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About sexual difficulties
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Partner can't keep erection for intercourse; Doctors say there's no physical cause
Originally Published: June 22, 2001
~ Last Updated / Reviewed on: June 12, 2006
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Dear Alice, My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point? Desperate For Answers
Dear Desperate For Answers, It can be difficult and frustrating for men and their partners to cope with erectile dysfunction, especially when the cause is unclear. At this point, it is important to be supportive and understanding of the situation and of one another. Erectile difficulties can cause feelings of inadequacy in both men and their partners. Each may internalize the situation, fearing that s/he is the one to blame. Therefore, open and honest communication with one another is an essential ingredient in strengthening your relationship as you work through this situation together. Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness, physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. For others, psychological issues, including stress, performance anxiety, or self-esteem, are the source. Since your husband has already visited several medical doctors and has had many diagnostic tests to no avail, the two of you can explore whether the cause may be psychological in nature. You mentioned that your husband's penis gets hard but that he cannot maintain enough of an erection for intercourse. However, does your husband have firmer erections:
If he answers "yes" to any of these questions, then perhaps the act of intercourse is causing anxiety and is the reason for the partial erection. As an exercise, engage in activities other than intercourse. When you're intimate, focus on non-genital sensations, such as kissing and cuddling. You can also pleasure by caressing, touching, and stroking one another, having oral sex, or incorporating sex toys into your sex play. If he answers "no" to any of the above questions, perhaps your husband's erection issues are due to other psychological factors. In either case, it may be helpful for your spouse to make an appointment with a therapist. Depending on the therapist — psychologist, social worker, sex therapist, psychiatrist, etc. — and the type of therapy, your husband may go to sessions alone or you may be encouraged to participate in the process. For a sex therapist, check out the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) web site and click on the "Locate a Professional" link. In the meantime, it would be important for you and your husband to continue to be physical and sexual, giving each other pleasure in other ways. For more information about erectile dysfunction and therapy, look for Bernie Zilbergeld's book, The New Male Sexuality, as well as Richard Milsten and Julian Slowinski's book, The Sexual Male: Problems and Solutions.
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