How do I keep erectile dysfunction from ruining any more of my relationships?
May 17, 2010 1:33 PM   Subscribe

How do I keep erectile dysfunction from ruining any more of my relationships?

I am a heterosexual 31-year-old guy. Since some of my first sexual experiences 10 years ago I have had some problem getting and keeping an erection with a partner. Bullying by girls when growing up led me to be afraid of girls, and anti-sex education from the conservative-run public schools in my home led me to be afraid of sex. I was scared the first time a girl wanted to have sex with me, and after I panicked, she threw a big temper tantrum, screaming at me and throwing heavy objects around. Since then I have been in any number of relationships and had a few one-night stands.

My erections can be good enough for penetration but I am never totally satisfied with them. One girl noted that I was only really totally hard during orgasm. I need constant wet stimulation to keep an erection. I often lose it while putting on a condom. I sometimes lose it during oral sex or hand jobs, and sometimes even during intercourse. I'm fairly unsuccessful at having intercourse other than in the missionary position. I feel incompetent at vaginal sex, I can't last very long, and this is worse when I overstimulate myself to avoid the possibility of losing my erection. These things make me unhappy but they aren't the end of the world. There is more to love, life, and sex than a hard dick and vaginal intercourse.

Sadly, many women do not see it this way. I've been with other girls who have reacted incredibly badly when I have lost my erection (some think it reflects poorly on me, others think it reflects poorly on themselves), unsatisfied at my inability to engage in other positions or last for very long, and some who are simply uninterested in anything other than vaginal sex, and refuse to allow me to stimulate them in other ways. These difficulties have directly led to the failure of a number of relationships. Every time that happens the problem gets even worse.

I tried Cialis. It helped for a while, but isn't as useful anymore. I don't know if this is because the effect has worn off, a physical problem has worsened, or if it's because more anxiety has built up. I've seen a urologist. He gave me a prescription for Viagra and Xanax. I never got to use it because my girlfriend dumped me a month ago because she couldn't deal with the sex anymore. She fit into every category of not seeing things my way above. We had what I thought was a fantastic relationship for a while, she was incredibly attractive, and it was all thrown off by sex. I have been at a low point since then in my feelings on this issue, and haven't felt like dating.

I've had happy sexual relationships too, some even lasting more than a year. I think about the common elements there. Before we had sex, I was always totally secure that the person was into me. Ideally this is because things just clicked right from the start. Unfortunately this was sometimes due to dating someone who I was less attracted to because I felt more secure that they would want me, feel lucky to have me, or put up with this nonideal situation. Other important elmenets are that we were exclusive, we had discussed birth control and sexually transmitted diseases and I was confident that neither would be an issue. It was also with people who enjoyed non-intercourse forms of sex. I was the one who initiated each increase in physical intimacy, and we had only non-intercourse sex for a period of time. They seemed really satisfied with oral sex. This is important to me because I feel incompetent at providing a girl with a satisfying experience via intercourse. Skipping extended foreplay and going straight to intercourse makes me feel bad. We didn't talk much early on about previous sexual encounters or partners.

The previous paragraph indicates the things I feel that I need to have a good sexual relationship. I don't know how to get them anymore. As I've gotten older and started dating more experienced and older women, and moved from the Bible Belt to a big city in the northeast United States, I've found that they are more unwilling to wait for sex or intercourse, and unwilling to put up with a sub-ideal sexual experience. It's difficult to bring up in advance my need to delay sex a little without seeming incredibly presumptuous, and ruining spontaneity and chemistry. It's difficult to bring it up while making out or messing around without it being somewhat emotionally charged. It's difficult for me to stop and say "hey, we should talk first" when an attractive girl that I like really seems to want me, because I actually really like sex and ironically I have a fairly high sex drive in spite of all these erectile difficulties. And talking often leads to the other person losing interest. Furthermore, it seems impossible to know in advance whether someone is into non-intercourse sex.

What do I do? Really, things have been the best with sexually inexperienced women before. This is not a sustainable solution, and besides, I don't particularly have a desire to have sex with inexperienced women. It just smoothed over the earlier parts of a developing relationship because they didn't know to expect more. So how do I bring things up and when? And what do I say? Have you handled this well or been with a guy who did? What happened? If I'm with someone new and I think we might get sexual, should I take a Viagra and hope for the best? Talk about it first? If we're drinking I won't be able to take the Xanax.

