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Tackle Erectile Dysfunction as a Couple

Good communication, loving touch and fun toys can all help

By Barb DePree, M.D.

It happens.

Whether occasionally or persistently, virtually all men are visited by erectile troubles at some point. Even though it will happen to practically every male on the planet, not being able to maintain an erection is inevitably embarrassing and distressing, and easily leads to an unhappy cycle of erectile­-deflating anxiety.

Instead of ignoring the elephant, it makes better sense to tackle the beast straightaway — realistically, practically and as a couple.

You can work together with erectile issues in the same way that you’ve approached all the other age­-related challenges that come along — with curiosity, intelligence, creativity and a bit of an adventuresome spirit. Like a lot of physical changes, erectile dysfunction gives couples a chance to embrace a new challenge and to explore a variety of options they might not have considered before.

Physical Health First

Let’s be clear: Occasional difficulty maintaining an erection happens to every guy, and it starts much younger than the endless commercials on ESPN would have you believe. (One in five times or less? Not something to worry about. Relax.) But when you have trouble getting or keeping erections more than half the time, you really should talk to your doctor.

It’s important for your doctor to make sure the erectile dysfunction (ED) isn’t a symptom of some other health issue. If it is, fixing the underlying health problem could easily fix the ED.

The first line of defense in addressing erectile problems is to address physical issues, which often cause ED or make it worse. Among them:

  •  Alcohol, tobacco or recreational drug use
  •  Obesity
  •  Cardiac problems (for 30 percent of men, erectile dysfunction is often the first symptom of cardiovascular 
  •  Prescription medicines
  •  Prostate issues
  •  Diabetes or other chronic conditions

Beyond the Physical

However, ED is not purely a problem of blood flow, though the pills and paraphernalia that treat it usually focus just on that. It’s a head game, too. This is where couples can work on both fronts to sustain blood flow to his penis and sexy thoughts to his brain.

Smart foreplay and smart sex — even sex that requires no erection whatsoever — can be the adventurous, creative, playful approach to the mind game that is also part of sex. That’s where you can boldly go, as a couple, where you may never have thought to go before.


The goal is to feel relaxed and playful, because nothing is at stake in your sexual play — no expectations, no need to “perform,” no pressure even to have an orgasm. At this point in your lives, just being together and making each other feel good is a very worthy goal.

Sex is a lot more than orgasm. It can be loving touch, embracing, caressing. You can massage each other. Stroke and play. Lather up and take a shower together or sit in the hot tub. It all feels good, and it all counts as sex. You can create an atmosphere that appeals to all the senses with music, candles, a sexy movie, chocolate, maybe a bit of wine (enough to relax, but not enough to slow your responses).

Then, you can practice with creative workarounds:

  • Toys. Novelty is a great sexual enhancement, and rest assured, an enormous variety of products await you for just that purpose. Try using a vibrator — on both of you. Flavored or warming lubricants are fun to experiment with. Various textures to tickle the skin — soft and feathery or cold or warm. Your skin and your brain are your most powerful sex organs. Engage them! Just make sure that all your toys, lotions and potions are safe and high quality.
  •  Preserve the erection. Once there is an erection, don’t divert that precious blood flow. Think about positions that reduce effort for him, such as both of you lying on your sides or the partner on top or on his lap with his back comfortably supported.

Worth the Effort

Erectile dysfunction is a complex beast with many interconnected parts. It can be exacerbated by psychological troubles, such as stress at work or home, as well as physical issues. Very often, it seems easier to withdraw from each other, deny and refuse to talk about ED.

Not only does this perpetuate the problem, ignoring the possibility of an easy fix or the potential of underlying physical issues, but silence often feels like rejection to a partner.

How much sweeter at this time of life to keep love — and whatever its sexual expression may be — alive and well. Ours is the generation that ought to make ED no big deal.

Barb DePree, M.D. Dr. Barb DePree is a gynecologist who has been providing health care to women for more than 25 years, and has devoted her practice to midlife women since 2006. She is the founder of Read More
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