How to support a partner with (maybe) ED?
August 13, 2019 12:14 AM   Subscribe

It appears my boyfriend has ED or some other type of anorgasmia, and I'm trying to figure out the most supportive way to tackle this together.

I've been seeing my boyfriend for about 9 months. We are both mid-30's-ish. We have sex usually 2-3 times a week and both feel like we are happy/engaged. However, my boyfriend does have trouble getting an erection I'd say maybe 30-40% of time? And he rarely has an orgasm/ejaculates--like probably a small handful in our entire relationship. We had a good long talk about it this weekend and he told me the following:

--Both the erection thing and the orgasm thing have always been a problem for him in varying degrees, although the inability to orgasm is more of a problem now than it's been in the past.

--He's struggled with depression, and meds have proven to be really problematic for him in terms of sexual side effects. He previously went through more than a year without any kind of sexual desire, which ultimately was a huge factor in his divorce, so he's really reluctant to explore therapy and/or medication at this time. He's said that he's considering that a "nuclear option" and would like to try and figure out if anything else would be effective for him before he goes down that route. FWIW he's been open to therapy in general, but doesn't feel like he is comfortable pursuing sex therapy, though I haven't asked any follow up questions on this.

--He hasn't been to a doctor in years and has never discussed this with a doctor. He's calling today to see how quickly he can get in to a GP, which I think is a good first step.

He wants kids more than anything in this world and we've had some pretty serious conversations about trying to get pregnant in 2020 at some point. He is feeling at lot of pressure about this right now, partially because he feels "broken" in his words, partially because he is worried about the health of our sex life, and partially because he is afraid his inability to ejaculate combined with our ages will result in us never having kids.

I've never really been with a man who had either of these issues, let alone both of them, and I am feeling really out of my element here. Thus far I haven't really asked too many questions--I'm trying to stick to listening right now. It's been hard for him to talk to me about all of this. The only thing I've insisted is that he make an appointment with a GP right away to ensure that there's no physical problems.

I've had some concerns that our sex life is much more vanilla than he's been into, although we both agreed this weekend that there is definitely a lot of desire present, we're having sex frequently, and the sex is good, despite these challenges. He's saying he doesn't need anything different in terms of the sex we are having, and while it may be something to bring up again I didn't push it during this conversation.

So I know you're not doctors or therapists and not his doctor or therapist, but I guess my real questions are: what should I be asking him/encouraging him to do beyond the regular GP? Or, are there specific things he can be sure to tell the GP or ask about in order to help get him to the treatment he needs?

Should we be considering this as two separate problems, or is this one problem?

If you've dealt with this during a relationship, is there anything you can suggest that I do to support him? Questions I should be asking him?

Also, anything helpful to read on this? I guess maybe I'm looking for resources related to both the actual physical problems he's experiencing, but also possibly some resources in terms of maybe how to have productive conversations about our sex life, what kinds of questions we can talk about together, etc.

Our relationship is pretty strong but after this conversation over the weekend I'm realizing we don't really talk about sex as much as we should, and it was really difficult to get through this conversation for both of us and I don't know how to make it better/easier.
posted by anonymous to Health & Fitness (9 answers total) 3 users marked this as a favorite
 
When you say he's reluctant to go on meds, do you mean anti-depressants, or ED drugs like Viagra?

My husband takes generic Viagra, if needed (sometimes he does, sometimes he doesn't). It requires a little planning ahead, but not much, and he has no problems with it. He was the one who brought it up with his doctor.

If he is open to that, and nothing prevents him from taking it (other meds, health issues, etc. his GP would be the one to know that), what's the harm in trying it? Make sure he asks about dosages, as my husband was initially given a very small dose, which wasn't working. He saw a urologist for an unrelated issue, and asked him about it, and was told he can take up to 100 mg at a time (a female doctor had given him 15 mg, which is so low it might as well be a sugar pill).

