“When Your Husband Doesn’t Want Sex” Part Four: Causes of and Treatments for Erectile Difficulties

            Ask your husband what he fears the most, and you may hear answers like “heights,” “loneliness,” or even “your mother.” What you probably won’t hear is the truth about one of men’s greatest fears: being unable to obtain or maintain an erection. Yes, men can be afraid of erectile difficulties because often their sense of masculinity is linked to their penis. This sets them up for future trouble because, you guessed it, most men will experience erectile difficulties at some point in their life. In fact, by age 40, almost all men have experienced at least one time where they had trouble getting or maintaining an erection sufficient for intercourse, and by age 50, over 50% of men say that they experience mild to moderate erectile difficulties.

            While most erectile difficulties for men under 40 are due to psychological issues or relationship problems, physical factors or medical conditions need to also be considered, particularly as a man ages. According to Rekindling Desire, common physical causes of erectile dysfunction include:

  • Alcohol abuse
  • Smoking
  • Drug abuse
  • Medication side effects (especially high blood pressure and psychiatric medications, like anti-depressants)
  • Spinal conditions
  • Prostate surgery
  • Chronic illness
  • Poorly controlled diabetes
  • Vascular insufficiency (inadequate blood flow)

Common psychological and relational causes include:

  • Anticipatory anxiety (discussed in this blog http://www.cwives.com/?p=1366 )
  • Performance anxiety (discussed in this blog http://www.cwives.com/?p=1396)
  • Distraction
  • Self-consciousness
  • Viewing intercourse as a pass—fail test
  • A reluctance to request stimulation from his wife
  • Anger at his wife

When a husband has erection difficulties that last for at least six months, it’s likely that he will begin to avoid sex unless you have a frank and compassionate conversation about what’s happening in the bedroom. He needs to consult with his physician (possibly a urologist) to treat any physical causes. His doctor may suggest lifestyle changes, including diet and exercise, a change to medications without sexual side effects, drug/alcohol addiction treatment, smoking cessation, and/or medical interventions such as Viagra, injections, or external pumps.

A couple’s consultation with a sex therapist for treatment of psychological causes is also helpful. A sex therapist will help you as a couple to have accurate sexual expectations and also to increase intimacy, eroticism, and the use of caressing without the expectation of intercourse. This last technique is called “nondemand pleasuring” and helps men learn that erections will wax and wane during sexual activity. I tell couples “erections are like the sun. They will rise again. The trick is to not panic when they temporarily fade.” (Sometimes I even break out into a chorus of “The sun’ll come out tomorrow, bet your bottom dollar, that tomorrow, there’ll be sun…”). 😉

So, if your husband has lost interest in sex, search your memory for episodes of erectile difficulties. They may have been the start of his current lack of interest in sex. The Part Five blog will cover another male sexual dysfunction that can lead to inhibited sexual desire: premature ejaculation.

What suggestions do you have for what to say or do if a husband has trouble getting or maintaining an erection?


Comments 8

  1. Jayne
    February 20, 2012

    All of this is so true. But I have to say, I am so tired of fighting this battle w/ my husband. He refuses to take care of his health. He is plagued by health issues at the age of 46 which include diabetes, a heart attach & 5 bypass surgery. I am having a very difficult time taking care of myself. I try to come up w/ different alternatives for him such as natural ways to lower his sugars. He will try it for a while then w/ in a couple of weeks will go back to his usual ways. At this point I am just trying to make it through the day w/ no light at the end of the tunnel.

    1. February 20, 2012

      Thanks for sharing your struggles, Jayne. It sounds like he hasn’t taken full ownership of his health which may make you tend towards taking ownership of his health. Please consider redirecting your energy toward taking care of yourself. Part of your exhaustion comes from the reality of living with a spouse with multiple chronic health issues, but part of your exhaustion may also come from trying to change your spouse’s habits and values. It wears us out when we try to change other people because we are trying to what only God can do. Often, we have to step back and let people choose what they are going to choose. I understand that in your husband’s case, his choices could have deadly consequences; however, it sounds like trying to push him toward healthy habits is killing you.

      I am praying for you and your husband today.


