Why Is My Husband Not Getting Erect?

Every year, new women join a rarely talked about unofficial club as the wives of men with erection problems. Much has been said about the topic from a man's point of view, but what about their female partners?

What do we know about how erectile dysfunction affects a woman?

Considering roughly 30 million men are affected by erectile dysfunction (ED), according to the Urology Care Foundation, it's natural to infer the sex life and relationships of millions of women are also impacted by their partners' loss of sexual function.

A whopping 53 percent of men surveyed who had ED within the past year fought with their partner because of their erectile dysfunction, according to one 2021 survey.

Whether the ED cause is nerves or a side effect of high blood pressure medication, sexual health experts offer advice on how couples can maintain a spicy sex life and a healthy marriage with erectile dysfunction.

Why is my guy too nervous to get it up?

Dating a guy with performance anxiety is one thing, but what happens when you're married? Is your guy too nervous to get it up, or is it something else? There are many reasons, physical and psychological, why your man's erection isn't what it used to be.

The cause of erections is like a "three-legged stool," said Barbara Chubak, M.D., Assistant Professor of Urology at the Icahn School of Medicine at Mount Sinai in New York.

"If one of those three legs is missing, the stool will not stand," Chubak said.

From heart disease to blood flow issues, the causes of ED can vary widely as men age. To easily understand the disorder, Chubak breaks those "three legs" down into the following categories: the messaging system, comprising two of the "legs" in the form of hormones and the nervous system, while the third "leg" takes general penile health into play.

How do messaging systems contribute to ED?

Two of the three major components of an erection lie in the body's messaging systems.

"One is hormones, chemical messengers that need to convey the signal from your brain, 'I want to have sex,' to your body, 'Let's do this thing,'" Chubak said.

"The other messaging system in our body is electrical, our nervous system, brain to spine to peripheral nerves, to whatever end organ, in this case, the penis," she said

Both messaging systems need to be functioning correctly in order to appropriately signal to the organ, the penis' blood vessels, that it's time to perform.

"The small blood vessels in the genitals need to be told by these instructions: Dilate, open up, let more blood in and keep it there," she said.

Without that natural rush of blood to the penis, erections can become difficult to achieve, much less sustain. The penis' messaging systems can go awry in a number of ways.

How do psychological issues affect his ability to maintain an erection?

Some women may not realize they're dating a guy with performance anxiety until an anticipated intimate act falls short of expectations.

There are many psychological reasons why a man may not be able to get or sustain an erection, the majority of which have little to do with their partner—especially when it involves a younger, generally healthy man.

"That their psychological state, or performance anxiety, relative inexperience, or tendency to be dating maybe partners they're not so comfortable with can interfere with that neurological, psychological signaling," Chubak said.

Whether you're dating a guy with performance anxiety, or married to one, sometimes his psyche is at the root of their erectile problems. One bout of erectile dysfunction may cause enough psychological distress that it turns into a self-fulfilling prophecy where the fear of ED actually causes recurring ED. Erectile dysfunction may also be caused by an extreme fear of intimacy, also known as erotophobia. 

How does vascular erectile dysfunction (ED) create sexual function issues?

As veins narrow with age, and fatty diets, a man's erection may be the first casualty. There's good reason for men to be concerned with the condition of their veins as they age. For a man to experience a rigid erection, the penis' blood vessels must dilate to increase the blood flow for sexual penetration.

If a man's veins are clogged, the blood flow necessary to sustain an erection cannot reach its intended destination.

"Given the nature of health problems, especially as people get older—high blood pressure, high cholesterol, diabetes are very common, and those are all conditions that can cause injury to the small blood vessels," Chubak said.

"So, vascular erectile dysfunction is—on a population scale—the most common cause, especially in older people who are more likely to have those comorbid medical problems," she said.

Eddie by Giddy™, an FDA-registered Class II medical device designed to treat ED, tackles the vascular side of ED by constricting the veins in the penis, allowing blood to flow into the penis.

My husband can't stay hard—is he cheating?

