
That’s too bad. For most couples, talking about erection difficulties is the first step toward treating them -- and enjoying better sex. A few simple strategies can help you communicate more easily.
If you feel hesitant about starting the conversation with your partner, spend some time by yourself preparing your approach. If it helps, rehearse your opening and then choose a time and place that feels comfortable.
“Sometimes the best way to start is by acknowledging that this isn’t an easy subject to talk about,” says Louanne Cole Weston, PhD, a sex therapist in private practice in California. “You might say, ‘This is a little embarrassing, but I seem to be having some problems in the erection department.’ Of course your partner may bring up the subject before you do. Then your job is to make her or him comfortable.”
When problems happen in the bedroom, emotions can run high. If you’ve begun avoiding sex for fear of not getting an erection, your partner may begin to think you no longer find them attractive. Feelings get hurt. Couples begin to feel less intimate. Resentment creeps in.
“That’s why it’s so important to talk about sexual problems like erectile dysfunction in an open and supportive way,” says Weston. “Say right up front that it’s not a matter of being attracted to your partner. Reassure your partner that he or she is still attractive to you.”
Web sites and books offer valuable advice on how to overcome erection problems and enjoy better sex. Along with providing information, they provide a language to communicate for couples who don’t normally talk directly about sex.
“Words are a big problem for many people,” says Zamboni. “Some people feel comfortable only with medical terms like penis. Others are more comfortable with slang terms. Any words will do, as long as they make it easy for a couple to talk openly.” Sharing a good book or web site about sex can help give you permission -- and a vocabulary -- to talk together about ED and your sex life in general.
That’s right. Many sex therapists recommend taking a break from sex while you and your partner focus on emotional intimacy.
“Most of the couples who come to our clinic assume that we’re going to be talking a lot about sex,” says Zamboni. “In fact, we often talk a lot less about sex than they expected.” That’s because most erection problems have little to do with the mechanics of sex and a lot to do with stress, anxiety, anger, and other feelings that find their way into the bedroom.
“Talking intimately about work, about the marriage or relationship, about yourself, can be much more helpful than banging away and trying to have sex,” says Zamboni. He counsels couples who are having sexual problems to take walks together, go out for dinner at a favorite restaurant, or spend a quiet evening just talking. Once you and your partner feel more intimate on an emotional level, you may find that your sex drive and your erections perk up.
When you’re in the mood for having sex again, get creative. “In the routine of a long-term relationship, many couples get into a rut. They only use one or two positions. They rush through foreplay. Especially when people are very busy with the other aspects of their lives, there’s a tendency to rush to the finish line,” says Weston.
That kind of goal-directed sex, she says, puts a premium on getting an erection quickly -- adding to the pressure many men feel. Explore other ways of being physical that don’t depend on a firm erection and penetration, such as caressing or massaging each other.
Talking to your doctor about erection problems is essential. Your doctor can rule out health problems associated with erection difficulties, such as heart disease or diabetes. Your doctor may also recommend an erectile dysfunction medication.
Some men depend on oral drugs (like Cialis, Levitra, Staxyn, and Viagra) to get an erection, says Zamboni. “But other men use them for a little while to regain their confidence and then no longer need them.” If ED drugs aren’t enough to address the problem, your doctor may refer you to a specialist who can discuss other options, including other medications, mechanical devices, or penile implants.
For some men, erectile dysfunction is caused by low sex drive related to having a low testosterone level. In that case, testosterone can help boost libido. Persistent erection problems can lead to depression and anxiety. Resolving the emotional aspects that interfere with intimacy and erections may help ease erection problems.
Many couples also benefit from seeing a sex therapist. “Even if erection problems have a physiological cause, sex therapists can help couples talk more openly and feel more intimate,” says Weston.
Erection problems aren’t resolved overnight. Even in the age of ED medications, a strong and intimate relationship depends on sharing feelings. Every relationship has its ups and downs, after all. Feelings get hurt. Sexual attraction waxes and wanes. Keeping the lines of communication is essential to both emotional and physical intimacy. “Sexual intimacy isn’t a beginning and ending process,” says Zamboni. “It’s something a couple works on every day of their relationship.”
SOURCES:Brian Zamboni, PhD, clinical psychologist specializing in human sexuality at the University of Minnesota; Louanne Cole Weston, PhD, family and marriage therapist; National Kidney and Urological Diseases Clearinghouse, “Erectile Dysfunction”; American Academy of Family Physicians, “Erectile Dysfunction”; EMedicine, “Erectile Dysfunction." American Urological Association "Non-Surgical Management of Erectile Dysfunction."
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