Prevention Australia – June – July 2017

Opening up about sex

can be diicult, but the

alternative – lying next

to someone in bed and

feeling like you’re a

million miles apart –

is more so. It’s worth

starting a conversation

and when you do, try

the following:

QThe goal is to turn a

sexual problem into a

sexy solution, reframing

criticisms of your sex

life and rearticulating

them as fantasies. The

conversation can then

shift to a language of

love, with words like

touch and connection.

QTry describing what

you would like as if it

was on a menu, a

technique inspired by

sex therapist Suzanne

Iasenza. What will be

the appetiser? What is

the entrée? Dessert?

Together you can create

a new menu that

includes some treats

you’d like to enjoy right

away and some for

down the line.

QTalk honestly and

positively about what

you want. It may be

as simple as bringing

back old favourites, like

kissing. Other requests

may involve trying

something new. There

may be some “no

ways” from the other

partner. But there may

also be some yeses

and maybes.

QRemember any

conversation that

leads to good sex

provides an extra

boost of positivity.

LISTEN & LEARN

PHOTOGRAPHY iSTOCK

self-consciousness over an ageing body, or even

concerns about penis size. Worries related to work

and family and life-cycle passages such as turning

50 or 60, the death of a parent, retirement, or an

empty nest can also contribute to the problem.

That’s because stress hormones such as cortisol

constrict blood vessels, including those to the

penis, which are among the body’s smallest.

Sometimes, though, relationship stress is at

the root of the problem. Anxiety brought on by a

“relationship deepening ” milestone (say, getting

remarried or recovering from infidelity) may lead

to an episode of erectile dysfunction. The same can

be true in the opposite situation: a newly divorced

or widowed man, suddenly back in the dating pool

and confronted with the pressures of casual sex,

may experience diiculty with erections.

If you are in a relationship with a man who is

regularly experiencing erection diiculties, here’s

what you can do to help.

✱ Don’t take it personally

Try to remember that a sexual problem is not

necessarily related to the sex a man is having

or the person he’s having it with.

✱ Consider the cause

Is it a rare occurrence or something that seems to

be happening regularly? If it’s the latter, urge him

to visit his doctor for a thorough check-up. First,

the doctor will want to know if he’s able to get an

erection via masturbation. This question may be

embarrassing, but it helps the doctor to better

understand whether the problem is physiological

or psychological. The doctor will also check

whether any medications your partner is taking

has a risk of sexual side-efects. Antidepressants

and drugs for high blood pressure and prostate

cancer are common culprits. Tests may be

conducted to rule out other medical conditions.

Even if there is no serious problem, erection

diiculties are nevertheless a signal for him to

carefully consider his lifestyle – diet, exercise

regimen, sleep patterns, stress levels, smoking

habit (if applicable) and alcohol consumption.

After a thorough physical examination, the

GP may decide he could benefit from seeing a

urologist, who can measure testosterone levels,

check for night-time erections, and gauge the

volume of blood flow to the penis.

✱ Talk through treatment options

Often, a combination of physical and

psychological issues are at work, so treatment

could include medication such as Viagra, along

with counselling. Even if the problem is purely

physical, going for individual or couples

counselling can ofer valuable insight and

strategies for managing the condition, open up

lines of communication so partners don’t feel so

alone, and help the man recognise and replace

negative thoughts (“I’m less of a man when I lose

an erection”) with positive ones (“Being a man is

about more than having a hard penis”). And even

if the problem is psychological, temporarily taking

medication can help break the negative feedback

loop and start rebuilding sexual self-esteem.

✱ Support him at home

Here are some steps you can take, no matter

what the source of the problem.

Q Focus on foreplay

Just because a man has an erection at the start

of sex doesn’t mean he’s fully aroused. If he’s

physically but not mentally aroused, he’s more

vulnerable to losing an erection midstream, so

you want to help create a sexual environment

in which mental arousal can be “louder” than

anxiety. Extend physical foreplay to maximise his

arousal, or try sharing a sexual fantasy, reading

erotica, or watching a sexy movie together.

Q Take the emphasis of intercourse

Try “outercourse” instead. Many men associate

erection diiculties with the act of intercourse,

but not as much with oral sex and manual

stimulation. By finding other pathways to mutual

pleasure, you may be helping to liberate him

from some of the anxieties that lead to the

problem, and to manage it if it does happen.

And most important, tell him you love him.

EMOTIONAL HEALTH

JUNE/JULY 2017 PREVENTION 111