I'd just be matter-of-fact about it, and probably not go into deep discussions until he's seen his GP. I would offer up the suggestion of Viagra, and that's about it. My husband was somewhat embarrassed, but now he's wholeheartedly into taking it for fun sexy times, and it has also improved his confidence so that other times, he doesn't need it. Maybe knowing he has it as a backup helps? IDK.

I've had success in the past by telling him what I want, in terms of foreplay, what I like and don't like (touch me here, say these things, etc.) and now he knows what I like, so that's fine too.
posted by Marie Mon Dieu at 1:24 AM on August 13 [4 favorites]


Would he be comfortable trying prostate stimulation (using a gadget or finger). It might take things up a notch without any medication.
posted by nouvelle-personne at 6:12 AM on August 13


A few thoughts I had reading this:
  1. There are antidepressants that don't have sexual side effects, though they aren't the right antidepressants for everyone.
  2. You can do therapy for depression without taking antidepressants.
  3. You don't mention if he can have orgasms when he masturbates with nobody watching. If he can, you have fertility options that are good and reasonably straightforward regardless of what happens when the two of you are together.
None of these solve the central problem, but they might make it seem a bit less dire.
posted by nebulawindphone at 8:57 AM on August 13 [2 favorites]


Some “Doctor 101” stuff: Hopefully his GP can assist but, if not, your boyfriend should ask about seeing a urologist. Either the GP or the urologist can ideally rule out physical issues. I’ve always found it helpful to approach my doctors with a written list of symptoms that addresses some of the questions they’re likely to ask: description of symptoms, when they started, how/if they’ve changed over time, specifically what I’d like to see “fixed.” I tend to blank out in the moment and that can be a really helpful guide to the conversation.

Your boyfriend is at the age where he’ll be needing to see a GP and various specialists with greater frequency. Your thoughtful and supportive approach to this issue is great, and I’d encourage you to use this specific issue to help him come to grips with the fact that health concerns sometimes take time to resolve and that one or two visits may not be enough. You can do that by gently encouraging him to seek annual physicals and routine preventive care.
posted by cheapskatebay at 9:13 AM on August 13 [1 favorite]


Wellbutrin is specifically an anti-depressant that does not have those sexual side-effects. The opposite in many cases since it is a stimulant. I don't see that your question mentioned masturbation. Is he masturbating? Many men... do it... poorly. Or in a way that builds a certain stimulation experience that isn't similar to actual sex. The kung-fu death grip comes to mind.

He wants kids more than anything in this world and we've had some pretty serious conversations about trying to get pregnant in 2020 at some point. He is feeling at lot of pressure about this right now, partially because he feels "broken" in his words, partially because he is worried about the health of our sex life, and partially because he is afraid his inability to ejaculate combined with our ages will result in us never having kids.

This sounds like textbook depression to my ears. He is catastrophizing something in the future when there are regular solutions even if he had a medical issue. Then he's using that feeling as an excuse for avoidance. Lines up very well with my depression experiences. For a man who wants something more than anything else in the world, I'm finding a lot of really not sounding great ways he thinks to tackle the problem... (or not tackle it more like).

--He hasn't been to a doctor in years and has never discussed this with a doctor. He's calling today to see how quickly he can get in to a GP, which I think is a good first step.

Dude needs to get his bloodwork and such done. There is one other thing that was a major red flag to me. Re-read this carefully and see how he tackles problems/life issues.

--He's struggled with depression, and meds have proven to be really problematic for him in terms of sexual side effects. He previously went through more than a year without any kind of sexual desire, which ultimately was a huge factor in his divorce, so he's really reluctant to explore therapy and/or medication at this time. He's said that he's considering that a "nuclear option" and would like to try and figure out if anything else would be effective for him before he goes down that route. FWIW he's been open to therapy in general, but doesn't feel like he is comfortable pursuing sex therapy, though I haven't asked any follow up questions on this.

