How To Resolve Erectile Dysfunction

Dear Duana,

This New Year’s, I’m resolved to get my husband’s and my sexlife back. We’re best friends with a great sexual history—but for two years, he’s had erectile dysfunction he won’t discuss or treat. Eric says is he’s “fine” with how things are. I think it’s closer to truth to say he’s anxious and would rather shut down sexually than be crushed by trying something that doesn’t work. Is there a way to resume sex of *some* sort with the man I love and married?!

Cassandra

Dear Cassandra,

I hear your frustration, but I’m not a sex therapist. I could claim to be—in most of the USA, *anyone* can . Ye olde local psychological association can often direct you to someone reputable, but even then, therapy involves something Erik’s avoiding: talking.

So you might have to treat Erik’s erectile dysfunction under-the-radar, and here’s how:

 

1. Rule out physical causes.

Ever met a guy with a penectomy**? I have. And I think if more men understood what that implied, they’d visit the doc at the first sign of erectile dysfunction.

Erectile dysfunction is a frequent early sign of diabetes and other conditions that need immediate treatment to preserve life and, um, limb. Left untreated, diabetes doesn’t just create dead wood in 28% of men—it can, albeit rarely, result in guys who are literally dickless. And I’ve never met the man who was “fine” with that.

Which is why I didn’t suggest slipping Cialis™ into Erik’s morning brew; you don’t want to treat only the erectile dysfunction if it’s firing red flares about your man’s health.

Instead, reflect on this core finding of marriage research: Nagging Saves Lives. Then, announce it’s time Erik had a thorough physical; make the appointment yourself; attend it with him; and mark the intake box Yes for erectile dysfunction.

 

2. Figure out Erik’s head.

Given your prior active sexlife and emotional closeness to Erik, you’re probably spot-on that he’s not really “fine”, but has instead reached such a point of such fear that attempting any treatment feels threatening.

A partial list of the Bone-A-Fide Psychological Causes Of erectile dysfunction includes three that seem especially pertinent:

—Wrong Beliefs, such as, “My penis should always get hard when I want and stay that way the whole time, or sex is worthless,” “Aging should not affect my erection,” and/or “I’ll never get an erection, so why bother?”

—Performance Anxiety, aka worry about what Mr. Weenie will/won’t do; and

—Spectatoring, a term Masters & Johnson coined for when folks spend their sexual time as if they were outside their bodies and keeping score of their performance.

 

3. Get your sexlife back.

At this point you haven’t much access to helping Erik correct Wrong Beliefs, because he won’t discuss what isn’t up.

But you have a formidable ally for eradicating Spectatoring and Performance Anxiety—and it lets your hands do the talking.

The technique, called sensate focus, was invented pre-1970 by Masters & Johnson, and its success is based on eliminating a goal orientation in sex. Best part? You recover some level of sensuality immediately, and you get back some of your sexlife (usually All Of It) within a few weeks.

—First, offer Erik a massage. It’s a nude, non-sexual massage, and you should tell him that to prevent anxiety. Genital touching is disallowed. (That’s a rule). He’s the “getter” who makes noises, lifts a finger, or in some way indicates when you do something he likes. You’re the “giver” who *avoids his Groin* while lovingly stroking other areas of his body. If he gets an erection, ignore it. (You are allowed to be secretly pleased.)

—Second, repeat step one exactly, but this time you receive and Erik gives. If he goes for your nether petals, gently guide his hands away and maintain focus on the rest of your body.

Repeat giving and receiving twice a week for at least two weeks; after that, the “getter” can guide the “giver’s” hand…just not to the Groin.

—Third, in another week or so, lift the Groin Ban. Continue trading off “giver-getter” roles a couple times per week, but add stroking one another’s genitals along with the rest of the body. If Erik gets an erection, that’s fine, but don’t continue touching it, don’t make a Deal out of it, and don’t give one another orgasms…yet. Just smile and touch him elsewhere.

—Fourth, when it feels right and you’re the “giver”, incorporate repeated teasing of Erik’s penis into your session (you might want to tell him you’re intentionally being A Tease). Get him hard—stop ‘til he’s soft again- and then repeat, repeat, repeat.

Without discussion, this shows Erik he can have an erection; confronts his possible fears that if he has one erection, he’ll never have another; and helps him enjoy feeling his own pleasure for its own sake.

—Fifth, if and when Erik’s erections become a matter of course, you can ask if he’d like to be inside you. If he says no, be okay with it—when you’re both ready, you can bring one another to orgasm orally or manually. If he says yes, have intercourse for a few very slow, woman-astride, non-demanding motions before “finishing off” some other way (*not* while he’s in; it’s a rule). If erection is lost, return to manual teasing until penetration can recur.

—Eventually, it’s very likely that both you and Eric will be oh-so-ready to have coitus to the point of orgasm. Go for it. Even then, though, it’s advisable to prevent an erectile dysfunction relapse by repeating the first two steps at least once per month.

Cassandra, occasional erectile dysfunction is an occasional fact of life for many men, especially as they age—nothing and no-one can guarantee the permanent end of erectile dysfunction. But this plan has a high success rate.

And it has near-100% odds of returning some form of sex with the man you love while bringing both of you pleasure and communication and comfort you haven’t had in a long, long time. Here’s to a Happy New Year.

Cheers,

Duana

**penectomy = complete or partial removal of the penis

 

The author wishes to thank the following scientists and sources:

—Janet Shibley Hyde and John D. Delamater, for Understanding Human Sexuality . Everyone with a body needs a human sexuality textbook; this is my favorite, and provided the starting place for much research in this article.

—Inigo Saenz de Tejada’s thorough work on how the penis functions, as well as pathologies (such as diabetes) that cause dysfunction.

—Linda J. Waite and Maggie Gallagher, for proving that Nagging Saves Lives in their book The Case for Marriage.

—William H. Masters and Virginia E. Johnson, of course. They invented sensate focus and changed the world for countless people with ED and other sexual problems way before Viagra™, Levitra™, or Cialis™, oh my. Their book Human Sexual Inadequacy (1970) is a sex therapy classic.

—Raymond Rosen, Sandra Leiblum, and Ilana Spector, for creating a comprehensive way to treat ED that includes sensate focus, education that combats false beliefs, sexual novelty to keep the fire burning, help with conflict-resolution strategies so you’ll still like one another enough to have sex, and (most brilliantly, I think) training to prevent ED relapses. If I were looking for a sex therapist, I’d click the link and call Dr. Leiblum.

—Paul Joannides’ The Guide to Getting It On! It’s the most fun you can have with a layman’s how-to.

—And if you just want to read a quick, accurate overview of general sensate focus techniques on the Internet, this was the resource I found to be most clear: http://www.partnertherapy.com/node/365

 

All material copyrighted by Duana C. Welch, Ph.D. and Love Science Media, 2011.

© Copyright Duana WelchPh.D., All rights Reserved.