I also resent my lot as a guy with a sexual issue. I feel like men are expected to have sex as soon as the woman is ready for it, and if that doesn't happen most people think there is something wrong. I feel like a decent guy would be patient with a girl who had had previous bad sexual experiences, or who didn't want to have sex or intercourse right away, if she were clear she wanted it eventually. And if he wasn't he might get a reputation as an asshole. I feel like I have been dating seemingly "nice" girls who have not been patient or compassionate with me. Some of you probably think I am wrong about this, and you can say so. How do I get over these feelings?

My urologist said that in case the drugs didn't work, he scheduled me for a procedure where they will inject me with a chemical that causes an erection and watch how my blood vessels work with an ultrasound, to determine whether the cause is psychological or physiological, and if the latter whether the physiological cause is either treatable with drugs, or untreatable with current medical technology. Some doctors question the necessity of this diagnostic procedure, but my insurance will pay for it. However, it is personally hard to see the point, since the treatment for the first two cases is the same (viagra and therapy) and I don't even know what I'd do in the third. It's hard to come to grips with the thought that this might be entirely my fault mentally, or that it might be uncurable. The preocdure sounds incredibly embarrassing and uncomfortable (they are going to stick a needle into my penis!). They claim no permanent effects but I am a bit wary of minor surgical procedures right now since procedures elsewhere on my body has all resulted in some scarring I wasn't warned about. They say at worst there might be some bruising that lasts for a month. Should I go through with this procedure or hope that I can sort things out with drugs and a future partner?

Just to rule out these common suggestions from other threads: I don't use a death grip while masturbating. I seldom use pornography. My inclination is to masturbate once or twice a day but I can successfully avoid it when I am in a relationship. I am already seeing a therapist who specializes in sexual issues. He is great. I am asking for advice in areas where I think a cross-section of personal experiences will be more helpful.

I'm sorry this was so long. There's a lot to deal with and asking questions on this stuff even once is really hard, so I wanted to get it all out there. You can email anonymous2439203 at gmail if you have private suggestions.
posted by anonymous to Human Relations (13 answers total) 4 users marked this as a favorite

You ever try doing it with your morning wood? That may be an avenue to try; farther along that path would be making sure you're somewhat overhydrated before you try sex.
posted by notsnot at 1:53 PM on May 17, 2010

Not owning a penis, I can't comment on the physiological aspect, I'll leave that to the penis-havers.

Okay what I can say...#1 some women, like some men, are assholes. Don't assume because one woman was an asshole, they all will be. It sounds like you've dated one or two assholes.

#2 You said yourself that you did better with women that you had strong communication in regards to sex from the get-go. This should be your goal with future partners. It's true, the way our culture screws over both men and women, is women can think erection=attraction, and the lack of one means that they aren't attractive enough. I've been guilty of thinking that myself in the past. So I think your goal should be upfront communication and reassurance. Tell them how attracted you are to them, show it to them, and be upfront that your equipment sometimes doesn't come through. Don't mention it on the first date, but perhaps after the first heavy-breathing make-out session. If the lady is worth your time, she will be psyched that you want to talk about it and not leave things up to assumptions. You're 31, it's time for grown-up sex conversations. No shame, just honesty.

#3 Vaginal penetration is just one kind of sex, how are you with your hands, mouth? You don't mention these at all, whether you enjoy them, etc.. These are most definitley sex. I had a long-term relationship with someone who had some erection problems due to medication, but that guy could give head like no-one's business. Dear god, I'm blushing just thinking about it. Work on these skills. Consider a strap-on if she needs that "getting fucked" feeling. Oh and communicate, communicate, communicate. In fact, consider taking PIV sex off the table for awhile, and don't put pressure on yourself.

#4 Dan Savage has covered this topic in detail. I don't have links for you, but a search of the Savage love archives at may be helpful.
posted by Maude_the_destroyer at 2:05 PM on May 17, 2010 [6 favorites]

Cialis didn't work on me. Viagra does. I know a friend that thinks Cialis is the greatest thing ever. You may want to try the blue pill then next time you are getting ready to get busy. You shouldn't drink to much when using ED medication since it will nullify the drug. It isn't a miracle pill though.

But it sounds like a lot of this is in your head. Easier said than done, but try not to obsess about your performance or lack of performance. It isn't a contest. Have a good time. Get her off and worry about yourself secondarily. We place so much pressure on both partners with sex and if we just chilled out a little more everyone would be happy. Women feel shitty when their guys don't get rock hard in a second because they feel inadequate. So you end up with two people with feeling of inadequacy.
posted by birdherder at 2:05 PM on May 17, 2010

While reading your post, I was preparing a response from a female's perspective, but I cannot articulate it better than Maude_the_destroyer. Ditto Ditto Ditto!
posted by SuzB at 2:34 PM on May 17, 2010

#3 Vaginal penetration is just one kind of sex, how are you with your hands, mouth? You don't mention these at all, whether you enjoy them, etc..