What I get from it: delay, avoidance, letting something end because of those, reluctance to address even after that, calling something a "nuclear option", all-or-nothing black/white thinking. There are a lot of questions on here that follow a basic pattern I'm seeing. Man has problem, man avoids problem, bad consequence, new relationship, man doesn't learn the right lesson which is help exists and incremental things can be tried, man declares NUCLEAR OPTION, either that doesn't happen due to further avoidance or it is declared a failure almost immediately. Man blames "I just can't even" and we get another question a few months later.
posted by OnTheLastCastle at 9:24 AM on August 13 [4 favorites]


Given his wished-for timeline for children, I would really strongly focus on supporting that he get professional help for the depression. There are options that will help him without further impacting his libido, and these are issues that he's tried to address independently and they've not improved. Do not get into the position of becoming his quasi-therapist. It's great to sensitively support and encourage, but do not become a stand-in for actual therapy. By his own admission, these issues were a significant factor in the dissolution of his marriage. He needs the nuclear option.

I would really hesitate to have children with someone who has unaddressed depression of this severity as the stress of parenthood will likely make things worse and you'll need a lot of support during that time. It's not the depression that necessarily worries me, it's the avoidance and lack of interest in seriously addressing it. I would strongly encourage GP visit for a general check-up, urology work-up, and starting therapy/mental healthcare. Good luck and remember to avoid getting into a pattern where you care more about managing his health, well-being, and ability to connect with a partner than he does. This is his work to do.
posted by quince at 10:51 AM on August 13 [3 favorites]


*sighs* Okay, so my own marriage ended largely due to my husband's years-long avoidance of and disinclination to treat his ED, and all the terrible consequences that flowed from that, so that's coloring my feelings reading this. So while of course he should make an appointment to see his doctor immediately to diagnose and address physical causes (if any), I think this is actually your much bigger problem right here:

He previously went through more than a year without any kind of sexual desire, which ultimately was a huge factor in his divorce, so he's really reluctant to explore therapy and/or medication at this time. He's said that he's considering that a "nuclear option" and would like to try and figure out if anything else would be effective for him before he goes down that route.

His lack of sexual initiative and avoidance of the problem ended a marriage and yet he considers therapy a "nuclear option"?

Would he have called the GP on his own if you hadn't "insisted"?

Did he open the conversation about the sexual issues or did you?

You don't talk about your sex life much, but when you do, who brings it up?

Honestly, I could have been unendingly supportive and hung on for much, much longer IF my spouse had been open, communicative, and committed around getting help and tackling the problem head-on instead of just drowning in shame and shutting down over it forever. I think how your boyfriend reacts to your initial conversation and how seriously he seeks out treatment options for both the physical and mental aspects of the issue will tell you everything you need to know about how this situation will ultimately play out.

Finally, to be frank, I actually wouldn't worry too much about supporting him right now beyond what you're already doing; I would worry about supporting you. Much of the advice given to women of partners with ED tends to be unbelievably, shockingly cruel and dismissive, and I have to believe that people blithely doling it out have NEVER actually been in this sad position. Go ahead and Google it and you will innumerable articles, web forums, and blog posts about how you need to just be unendingly patient and supportive of your man, prop up his ego, lavish him with non-sexual love and affection, and assure him you will wait for as long as he needs for the problem to be fixed. For an indefinite amount of time, apparently. You should be wary of any suggestion that lies solely in the hands of the partner and their ability to be patient, open, loving and supportive at all times. That is an incredibly heavy load to carry, particularly given the intimacy of the problem. Putting the onus on them to create an atmosphere that is constantly about the needs of the other, with the underlying suggestion that the lack of an erection means you didn't do it well enough, is a downward spiral waiting to happen and not a solution in and of itself.
posted by anderjen at 1:21 PM on August 13 [1 favorite]


He previously went through more than a year without any kind of sexual desire, which ultimately was a huge factor in his divorce, so he's really reluctant to explore therapy and/or medication at this time. He's said that he's considering that a "nuclear option" and would like to try and figure out if anything else would be effective for him before he goes down that route. FWIW he's been open to therapy in general, but doesn't feel like he is comfortable pursuing sex therapy, though I haven't asked any follow up questions on this.

