When Men Avoid Sex (Erectile Dysfunction)

This article is based on scientific evidence and clinical experience, written by a licensed professional and fact-checked by experts.

Posted: May 31, 2022

Estimated reading time: 6 minutes

When Men Avoid Sex (Erectile Dysfunction) by Melissa Abello
One Common Reason Men Avoid Sex

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 furthermore that, 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 the taboos of our society.  It is more widely accepted for older men to discuss because of the rise of Viagra, but is much less common for those under the age of 50 to talk about.

Due to the embarrassment of erectile dysfunction, it is important that we understand healthy sexuality. It is complex, and certainly 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 erectile dysfunction.

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.  Vascular, neurological, and hormonal aspects of your body can also play a role. These may be necessary to explore with your primary care physician, especially in the case that you are not able to obtain an erection by any type of manual stimulation.

One of the common expectations our society puts on men is that they can achieve instant, rock hard erections at any point in time, around the clock. This is not realistic physiologically, but is something that causes anxiety in some men.  When this fails to occur, men to can begin to question their adequacy, making it even more difficult for them to achieve an 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. What would have once helped him maintain and keep an erection may not be the same.

One specific example of a normal factor that contributes to erectile dysfunction is the age-related weakening of 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.


Feelings can affect the desire to have sex, as well as the 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.


Oftentimes 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 response is to be protective or motherly about it.  In an effort to make her husband feel loved, she leaves him feeling emasculated and like a child. This perpetuates a lack of erectile confidence.

Some women will become sexual nags, complaining that their partner owes them sex and voicing (in a variety of words) 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. This evokes tremendous shame for him.

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. The factors are many and varied. Therefore, it is important to enlist the help of a therapist trained in Sex Therapy and potentially a doctor. They can help you quickly identify the cause and come up with an effective treatment plan for this struggle which effects a man so powerfully and touches so many facets of his life.

Help for Erectile Dysfunction


It is critical you find a sex therapist when struggling with erectile dysfunction. Why? 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.


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. Usually they will take a blood and urine test. An oral medication trial may be in order to help 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.


Struggling with erectile dysfunction is extremely difficult for many men. They often feel very alone. 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.

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