  2. Teresa
    February 20, 2012

    This has happened to us due to him being a diabetic. When it does, I just cuddle with him and love him as he is. I don’t say anything about it if I’m disappointed. There will be other days, other times. He takes very good care of himself (dropping 65 lbs and being able to stop insulin) but it still happens. Yes, a sex like is important in a marriage, but that isn’t all that is important.

    1. February 22, 2012

      Thanks for sharing your experience, Teresa, and for being a loving and accepting wife.


  3. Julie
    February 24, 2012

    Thank you for your informative series Jennifer. The question remains: “What suggestions do you have for what to say or do if a husband has trouble getting or maintaining an erection?”
    I have trouble talking to my husband about this issue, but just love him and show my love in every other way I can. What more do you suggest? How can I initiate further conversation? Can you suggest some conversation openers?
    Thank you for your help.

    1. February 27, 2012

      Hello Julie,

      Tactfulness, timing, and teamwork are key when addressing erectile difficulties with your husband. Discussions like this often go better if you are both dressed and not involved in sexual activity. Pick a time when you are both well-rested and fed, such as after an early dinner or after lunch on the weekend. Make sure you are in a private place where you cannot be overheard. You might also try addressing this topic as you two take a walk around your neighborhood–that way he doesn’t have to look you in the face the entire time as you discuss a topic that may make him feel ashamed.

      Start by letting him know how much you admire and respect him as a man. Tell him how attractive he is to you and how happy he has made you sexually in the past (assuming this is true, which I hope it is). You might remind him of a particularly fun and satisfying past sexual encounter you had as a couple. Then say something like, “Honey, I’m concerned about our sex life. It seems like erections aren’t as easy for you as they once were. This is a common situation that couples face. It’s not “your” problem–it’s “our” problem, and I want us to partner together to see what we can do together to make things better. I need your help in this area. What do you think we should do?”

      Note how you have made the situation a couple problem–that’s the teamwork approach, and it makes your spouse feel less alone and less like he’s “the problem.” You also asked for his help and ideas prior to giving him your ideas. He will have more “buy-in” if the solutions are his own ideas. He’ll also feel less controlled by you.

      If he suggests a visit to his doctor (an excellent first step), you can offer to go with him if he likes. Ditto for a visit to a sex therapist if a medical evaluation should show that there aren’t any physiological reasons for his erectile difficulties. Reading a sex manual, like Restoring the Pleasure, is another great suggestion, but take turns reading it out loud to one another in your bedroom. That way you are learning together and continuing the team approach.

      If he tries to give you the brush off and says, “Sex is no big deal” or “People our age don’t have sex anymore” or “I don’t want to talk about this subject,” politely respond with “Sex may not be the most important part of marriage, but it is important, and I miss being sexually intimate with you. I still need you sexually. Please, let’s talk about what we can do together to make things better.”

      I hope these suggestions help. I am praying for you today.


  4. Angela
    May 25, 2012

    I have been married 30 years. The last 10 years has been a long struggle with my husband’s ED. He has multiple health issues and doesn’t always take care of himself. The reader who is struggling with this also- Don’t give up.
    After the last 4 years of a non existent marital bed- I decided for our 30th anniversary I was going to write my husband notes. Some notes are silly and still others are XXX rated in their content. In the course of writing notes – we have discovered sex toys. I have ( still am reading)read a ton of sex books, marriage books, men’s health books, sexual health, etc.
    The 2 books that probably saved my marriage are: Passionate Marriage by Dr. David Schnarch and Sheet Music By Dr. Kevin Leman.
    The question that came to my mind and probably saved us is: What does it mean to be sexually intimate with your spouse. In answering that question I have jumped started my marriage again.
    It is no means perfect but we are getting better. We are also having a fun sex life again.
    So my $.02 is this: write notes, seek knowledge/share knowledge with each other (including doctor visits), go on dates, initiate foreplay/sex, and finally explore your own sexuality that way you can share with your spouse what you learn!.

    1. August 14, 2012

      Thanks, Angela. I really appreciate the continued effort you put into your sexual relationship. It would have been easy to give up, but you persevered, got creative, and are reaping the benefits.


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