Chances are your husband's flaccid penis isn't a sign of infidelity. There are more than a dozen reasons your partner may be unable to sustain his erections that do not include cheating.

Typically, a man's erection can last anywhere from a few minutes to a few hours, according to the Cleveland Clinic. But when erectile dysfunction is part of the equation, which can occur for a number of reasons, an erection may not last long enough for penetrative sex.

How does erectile dysfunction affect a woman?

Erectile dysfunction can be difficult not only for the man experiencing it, but for his partner as well. ED affects millions of women in heterosexual marriages.

Urologist Jamin Brahmbhatt, M.D., of Orlando, Florida, said ED can create feelings of inadequacy, self-blame or rejection in partners.

"The number one piece of advice I'd give is to remember that ED is a medical issue, not a personal failing," Brahmbhatt said. "It's okay to seek help and there are plenty of treatment options available. Open communication, patience and mutual support can go a long way in navigating this journey together."

More research is needed in order to understand how erectile dysfunction affects a woman. Just as the disorder can cause psychological side effects in men, the same is true for women.

Some women are left to wonder the age-old intimate question, "Is it me?"

The majority of the time, it isn't about you. Here are a few tips from the experts on how partners can persevere in spite of ED:

Don't take it personal

As difficult as it may be, it is important for you to remove yourself (and your ego) from the equation when thinking of your partner's erectile dysfunction. ED isn't a pleasant experience for either of you.

"One thing I would tell them (wives in heterosexual relationships), is that they should never assume that their partner's erectile dysfunction is a commentary on them, on their sex appeal, or a sign that their partner has strayed or is cheating on them," Chubak said.

"It's almost never about them. It's their partner and their partner's body," Chubak said.

Think beyond penetrative sex

Get creative. Hands, feet and mouths can provide welcome additions in the absence of a traditional penetrative sex.

"It's obvious but it bears repeating: There's more to sex than tab A in slot B," Chubak said. "You can achieve so much wonderful physical intimacy and shared sexual pleasure in an absence of a need for a rigid erection."

'Lube is definitely your friend'

If conditions aren't prime for sexual penetration, grab a bottle of lubricant. Just be sure to keep your vagina happy and choose a high-quality lube.

"If tab A in slot B is your goal, which is a totally fair goal to have, lube is definitely your friend," she said.

The use of a trusted lubricant can aid penetration, decreasing friction at the entry point while also reducing the degree of firmness that's needed for penile insertion.

"You'll still need some bit of rigidity, but you can get away with a bit of a softer erection if you're generous with the use of lube to reduce friction," Chubak said.

Don't give up

Communication is the cornerstone of any healthy relationship. Maintaining open lines of communication can help couples address sensitive topics of every kind, especially when ED is involved.

"Often, I find that, even for the people who come in with their partners, it's difficult to talk about sex in general," Chubak said. "And it's difficult to talk about ED. And so often, rather than address the problem head-on and try to talk it out and work it out, men will pull away from their partners."

It is not uncommon for men with ED to pull away from their partners, Chubak said, but couples should work to tackle the natural tendency to retreat from sexual intimacy together.

"They'll become avoidant because of this fear of the slippery slope—if we are physically intimate in any way will it lead to a situation where the ED becomes a physical barrier and a source of stress," she said.

"That pulling away from hugs, kisses, etc, those things are an important part of relationships, as is sexual contact. So trying to resist that reflex to pull away from other kinds of physical intimacy is really important," Chubak said.

Get medical help

Talk to a doctor. Partners of men with persistent symptoms of ED should encourage them to seek the advice of a trusted medical professional if they have not already done so.

"We know that men are not always the best about adhering to doctor visits, but this is definitely worth getting checked out for," she said.

The bottom line

Erectile dysfunction can be disruptive in the bedroom, but there are ways couples can thrive and persevere. It's not always easy to see how erectile dysfunction affects a woman, but there is hope.

With open communication and a little sexual health education, married couples can navigate erectile dysfunction with mutual understanding and open minds. Remember, penetrative sex isn't the only mutually satisfying route to orgasmic bliss.