It’s common to believe that a lack of attraction or interest is part of the problem, but this isn’t always the case.The best way to move forward together is to learn about and accept each other’s bodies and needs, communicate clearly about expectations for sexual encounters, and create plans for addressing any concerns.
Starting a Conversation
It can be uncomfortable for partners who are not used to being vulnerable to bring up such a personal and sensitive topic, and many want to respect each other’s space for processing. For those who have histories with trauma, emotional pain, and triggers associated with body image, sex, or sexuality, this might be a hard topic to discuss even after the ice is broken. Jesse Kahn, LCSW-R, CST, reminds partners, “Tread mindfully, but don’t avoid it.” This topic could be a challenge for anyone who encounters ED no matter their gender experience, but Kahn explains that cisgender men (men whose sense of identity and gender correspond with being assigned male at birth) can be deeply impacted by toxic and rigid definitions of masculinity, placing them at increased risk for shame and embarrassment associated with ED. Kahn, a sex therapist, says, “Usually if someone comes to my office with ED, medical reasons have been ruled out [or are being addressed], and at that point, what we’re working with is shame, embarrassment, anxiety, and depression related to the ED.” Even if a cause unrelated to mental health is found, it can be liberating to talk about how erectile dysfunction is impacting lives and relationships and start examining personal histories, beliefs, and experiences with erectile dysfunction, sex, and sexuality. Sorting through both the possible medical associations or underlying causes of ED and the emotions of encountering this new experience is important for both the individual and their partners. It’s crucial to understand that the person with ED might feel that a very personal aspect of their lives and their body is on display. They could want discretion and ask that the topic not be shared with friends or online groups—and those requests should be respected. It can be hard to talk about but important to recognize if certain sexual needs and desires are difficult to fulfill due to ED. Partners shouldn’t feel silenced and can seek support if their own sex lives or mental health is impacted too.
Learning About Erectile Dysfunction
To be a supportive partner, it’s important to get educated. If you’re struggling to talk about the experience, gathering new information can help get conversations started or dispel misconceptions that sometimes make it difficult to start talking in the first place. A qualified therapist, sex educator, or supportive medical doctor can help to dispel rumors or misinformation and answer questions directly.
Understanding Erections
Erections occur when blood surges to the penile or clitoral tissue which responds by getting hard, and the inability to get those glands as hard as desired can lead to sexual challenges. People of all genders and with all genital types can get erections, and therefore could experience erectile dysfunction, but most people associate the term with the inability to achieve or maintain a penile erection that is strong enough for penetrative sex or ejaculation. Dr. Helen Webberley, MBChB, says erectile dysfunction is common, underlining that people of all ages, gender identities, sexual orientations, and partnership types could encounter it. She adds that all people need access to more reliable information about ED and notes that young people should know that this experience is normal. Sex drives can still be high despite sexual dysfunction, and partners should not assume disinterest. Trans people might experience erection changes when taking hormone replacement therapies or after gender-affirming surgeries. They might also find that their genitals are less sensitive than they were before gender-affirming interventions, which can lead to erectile dysfunction. Other general health-related causes are linked—including recent surgeries, various medications (including those that treat mental health concerns), hormone changes or fluctuations, sexually transmitted illnesses, and other ailments. All of these concerns can be explored with a doctor. Treatment of these medical conditions or adjustments to current approaches in treatment could help. Kahn explains that feelings of shame, guilt, or low self-esteem, and anxiety can also cause ED. Dr. Webberley adds that religious and cultural influences about sex or related traumas could be a factor, but the cause could also be personal and even related to topics or life experiences completely unrelated to sexuality. For instance, new life events—such as childbirth and parenthood—can be a cause. If partners are unsure why they’re encountering ED, keeping track of lifestyle changes–such as workload or exercise habits, diet–including alcohol, as well as moods, medications, and patterns that seem to occur in conjunction with ED could help a professional recognize and address potential causes.
Problem-Solving Together
Some people with erectile dysfunction prefer privacy and space while they try to learn more about their own bodies and sexuality. However, if partners are open to including each other in their discovery process, working together might create closeness and empathy. Kahn explains that that sometimes erectile dysfunction is the sign of interpersonal issues in a relationship, and it’s important to discern if relationship stress or pressure could be a contributing factor. But never assume that this is the cause without communication. It’s most important to talk openly about interpersonal dynamics so they can be addressed. It’s reassuring for partners to hear that an aspect of the relationship is not part of the cause, and if an interpersonal issue is present, addressing it will prevent it from festering. If an erection is something that’s important sexually for partners, reliable interventions could make it happen. Dr. Webberly explains that creams, pills, and injections can all kickstart an erection, and the added help can reduce the stress someone feels associated with performance pressure. Partners can help each other keep track of patterns that emerge to help identify the best time of day for connecting, preferred positions or stimulation techniques, and other factors that might promote an erection.
De-stigmatizing ED
Finding “solutions” to erectile dysfunction might not be desired if the person whose body is not able to get or keep an erection is content with their experience. Partners should respect any decisions to decline intervention and instead consider how to connect in new ways. Kahn says, “A sex therapist can help you brainstorm some options.” Dr. Webberley says, “Sex toys and erotic materials can help to get things going or keep your mind on track. See these as fun—not dirty! Find out what works for you and your partner.” Kahn reminds us that even penetrative sex doesn’t require an erection or need to end in or involve an orgasm. Kahn adds, “When we challenge narratives around whats sex means, we can reduce the pressure we feel to perform.” Although erectile dysfunction can make sex feel like a scary or tense experience, Dr. Webberley reminds, “Don’t forget to have fun!” It’s okay to feel nervous and take it slow. It’s okay to fumble around awkwardly in new experiences and laugh a lot along the way. It could be just as important to recenter and take time to relax and maybe even pause pursuits of sex altogether.
A Word From Verywell
Anyone can encounter erectile dysfunction, which might occur for a variety of reasons. Support your partner by encouraging them to seek medical advice or therapy when relevant, and make sure you get support when you need it too. Work together to find new ways to connect. It could lead to new discoveries about your bodies and interests!