Sheesh, project much? The poster says:

I've been with other girls [...] who are simply uninterested in anything other than vaginal sex, and refuse to allow me to stimulate them in other ways.

[...] it seems impossible to know in advance whether someone is into non-intercourse sex.

It's buried in there, and he's not terribly explicit, but it sounds like he's aware of this.
posted by pullayup at 2:56 PM on May 17, 2010 [1 favorite]

(I only feel like I can address this part of the issue)

I feel like I have been dating seemingly "nice" girls who have not been patient or compassionate with me. Some of you probably think I am wrong about this, and you can say so.

Well, to some extent they sound like assholes. I mean, throwing things? Flipping out? Obviously not cool. Then again, sexual compatibility is pretty important to a lot of people in a sexual relationship. And as a woman, it can be rough to be with a guy who seems to not be into you for whatever reason. We tend too have a lot of our worth wrapped up in our sexual performance, and we often judge that performance by your erection. Which is weird considering that we get aroused and sometimes have problems maintaining arousal, too.

I think that there are women who would be willing to wait until the relationship progressed in a way that made you comfortable--not just inexperienced women or women who aren't hot (to you).

The issue is that you have to be 100% willing to enforce your boundaries, even with women who are hot or sexually experienced. You can't put everyone into "will have sex how I want, but not the right person for me" and "I think she is hot but she won't have sex with me the way I want". I think that dichotomy might be psyching you and keeping you from being confident and firm with women whom you like. Of course, it's hard for many people to be completely confident when faced with a person who is very attractive and who wants to have sex with them! But even if you're making out you have to work on getting what you need out of the relationship in the long-term (if that's what you're looking for) which means setting the foundation. If she's not able to have patience or do things how you want to do them, well, get into the mindset that it wouldn't have worked out anyway.

On a personal note, some of the best sexual experiences I've had were with a guy who wouldn't take his pants off for a mystery reason. So, there are women willing to have that kind of sexual interaction. I am really on the far end of the spectrum when it comes to being sex-positive and open-minded, though, so meeting women like me might be a good goal for you.

(And, on the off chance that you haven't tried it, grab a cock ring and try it out. You might also consider using a strap-on for penetrative sex so that it stays on the menu, even if you don't maintain an erection. This takes an open-minded partner; then again, I think you might as well ask.)
posted by internet fraud detective squad, station number 9 at 3:08 PM on May 17, 2010 [3 favorites]

Ack, I did miss that. Apologies to the poster, like you said it was rather long. However, I fail to see how this is projection. After all, he was asking about personal experience, and I shared mine. I'm kind of blown away by the idea that there are multiple women out there who don't like non-penetrative sex. Considering that most women can't get off from intercourse alone....It's anecdata: but when talking about sex with female friends, the boasting is all about how good their partner is at muff diving, etc, not who is the hardest.
posted by Maude_the_destroyer at 3:12 PM on May 17, 2010

Oh and on another personal note, maybe TMI: when I have sex with a guy and the erection is only kinda there or not there, I do take it a little personally, which is not right of me. Especially because if I were a guy I would probably have the same issues that you do. If a guy is willing to do other stuff and confident and obviously into me, then obviously it's not ideal, but pretty much every guy I've ever slept with is unideal in one way or another and I've still had a lot of good and satisfying sex. Lord knows I have my own weird needs and quirks.

On a third personal note, stimulant medication for ADHD has really improved my ability to sustain arousal! Many, many people with ADHD have similar issues with sex. Also, taking a long time to orgasm.

I have no idea if that's what's going on with you, but you might consider spending a few minutes looking up some of the previous questions about ADHD as well as this excellent thread to see if anything rings a bell.

Best of luck. You have had a rough time of it and you have made a lot of good, proactive steps so far.
posted by internet fraud detective squad, station number 9 at 3:17 PM on May 17, 2010

Seconding that we women sometimes don't handle this well.

Sometimes it's because the woman is a selfish, demanding bitch (sounds like your example above with the girl throwing things!!). And sometimes the woman feels inadequate and frustrated because her internal monologue is saying, "Oh, if only I were attractive enough/sexy enough/skilled enough, he would be erect!"

Either way, the result is the same, and in both cases it's the woman's reaction that makes this tough for you. I'm sure you can understand the frustration and feelings of inadequacy, but that's the last thing you need to be saddled with when you, yourself, are feeling so frustrated.

