Medical issues, anxiety can cause dysfunction
Submitted by: Marc C. Gittelman, M.D.
Submitted on: November 8, 2005
Q: My partner and I have been together for five months and we have never had sexual intercourse. He can’t maintain an erection for intercourse. He can, however, maintain an erection during oral sex. We are only 21 and I know there is no pressure from me but it gets him down and is possibly causing stress that is worsening the erectile dysfunction. I know it’s psychological. How can it be treated.
A: You are correct in that this is very likely to be a psychological problem. However, don’t forget that there are some serious medical issues such as diabetes, thyroid problems and even hormonal problems that can first show up as erection failure. My advice to even the young person with ED (erectile dysfunction) is to start at your physician’s office for a checkup to be sure that some of these problems aren’t the true cause.
Once that is off the plate it may be worthwhile to seek help from a sex therapist to pinpoint some of the potential psychological blocks that are making intercourse difficult. As you mentioned, these often include stress, but there may be other factors such as alcohol, drug use or even a history of sexual abuse in the past that may make it difficult for him to perform in what seems like a “natural environment.” There may even be cultural or religious differences creating sexual tension in the relationship. These are typically things that young patients are very uncomfortable speaking about especially in new relationships. Or he may have something as simple and common as performance anxiety, making intercourse seem like “the impossible dream” for him.
A good sex counselor can often be helpful in sorting out these problems and can teach you and him how to use certain techniques to decrease this anxiety and make vaginal penetration an option. The use of oral medications such as Viagra, Levitra, or Cialis might even be used as a temporary crutch until he can feel that he is back on his feet again.
Go back to your Don Quixote and give him the encouragement to follow through with my suggestions. Perhaps soon you’ll both fulfill that impossible dream that once seemed so far out of reach.