As men age, they can be less assured of having a firm erection with every sexual encounter. While this is disturbing to men and may preclude sexual intercourse, it does not have to impact on their ability to give and receive sexual pleasure. The most crucial aspect of this problem is the meaning that men and their partners attribute to it. Unfortunately, in our society, a man’s concept of himself is very much tied up with a relatively small part of his anatomy and how big and hard it is able to get. Women often feel that they are to blame when their partner is having erectile issues: they often believe that they are not attractive enough, and that this is the cause of their partner’s problem. By the age of forty, 90% of males experience at least one erectile failure. This is normal and not a sign of chronic erectile dysfunction. It is the overreaction to the incident – the creation of anticipatory anxiety and performance anxiety – that often maintains the problem. Erectile disturbances can have either organic or psychogenic causes, or a combination of the two. Men who have no erectile problems when self-pleasuring and men who have experienced a sudden onset to their problem are most likely to have a larger psychogenic component to their problem. Those whose problems are more organic in nature notice a more gradual change in their ability to get or maintain an erection. It is important to be evaluated by a doctor to preclude a medical problem. Viagra and Cialis have been a boon to men. They can get a “quick fix” to their problem. The advertising the large drugs companies have embarked on to promote their products have taken this common concern for men as they age and increased awareness and given men hope: there is help available. The reality is that only 41% of men who have tried Viagra are satisfied or somewhat satisfied with the medication. Men often discontinue use of Viagra or Cialis after a short time. Psychogenic erectile disturbances are caused by many different factors, or combinations of factors that are often not immediately apparent to the man. Stress, anxiety, relationship problems, unresolved feelings from a former relationship, anger, depression, grief and illness all affect sexual functioning. Men must give up the myth that they are sexual machines that can function under any circumstance. As men age, they rely increasingly on stimulation by their partner for arousal and they derive more pleasure from sex when it is in an intimate and involved relationship.
Sex therapy is a process where the man is helped to solve the dilemma of why his penis is not functioning the way he wants it to. Erectile disturbances, like other sexual problems are best treated in couple therapy when the man is in a committed relationship. Single men often have more difficulty overcoming their problem. It is hard to approach a partner sexually for the first time when you are not sure whether or not your penis will get erect. To set up the best possible scenario for themselves, men with erectile disturbances need to talk about sexual concerns with potential sexual partners before they get into bed with
them. This creates a feeling of safety, and a more intimate emotional connection before they get into bed together. Men develop a broader view of their sexuality- one that focuses on pleasure rather than performance. This sets the stage for a decrease in performance anxiety and increases the chance for the relaxation needed for blood to flow into the penis to achieve an erection. Many men would prefer the “quick fix” to their problem. Those who have become engaged in therapy have learned to be more intimate in their relationships with women and, consequently, with others in their lives. They have experienced benefits that extend far beyond their ability to function in bed. Wendy Trainor, MSW, RSW, RMFT, offers individual and relationship therapy and specializes in sex therapy. For more information or an appointment, contact Wendy at 416.204.0336 or wtrainor@sympatico.ca. This article may be reprinted providing you credit Wendy Trainor, MSW, RSW, RMFT, and let her know where the article will appear.
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