First off, I think communication is key. Your potential partners should know that ED is part of loving you right now, it's an ongoing process you are dealing with, and they need to be wiling to work on this with you.

What I really took from your question is that you seem to do much better when you feel in control of the situation from the very beginning. That makes perfect sense to me.

This may sound off-the-wall, but have you considered looking into a submissive (as in BDSM) sexual partner? Someone who would take sexual cues from you and allow you to control when and how each encounter takes place and whether it leads to PIV intercourse, manual stimulation or oral sex? You say that you have looked for less sexually experienced women, and that now you are having trouble finding partners like that. But there are disadvantages to sexual inexperience, as well; women who don't know that erectile dysfunction is common may react in one of those ways above that are so hurtful to you. Something to think about.

If that makes you too uncomfortable, a sexual surrogate that is aware of the issue from day one could really be beneficial, I think. She could help guide you through potential situations, maybe through role-playing. You might even explore what the worst case scenario would be for you, so that you could work right through it and overcome it. At the very least, you would be less thrown no matter HOW the next woman you are with responds if you experience erectile dysfunction with her. I think that if you could find a surrogate who could work with you, that would be a good thing.

Anyway, those are just suggestions, but I really think that no matter what, you should hold back from any medical procedures for the time being and work on the therapy some more. Seems to me that a lot of what you are experiencing is at least partially as a result of the negative reactions you have had which have created a negatively-reinforcing loop that you need to break out of.

And, by the way, I really commend you for going to see your therapist, and I'm glad to hear he is very "sex positive". Good luck!
posted by misha at 3:30 PM on May 17, 2010 [2 favorites]

Let me guess, papaverine? Give it a shot, no pun intended. As long as you do it in a medical setting, the things that can go wrong (priapism) with that diagnostic can be dealt with right then and there, assuming basic medical competence and preparation. It can't hurt to ask them, though, if you're nervous "So, if I wind up with priapism, what happens then? Because I know there's just a few hours of window for treating that."

No, you are not the only guy who has dated women who are not into foreplay and/or oral (I had one girlfriend whose operational motto might well have been "stick it in and go"). Yes, there is an expectation of male performance. Yes, you will encounter women who will get very upset if you're not in the mood or you don't happen to climax. Rarely, one may scream at you if frustrated. It's good to know I'm not the only one out there who has had something hurled at him because the time wasn't right. Hopefully, you run across more women who are in the "yeah, so if I'm being sexual and we're in the same room together, that's good" camp. Ignore all of the male "sex is like pizza, even when it is bad it is still good" mumbo-jumbo that pressures you to just go jabbing away at anyone who lies still.

This will not be popular advice, but here goes: talk about this early. If she doesn't want to discuss this stuff in an open manner, move on. If she's not receptive, move on. If she gives you any grief about it whatsoever, move on. Save yourself the time. Otherwise, you've invested in a relationship and then you feel bad about ending a relationship because not everyone is having a great time sexually. Do not wait until parents have been met, friends introduced, or attachments formed. Breaking up for sexual reasons has a stigma of its own, so just short circuit it.

Try this on for size: "Hey, look, might as well get this out of the way now — about the sex thing ... sometimes I might not have the stiffest pole for vaulting in the world, but I can do pretty well in some of the other field sports. It's nothing personal, I'm working on it with my doctor. Would this be a problem for you? I'm not saying we're going to try sex out any time soon, but I'd rather be up front before we get any further with $this. I like you and would like to know if this is a deal-breaker before either of us gets too involved." ("$this" can be dating, a relationship, happen in the middle of a surprise makeout session, etc.)

And if it goes south right there, nobody has to go sorting through albums or defriending on Facebook.

If she responds positively, that opens you up for discussion of the particulars. You'll want to practice that in a mirror. What do you want? What are you game for? Compromise is good here — "I know this is unusual and since you're being so accommodating, is there anything you have been wanting that you haven't had a chance to try?" Treat it less like trading IOUs and more like "I'm so glad I can be open with you, please be at ease with me, as well."

I basically had to give a variant of that speech as I began dating (briefly) someone while I had an epically bad UTI, to which the doctor said, "Don't even think about having sex until we get this under control." It's very weird to have to say to someone who is, in some senses, functionally a stranger, "Yeah, I've got this kidney infection, all the way out. *turns hand away from belt buckle, flicks fingers outward from the waist* My doctor wants my penis to sit on the bench for a while, so ... if anything happens, it'll be hands, mouth, and anything else I can throw into the mix for the time being." Never forget the sports metaphors when talking about sex, they're so butch.

