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Reader Question of the WeekEvery Monday I like to tackle a Reader Question, and this week’s is a common one: “my husband has ED” (erectile dysfunction).

One reader writes:

Can you post about men with ED problems. My husband is 52 and I am 53. We have struggled in the area of sexual intimacy for most of our 27 yr marriage. I was always the one with low libido and my husband would react very negatively. I recently had my hormones checked and she gave me testosterone shots and it reversed our issues! He is struggling with ED. He is on blood pressure meds and thyroid pills. We are trying to talk thru the emotional aspects but it is very difficult.

I would say that’s the typical “face” of ED–a middle aged man, with some health problems, who suddenly finds that things aren’t working well. Yet increasingly it’s also younger men who have ED:

We’re in our twenties and we’ve been married for two years. My husband has never really been able to maintain an erection. Either it peters out before we really get started, or else he ejaculates too quickly. So now he’s almost given up trying, and he just plays video games until about 2 every morning. I want us to be intimate but I don’t know how to get around this.

This week I’d like to do a three-part series on erectile dysfunction and marriage, looking today at strategies to deal with impotence (ED), tomorrow at some of the “other” sexual problems we face, like premature ejaculation or delayed ejaculation, and then on Wednesday at how to keep a great sex life even when these things start to plague your marriage.

I have to admit from the outset, though, that I feel awfully sorry for men. Let’s face it: lots of times we women make love when “we’re not really in the mood”, and it works fine. We don’t always orgasm, and it doesn’t matter. But for a guy, if things don’t work perfectly, everything is thrown off. No wonder it’s so scary! And when things start to go wrong, there’s often a vicious cycle that starts, where they get so worried that it becomes a self-fulfilling prophecy, and then these husbands stop wanting sex altogether.

So let’s look at the three main causes of ED–one cause for ED in young men, and two causes for ED in older men–and then see some DOs and DON’Ts for the different scenarios.

If this isn’t an issue in your marriage, please read on anyway! I have a special word further down for wives who haven’t experienced this yet–because I think the key word is YET, and we need to be prepared!

My Husband has ED: A look at ED in young men, ED in older men, and what to do about itED in Young Men

It used to be that the face of ED was Bob Dole in the Viagra commercial–an older man, who had been fine in his younger years, but now health problems and circulation problems had affected things.

Over the last decade, though, an epidemic of ED in young men has started. Here’s Dr. Oz–pretty much as mainstream as you can get–talking with a panel about how ED is now becoming a young man’s issue. And the reason? Porn.

A few weeks ago I wrote about the top 10 effects of porn, and one of the most common that they’re finding is that it causes sexual dysfunction, from ED to premature ejaculation to delayed ejaculation. It trains the brain to become aroused to an image, and not a person. And then when the image isn’t present, the person doesn’t provide enough stimulus. And so the arousal process doesn’t work.

This can be the case even if your husband is no longer using porn. For instance, I received this email:

My husband and I were both virgins when we got married. I was 22 and he was 23. He told me that he had used porn a lot as a teenager, but stopped when he was 20, and while he was still tempted, he really doesn’t look anymore. He and his best friend meet regularly to keep each other accountable & before we were married he gave me access to his computer and phone. But we had sex on our wedding night (it was really quick), and then once three days later, and now it’s been two months and he says he isn’t interested. Is this normal?

Yes, actually, it is normal–at least it’s normal for guys who have used porn a lot in their formative teenage years. Even if they’re not using porn anymore, often that arousal process is still messed up and needs to be retrained.

Porn is not the only cause of ED in young men–it could be that the two causes that I’ll list in a minute for older men apply better to your husband. But for most men under 40, porn is the root cause. So what do you?

1. Stop the porn

No ifs, ands, or buts. This will not get better if he is still using porn–it will only get worse. Project Know is a community of over 73,000 self-reported internet porn addicts who have made the decision to abstain from porn and masturbation, and they’ve produced some great research on their membership. 37% of these addicts reported experiencing erectile dysfunction, and only 27% reported having no sexual dysfunction at all–meaning that 73% of active porn users do report some sort of sexual dysfunction. The good news? Once you abstain for a few weeks, and your body and brain start to normalize, 60% report an improvement in sexual dysfunction–though they could still have problems, as our letter writer shows.

Nevertheless, it will not get better while the porn-and-masturbation cycle is still occurring.

These posts may prove helpful:

Top 10 Effects of Porn (show them to your husband if he’s skeptical)
4 Things You Must do if Your Husband Uses Porn
Are you a spouse or an enabler? (if your husband refuses to deal with his porn addiction)

2. Start the Recovery Process Focusing on Intimacy

Assuming the porn use is in the past, and your husband realizes that it was a major cause, you can now retrain the brain to become aroused by true intimacy, and not just anonymous images. Here’s a post on sexual recovery from a porn addiction, which includes some exercises on learning how to become vulnerable and truly naked with each other.

31 Days to Great SexI’d also highly recommend my book 31 Days to Great Sex (which is only $4.99 in the ebook version), which can walk you through, step by step, how to build real intimacy. Taken together, the book helps couples understand the difference between real intimacy and just sex, and helps couples move step by step towards achieving that.

Some DONTs for Younger Men with ED

  • Don’t recreate porn in your marriage, thinking this will solve it! The answer isn’t to be “hotter” than porn; it’s to retrain the brain to find real intimacy!
  • Don’t berate him for it. See porn as the enemy, not your husband.
  • Don’t rush things. It takes a while for recovery, and if you cling to each other, and give it time, you’ll come out stronger.

