When Men Don’t Want To Have Sex

Melissa Abello, MA, LPC

The Truth About Struggling with Erectile Dysfunction 

It is commonly joked about that when a woman is ready to have sex the man is just around the corner waiting to pounce.  The world we live in today jokes about this dynamic between men and women often.  Many men believe that it is their job, as a sexual being, to please a woman and if they do not experience orgasm they have failed.  In my time working as a therapist, I have also heard men say they believe they should be able to achieve an erection at any point in time. Many of these are myths and cause men to become performance focused on their sexuality.  This fear-based sexuality can then create a whole group of other challenges in the sexual department for men.  One of the biggest challenges is erectile dysfunction. 
Erectile dysfunction is one of those things no man wants to admit or share he has issues with because of our society.  It is more widely accepted for older men to discuss because of the rise of Viagra but imuch less common for those under the age of 50.   Due to the embarrassment of erectile dysfunction, it is important that if you are struggling you understand healthy sexuality.  It is complex and not as simple as we may make it out to be in our society.  Understanding these complexities can be powerful for those who wrestle with performance anxiety.  Knowledge can be power in the minds of those who struggle with erectildysfunction.  

What is Erectile Dysfunction? 

The book “Coping with Erectile Dysfunction” states, “If you seldom get an erection or avoid trying to have sex because of fear, clearly you are suffering from erectile dysfunction,” (Metz & McCarthy, 9).  Erectile dysfunction is always correlated to the lack of comfort and confidence with getting or keeping an erection.  

Causes of Erectile Dysfunction  

There are many different facets that can cause erectile dysfunction.  The different dimensions include physical, emotional, relational factors with a spouse and other external issues.    
Your eating, exercise, and sleep patterns can contribute.  Also, vascular, neurological, and hormonal aspects of your body can play a role.  These may or be necessary to explore with primary care physician especially in the case that you are not able to obtain an erection by any type of manual stimulation.  
Feelings can affect the desire to have sex, as well as, ability to gain and maintain an erection.  Your day-to-day stress can affect your desire to have sexual intercourse making it difficult to get an erection.  Also, fears about achieving an erection can decrease the ability to actually achieve one.  When one is so focused on whether or not they will obtain an erection, their mind becomes consumed with the potential of this not occurring.  This causes too much stress, which inhibits the ability to get an erection.  When your identity and masculinity rises and falls on your performance sexually, it is likely you will struggle with erectile dysfunction.  Lastly, inaccurate views of sexuality and the way that body works can create pressure and anxiety for men.   There are a lot of unreasonable expectations for men to sexually perform making it difficult for them to relax when approaching intercourse.  Learning accurate knowledge of body and sex can help men to have more realistic expectations of themselves as sexual beings.  One of the common expectations our society puts on men is to expect that they can achieve instant, rock hard erections at any point in time and around the clock.  This is not realistic physiologically but is something that causes anxiety in some men.  When this is not achieved in the way it is believed it is supposed to be achieved men to can begin to question their adequacy, making it even more difficult for them to achieve erection moving forward.  Also, as men age, it is common that they expect to be able to achieve an erection as quickly and as frequently as in the past.  When this does not occur it can cause anxiety and fear of whether or not they will be able to maintain erection before and during sex.  In this case, many men choose to avoid sex in order to keep from feeling this way.  It is completely normal, though, that men, as they age, experience difficulty achieving and maintaining an erection.  At one time what would have helped him maintain and keep an erection may not be the same.  Getting older weakens the pelvic floor muscles.  These muscle contractions trigger erection and ejaculation.  This natural aging process makes each part of the sexual experience different and is totally normal.  This should not make any male question their sexuality or performance, as it is natural and part of the process of getting older.  
Relational factors:
Often times your comfort level with your spouse affects erectile function.  It is important to feel trust and mutual cooperation.  When a couple has unresolved fights, the man feels like a failure in relationship, or when they lack connection emotionally it undermines the confidence needed for the achievement of an erection.  Often times, women respond in a few different ways to erectile dysfunction.  A common one is for them to be protective or motherly about it.  In an effort to make their husband feel loved they leave him feeling emasculated and like a child, which perpetuates a lack of erectile confidence.  Some women will become sexual nags.  Stating their partner owes them sex and an expectation that she should be serviced to achieve orgasm.  She may constantly remind her husband of his need to go see the doctor and tell him about his penis not functioning, which for him, stirs up tremendous shame.  Other women can become insecure and feel inadequate, believing it is their fault the husband cannot achieve an orgasm.  These women believe they must not be attractive enough or sexually experienced enough to keep their husband excited.  This can lead to more relational distress, which will impact the couple’s sexual relationship and erectile confidence.  If you are a female and you have reacted to erectile dysfunction in this way it is important for you to learn as a spouse how to be helpful to yourself as well as to your husband. 
The previous factors listed all contribute to erectile dysfunction

It is important not to attempt to diagnose the reasons why you may struggle.  It is imperative you consult with a therapist trained in Sex Therapy and potentially a doctor for you to identify the cause and then the treatment plan moving forward. 


What do you Do If you Find Yourself Struggling with Erectile Dysfunction?  

Find a Sex Therapist  

It is critical you find a sex therapist when struggling with erectile dysfunction because, even if you find the issue is medical, there will still need to be healing for the relationship due to the distress caused by erectile dysfunction.  A sex therapist will help arm you with skills to recoup and will help you to nurture and restore sexual intimacy to your marriage.  Finding a sex therapist who can help treat your individual distress as well as your relational distress is going to be key in developing a fulfilling sexual relationship.   

Get a Medical Evaluation 

Your primary care physician who is aware of your medical history will be your best pick in regards to who to speak with about any medical concerns They will ask about the history of your erectile dysfunction, including how often you experience it, a non-detailed sexual history, your symptoms, and your stress level.  The doctor will rule out physiological causes.  They will most likely do a physical examination checking your penis, testicles, and your genital nerve reflexes.  They will also usually take a blood and urine test.  They may do an oral medication trial.  This will help determine if your vascular system is working.  If none of the findings seem to be helpful they may refer you to a urologist who would be able to do ultrasounds and other tests.   

Educate Yourself 

Struggling with erectile dysfunction is extremely difficult for many men.  They often feel very alone. Often times finding other resources can encourage those who feel alone in this struggle.  Educating yourself can help you to begin to understand the complex nature of what you are struggling with.  Knowledge is power for those with erectile dysfunction.  The book, “Coping with Erectile Dysfunction: How to Regain Confidence and Enjoy Great Sex” by Michael E Metz, Ph.D. and Barry W. McCarthy, Ph.D. is a wonderful book for those who may be struggling.  
We are blessed at My Counselor Online with having Board Certified Christian Sex Therapists.  If you are struggling with erectile dysfunction we know how to help.  Do not hesitate to give us a call.  We are here for you and are competent to help.   
Metz, M. E., & McCarthy, B. W. (2004). Coping with erectile dysfunction: how to regain confidence and 
enjoy great sex. Oakland, CA: New Harbinger. 

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