Oh, and get a papasan for your bedroom, your neck will thank you.
posted by adipocere at 4:07 PM on May 17, 2010 [2 favorites]

The preocdure sounds incredibly embarrassing and uncomfortable (they are going to stick a needle into my penis!).

And you'll be walking funny for a couple of hours - it's a bit painful afterwards - but you've already been through trips to the urologist, and it's no worse.

Also, it's not a surgical procedure per se, any more than a flu jab is. You are not going to get scarred, or otherwise permanently damaged. Your zipper is more dangerous.

What this will do is allow them to check our your bloodflow. Your situation, from your description, sounds almost exactly the same as mine - after I had such a test, I was diagnosed with venous leakage. So it wasn't all in my head (as many people will tell you it is, even in this thread). When you discover you can't fix it with just an attitude adjustment, you can go about finding out what actually DOES work without wasting time mentally blaming yourself. This is a huger relief than you might anticipate. Knowledge is your friend. Take the test.

Of course, when I was diagnosed (very early 20s), we didn't even have Cialis or Viagra or Levitra, the best we had was Muse and Caverject, which involved injecting your penis each time before intercourse (which thankfully didn't work pharmaceutically for me) so consider yourself at least a bit lucky that you've got some other options. Cialis doesn't do much for me either, I find Viagra works better (plus the 100mg pills cost the same as the 50mg, so you can make them last longer with a cheap pill splitter).

As to how to broach the subject with prospective partners, I've got at least 15 years of experience, and I have never, not once, had a problem with the open, direct approach. "Look, before this goes much further, there's something you should know. My dick doesn't work properly - I have to take pills. It's a physical thing - the hydraulics, basically" If they really have a problem, it's their problem, not yours. You are better off without them and they will never encounter your awesome skills at Plan B (assuming you don't have pills with you).

Yes, it does suck. Yes, you are going to be resentful. But it gets better and a little less embarrassing each time the subject is breached, and in some ways it can give you insights into the human psyche you might not otherwise have glimpsed.

My guess is you'll end up with the right medication (the Xanax thing surprises me - it might be good for anxiety but isn't ED is a possible by-product?) and, that will give you the sense of security you're most likely missing right now. Plus of course, it actually happens to all men in time, you just got to learn how to deal with it a little earlier than some.

But yeah - take the test so you know what you're dealing with, be honest and direct with your partners beforehand and they more often than not will be more understanding than your yourself are about the situation, and don't worry about the future, relationships, marriage etc is all still possible, and you will adapt, to the point where you can respond to an askme question about ED and not have to use anonymity because it's just another common, treatable condition.
posted by Sparx at 4:12 PM on May 17, 2010 [4 favorites]

There's some info you don't give. You masturbate a couple of times a day. How are your erections then? If they're ok, maybe your problems are indeed just psychological. In the sack, if you need to take yourself in hand to get or maintain your erection, I would advise don't be shy, do so. Your partner might enjoy watching; certainly, if the result is you penetrate her in the way she wants she ain't going to object. Also. How is your general health and fitness? If you are overweight, this can affect your ability to get and maintain an erection. If you are unfit, ditto. I'd advise working on all aspects of the problem, with a tablet for back-up especially the nerve-wracking first few times with a new partner. My guess is you'll find someone with the right chemistry and your problems will disappear.
posted by londongeezer at 5:39 PM on May 17, 2010

Oof, you're putting a lot of pressure on yourself and have had some pretty bad luck with women in terms of attitude. It seems obvious to this armchair psychologist that this is largely psychological for you, and that your sexual confidence is damaged. But yeah, get the tests to rule out a physiological cause.

I'm always dismayed to hear when women go all insecure and freaked out when a boyfriend has trouble in the erectile realm. Sure, it can be a little frustrating, especially in terms of momentum, but hey, women's orgasms can be pretty freaking elusive too, and I'd sure as hell give a guy an earful if he got cranky because I couldn't come like clockwork.

I don't know if this will make you feel better or worse, but maybe it would help to talk to older men? A rock-hard cock on command is just less of a realistic expectation as men get older, and the guys who can switch gears gracefully are, well, really sexy. (If you lose your erection during sex, don't stop and apologize, just be ready to keep going with fingers or a toy. Bonus protip: This means you can simultaneously reach tender bits with your tongue, a feat which would require you to be an invertebrate were you still fucking with your penis.)
posted by desuetude at 10:18 PM on May 17, 2010

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