Some DOs in Marriages where Young Men have ED

  • Do work on your friendship with your husband–the more you can laugh together, the more you can take on anything!
  • Do work on creating more spiritual intimacy–like praying together or reading a chapter of the Bible before you go to bed. When you can become spiritually vulnerable with each other, this has a big impact on our intimacy, and often triggers a sexual response because of that intimacy.
  • Do encourage your husband to talk to someone else. You can’t be his accountability partner. You have to be his wife. Let him go to someone else to grill him. Don’t let that person be you.

ED in Older Men

When we think of ED, we do tend to think of older men.

Good Girls Guide My Site1. Dealing with the Physical Causes of Erectile Dysfunction

Here’s what I reported in The Good Girl’s Guide to Great Sex:

According the the National Institute of Health, chronic erectile dysfunction affects 4% of men in their 50s, 17% of men in their 60s, and 47% of men over 75. Transient, or temporary, ED affects about 50% of men between 40 and 70. About 70% of chronic ED has physical roots, while the rest has emotional roots.

If your husband experiences ED once, don’t worry about it. It’s likely just temporary and it will pass. If it happens a few times, though, your husband needs to see a doctor. ED is often one of the first signs of circulatory issues, heart issues, and other health concerns. He may not like seeing a doctor, but think of ED as an early warning beacon. Don’t ignore it.

Sometimes ED can be caused by medication. If he’s on a number of medications and he starts experiencing ED, have the doctor or pharmacist take a look at all the drugs in combination and see if they’re all necessary, or if there may be a better combination that he could try.

ED can also be caused by obesity, smoking, or drinking too much alcohol. We may think we can “have a few drinks” to get us in the mood, but actually the opposite is far more common. Living a healthier lifestyle can often overcome many of the causes of ED.

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UPDATE: I’ve had a number of readers write to me swearing by l-arginine, a compound that health food stores sell that apparently really helps. One man writes,

I didn’t want to take Viagra or Cialis because of the potential complications so I went to a health food store and bought some pills with L-arginine. I take one a day and now I’m fine.

I’m not a doctor, so I can’t give you any medical advice, but enough people have emailed me I just thought I should mention it. You can see arginine supplements here.

2. Dealing with Emotional Causes of Erectile Dysfunction

A physical root to ED can often morph into an emotional cause for ED. Because a guy’s virility is so tied up in how he performs sexually, when he suddenly isn’t able to, even if it’s for a legitimate physical reason, it can cause him to become so insecure that he’s afraid to try again. Or when he does try, the stress that he’ll fail causes him to fail.

Other men have an emotional root to ED to begin with. It could be sexual issues–perhaps sexual abuse in the past, or dealing with homosexual feelings, or some issues from the family of origin. Or more commonly it could simply be stress. He starts to feel like he’s not man enough at work or in another high pressure situation, and this comes into the bedroom.

If your husband has ED, he’s going to feel sexually nervous. Many men, after a handful of times dealing with ED, swear off sex altogether. I’ve even received letters from women saying that their husbands have moved into another bedroom. Sometimes these same men are then caught masturbating. The men want release, but they’re scared of what may happen to their ego if they attempt intercourse. Or they become almost asexual, deciding that it’s safer psychologically to shut down that part of them.

Some DOs If Your Husband Has ED:

  • Do help your husband through stress he’s feeling–at work, with finances, with family. Help him talk through his feelings by being a sounding board. Do fun things with him.
  • Do treat ED as a minor inconvenience–not the end of the world. Sometimes things don’t work; let’s watch a movie instead, or just kiss for a while.
  • Do work on helping your husband stay healthy. Drink less alcohol, lose some weight, and quit smoking. These can help in the bedroom, too!
  • Do talk to your husband before this happens.

I want to emphasize that last one:

Even if your husband has not experienced ED yet: chances are one day he will. If you talk about it beforehand, it can make it easier. Look: we women are going to go through menopause, and EVERYBODY knows that. It’s talked about and joked about. We’ll get moody, we’ll get hot flashes, and our libidos may disappear–for a time. Because we’re expecting it, it isn’t as big a deal. Maybe we need to talk about ED in the same way! Most men will likely experience at least intermittent ED. If you talk about it now, before it happens, and acknowledge it openly, you can decrease the emotional punch that it may bring. Say that you expect it one day, and when it happens you’ll get through it together and develop strategies once you need to. If it’s something you’ve talked about, then it isn’t coming out of the blue, and it isn’t likely that he’ll be as self-conscious about it.

Some DONTs If Your Husband Has ED:

  • Don’t try to analyze this at the time. Let it go, and then talk about a few days later. Don’t push things in the bedroom, when it just happened.
  • Don’t baby him. Treat it matter-of-factly: this is something most men go through at some point, and we’ll get to the bottom of it. I have confidence in that–and in you.
  • Don’t Make This About You. Helen, from the The Unintimate Marriage, writes about her journey with a husband who has ED. And she has this advice for us: There is one temptation you will have through all of this: to make it about you. I’ve been there. You’re in the middle of a pretty hot and heavy make out session and you realize that it is causing very little reaction in him. All of a sudden you are off track too. You’re thinking, “Oh my goodness! He does think I’m fat!” or “I knew it, he does hate this haircut” top it off with a little, “Has he met someone else that he thinks is prettier than me?” Our insecurity comes on quickly, so I want you to really hear me when I tell you that this is not because of you! Don’t question how he feels about you at the time; treat it matter of factly, and move on to something else. You can talk about the root causes when it isn’t so emotional.

Where We’re Going From Here

Tomorrow we’re going to talk about how to handle two other areas of sexual dysfunction: premature ejaculation and delayed ejaculation. On Wednesday, we’ll look at how to keep a sex life alive even if sexual dysfunction means that intercourse itself isn’t always lengthy, possible, or very enjoyable.

 

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