Talking to Your Partner About His ED Without Blame or Guilt

Your partner is having trouble maintaining an erection during sex. You know your partner has erectile dysfunction (ED), but neither of you has addressed it in a meaningful way, and it's causing him to avoid intimacy. Maybe it's adding stress and anxiety to the relationship, too.

How do you and your partner talk about ED?

"It's a really important question," said Daniel Watter, Ed.D., a sex therapist at the Morris Psychological Group in Parsippany, New Jersey. "Men are not particularly good at discussing this or bringing it up. What they tend to do is withdraw from sexual opportunities."

Men avoid sex altogether because they don't want to confront the issue. They're too embarrassed or frustrated about their ED. Many men even see their healthcare provider about getting prescription help before they talk to their partner about it.

Slowly getting better

Since the advent of ED drugs in the 1990s, Watter believes communication has become less of a problem. Before the days of these medications, men sometimes went years without addressing their erectile problems, he said.

"Men are seeking out help earlier," Watter explained. "The conversation between partners is still pretty infrequent, in my opinion, because men don't have an explanation for [the ED]."

They don't know what to say. All too often, men don't know why they've developed ED. And the reasons could be psychological, physical or both.

"Usually, partners are pretty good at trying to start the conversation," Watter continued. "They'll say things like, 'Is everything OK?' 'Is it me?' 'Is there something I can do?' The questions are pretty reasonable. Rarely have I heard of partners who begin with accusatory or derogatory statements. It's not like that. Because the men are so frustrated and really don't know what's happening, they do their best to shut the conversation down."

Much stigma and anxiety surround ED, said Robyn Flores, M.S., L.M.F.T., a sex therapist and doctoral candidate who provides client care in Texas and Colorado for Respark Therapy. When Flores sees couples dealing with erectile issues, she works on reframing ED. Instead of calling it erectile dysfunction, she calls it an erectile difference.

"His arousal is different than maybe what society is saying it should be, or it's different than what maybe his partner has had, and they've talked about that," Flores said. "Reframing it kind of takes the sting out of dysfunction."

What to say and what not to say about ED

As far as the man approaching the ED topic with his partner, Flores recommended men say they'd like to slow things down. Another option is engaging in sensate focus, during which the man and his partner can work on communicating what kind of touch feels good.

Talking about the type of context can make you and your partner feel safe, sexy and intimate, Flores explained.

"You can feel more in the moment instead of worrying about the 'what if' that happens with the anxiety that often leads to this erectile difference," she said.

The man's partner can help by providing encouraging words and asking questions in a context where they both feel safe speaking. Flores suggested asking questions such as, "What have we learned about intimacy this year?" and "What's something we've done in the past that's felt really good that we can recreate?"

If the partnership is new, you may want to approach the topic with questions such as, "How do you want to feel during sex?" and "What does intimacy look like for you?" These questions will start to normalize the conversation.

The man's partner can help by providing encouraging words and asking questions in a context where they both feel safe speaking.

The worst thing you can do is to stop communicating about intimacy altogether. That's not going to help the arousal process at all, Flores said.

"The best thing is like, 'OK, we can't do this. What can we do instead?' Coming up with alternatives," she explained. "What are some other ways they can connect in that moment? Maybe they switch positions. Maybe they switch to oral sex. Maybe they switch to gazing at one another and doing some tantric breathing or something to stay connected."

If you are taking your partner's ED personally, try to avoid saying something like, "You're not attracted to me anymore." It's not productive and can be hurtful to the man.

"That's where that blame comes in," Flores said. "They're projecting that assumption onto that person, which is breeding resentment."

Watter said men with ED don't always appreciate the fact that their partners are concerned and eager to help.

"The advice that I would give to men who are experiencing erectile difficulties is to not turn away from their partners, to turn toward their partners," he said. "That's often a very helpful thing to do. They are supportive, and they can be soothing and helpful and understanding."

How sex therapy and couples therapy can help

Sex therapy, particularly couples therapy, can be beneficial in terms of facilitating the discussion surrounding erectile difficulties, according to Watter.

"Sometimes, helping men find the words for what they're feeling can be very helpful," he said. "A lot of times, just being able to talk it through can be therapeutic in and of itself. Sometimes, just putting things into words resolves some of what's going on."

Many men hold in their issues and emotions and struggle to express them, which can make their erectile problems a lot more difficult to resolve. Therapy can help that process.

From his experience, Watter said when men develop ED with partners with whom they have a history of successful intercourse, it's often not due to performance anxiety but an unconscious triggering of an earlier trauma.

The problem is often physical, but too many people overlook the psychological aspect of erectile dysfunction.

"Because it's unconscious, they don't know what it is," Watter said. "They don't know how to explain it. They don't understand it themselves and they shut down the conversations."

The first thoughts many partners have include the following:

• "Is it me?"
• "Are you not attracted to me anymore?"
• "Do you not love me anymore?"
• "Are you interested in somebody else?"

These questions can lead the man to pull away from sex and affection, ultimately resulting in fights. In these cases, Watter has a lot of work to do to repair the relationships of couples in sex therapy.

When addressing the psychological aspect of ED, Flores said therapy can break down the barriers of anxiety that could be perpetuating the issue.

"We can work on any kind of trauma that has occurred in the past or recently and really demystify arousal in general," she said. "That's one of the perks of working with a sex therapist."

Simply noticing the problem instead of judging it is vital, Flores said.

"Just notice something is going on here, instead of, 'What's wrong with me? Why can't I get it up?' That doesn't help. That just makes it worse," she said.

It's not always easy for couples to seek help, especially for something as personal and sensitive as erection troubles. Plus, a lot of people don't have a therapist they see regularly, so taking that first step isn't always intuitive. Video visits have become a viable option for most people, and more physicians and therapists have added them as a service. Giddy telehealth makes it easy to get connected to a qualified healthcare professional who can help individuals and couples talk through their issues, including ED.