FAQs About Sexuality
Difficulty Getting an Erection

QuestionI've never had a problem, sexually speaking, until recently. Now, all of a sudden, I seem to be having difficulty getting an erection. I really do love my wife. In fact, she's probably more attractive today than she was 23 years ago when we first got married. So what's wrong with me?

AnswerGetting an erection is an involuntary response controlled by the relaxed branch (parasympathetic) of our involuntary nervous system. So when a man is relaxed and soaking in pleasure, he is likely to get an erection. However, anxiety or physical factors can interfere with this natural bodily response.

We would recommend first that you pursue a tumescence evaluation by a urologist who is a specialist in erectile dysfunction. A cardiac and vascular workup would also be indicated since an erection is a vascular response. You need to be sure that diabetes and certain medications can be ruled out as a possible cause of your difficulty.

If medical causes are eliminated, you should consider the emotional reasons for having difficulty getting an erection. First, men of all ages experience erectile difficulty at some time or another. The occasional inability to get or maintain an erection need not be an issue of concern. However, once anxiety and preoccupation with getting an erection has occurred, it tends to perpetuate itself. But the good news is that erectile responsiveness can be regained. Here's how to do it:

First, you need to be distracted from the anxiety about getting an erection. To do that you need to temporarily rule out sexual intercourse, all attempts at having intercourse, and any demand or expectation of an erection during your times of lovemaking.

Second, you need to focus on pleasure and enjoying each other's body, rather than concentrating on having sex. If you came to our office for counseling, we would take you through the teaching, talking and touching exercises of our sexual retraining process in Restoring the Pleasure.

As part of the process, we suggest that spouses give names to each other's genitals and then make a habit of regularly touching each other's genitals in an affirming manner. (Remember, sexual intercourse is not the goal here.) If preoccupation or concern about the state of your penis enters in at any time, you should tell your wife. Verbalizing your anxiety interrupts the control your concern has over your penis.

Third, it's important that your wife be freed to really enjoy your body for her pleasure. The more freely she can lose herself in the pleasure, the more likely it is that your natural response of erection will occur. In contrast, if she is concentrating on how your penis is doing, her evaluation will increase the performance demand on you and will likely decrease your erectile response. If following these guidelines does not solve your difficulty, you may want to consult with a sexual therapist.

With the availability of Viagra, you may wish to pursue getting a prescription. Viagra can be used to regain confidence when anxiety is the issue or to counteract physical interference with erectile response.

For Further Exploration:
Restoring the Pleasure

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