I'm wondering if you see the inconsistency here. Unless I'm misreading this, he's saying that he went a year without sexual desire, which led to issues with his ex-spouse, and therefore... he doesn't want to deal with these issues? That just doesn't make sense. Is he saying, "If I deal with this now, then I feel guilt for not dealing with this during my marriage?"

Divorce is a nuclear option. Maybe he thought a new relationship would solve this problem, but it sounds like it's only solved some of the issues. He already went through one nuclear option. Has he been pursuing any other possible solutions to this?

ED can be a really sensitive issue for men. I had a partner, also in his early 30s, who dealt with this. It was difficult for him to talk about. I think he was still dealing with some emotional fallout from his previous relationship. But I'm not understanding why it's ever a bad thing to talk to a doctor about this.

In the big picture, I would encourage you to proceed very cautiously in moving ahead with this man--not because of the ED but because of his approach to this issue and how he deals with it. He is showing you how he deals with problems. You've been together for nine months and are talking about trying for kids, so it sounds like a pretty serious relationship. But there are some big red flags I want to highlight before you even think about pregnancy:

1. He has said outright that lack of sexual desire and erectile issues were problems that led to the end of a previous relationship and yet he didn't then and still hasn't sought help for either issue (maybe I'm misreading this but did he go on medication and that caused the sexual side effects? but he didn't follow up with a doctor?)
2. He is reluctant to pursue therapy around this issue now (he seems to be assuming that the outcome of therapy is medication. There's a lot more to therapy than that).
3. You are in a serious relationship and there is a major issue around sex for you both but he has a difficult time talking about this with you.
4. He feels broken and isn't really doing what needs to be done to address these issues.
5. You are somehow getting stuck in the role of solving this issue for him rather than simply being a good, supportive partner (like, he should be asking this question, not you!).

Kids are a big commitment. It's important to try to find a partner who is committing to working through and solving problems. It's important that your partner is able to talk about these issues with you, even if they are awkward and uncomfortable.

You're talking a lot about what you should be doing and saying. But this is on him, not you. You can't be his therapist. Please work hard not to be his therapist! He needs to be in therapy for his depression and the associated issues (and after he does that for a while, maybe it would be good for you all to be in couples counseling to learn how to have difficult conversations more easily), and he needs to be attending to his physical health with regular doctor's visits.

This sounds like someone who maybe hasn't worked through the issues in his past relationships and has built some walls of denial. It is totally reasonable for you to need to see him taking care of himself by going to therapy as a condition of you wanting to move further ahead in a relationship with him. The shine of newness is wearing off and you need to know if you all can communicate and problem solve before you commit to parenting with this man. How he handles this issue should be giving you a lot of information about how he will be as a partner and father in the long term.
posted by bluedaisy at 4:38 PM on August 13 [1 favorite]


I'm sorry, I didn't mean to be insensitive in regards to depression. My husband has had symptoms of depression, which turned out to be low Vitamin D and B12. One time, they wanted to give him anti-depressants, and I insisted he get tested, and his D was below 20, and the next time both his and and B12 were very low. SSRI's would not have helped in that case.

He thought of getting the Viagra on his own, and asked the doctor about it himself, I didn't tell him to do that. I just thought it might be a useful suggestion, as I know sometimes guys get embarrassed, and maybe part of being depressed might be alleviated by being able to have sex on a regular basis. I mean, it's not the cause of depression, but being able to get it up and perform has certainly helped my husband's self esteem and confidence.

Obviously, if he has a history of depression, that should be examined and treated. I think human beings are multi-faceted, and I know I've had situations in my life where I was considered clinically depressed, but circumstances changed, and I was not anymore. I have had mentally ill partners before, as well as close relatives, so I am all for treatment of depression, of course. I agree it's not your job to make him do things, but I was just thinking that if performance was an issue, a little help along the way might do him some good in both the physical and mental department, that's all.
posted by Marie Mon Dieu at 4:51 PM on August 13


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