Q. My husband and I haven’t been intimate for nearly two years. He’s had a hard time — he lost his job, and his mother died — which is why it all stopped in the first place.
I really want to reignite our sex life. However, now that we’re trying again, he can’t get an erection. What can we do? What could be the cause?
A. Although most people whinge about having to work for a living, once they are denied the opportunity to do so they quickly realise how much their identity and their self-esteem has been tied to their employment status.
Besides financial remuneration, work also provides structure, routine, social interaction, peer-group validation, and prospects — a ladder to climb.
Take all that away and an unemployed man, or woman, feels at best, disorientated, at worst, chronically depressed.
Your husband must have hoped that when he got another job he would stop feeling so “redundant” but, instead, everything got much worse when his mother died.
What was left of his fragile world completely fell apart. In my experience it takes at least two years to get over the death of a parent, particularly when that parent should have had many more years of life left to live.
And, although grief is something that people can and should share, the profound sense of loss that is experienced when the person who gave you life is abruptly robbed of theirs can be terribly difficult to articulate.
Men can be particularly bad at expressing vulnerability, but powerful emotions find their own way to manifest.
In your husband’s case, the maelstrom of confusion he is coping with has killed his libido. He is in pain and, as many men do, instead of asking for a hug he has curled up into a ball like a hedgehog.
It is ironic that sex, the one activity that can actually help men to feel better, is so often the first casualty of trauma. However, there is a well-established relationship between stress, loss of libido and erectile dysfunction.
Chronic stress triggers a complex interaction of psychological and physical responses in the male body. Initially, it triggers the release of adrenaline and cortisol.
These stress hormones are supposed to be a short blast response to threat, but when anxiety persists over a period of months, or in your husband’s case, several years, elevated stress hormone levels can lead to a drop in androgen (male hormone) levels and this can interfere with libido and erectile function.
Erectile dysfunction should never be ignored because it can be an early warning sign for more serious problems such as heart disease, diabetes, or high blood pressure.
Your husband’s sexual difficulties were almost certainly triggered by the double whammy of unemployment and bereavement, but men who experience unreliable erections often find it difficult to assign erectile failure to stress alone. Once a man starts to doubt his ability to perform sexually, erectile difficulties become a kind of self-fulfilling prophecy .
Although I can understand you are keen to get your sex life back on track, your concerns about his sexual dysfunction may actually be making the problem worse.
Rather than try to coax an erection, you need to let your husband know what you want is “him”, not “sex”.
Focus on kissing, cuddling, touching, massage — any form of physical contact that brings you close physically but doesn’t put pressure on him to perform sexually. Touch is a great healer.
In fact, research carried out by Laura Berman, the director of the Berman Center for women’s sexual health in Chicago, has found that couples who kiss and cuddle a lot are eight times less likely to be tense, or depressed.
If you would like a structured route back into sexual contact you could try sensate focus, a therapeutic technique which was devised by the sex researchers Masters and Johnson.
(To download an instruction sheet see: bit.ly/1QzOyIj)
Once performance anxiety is eliminated, normal service will eventually resume, however, these things are never linear, and you may find that things go up and down (no pun intended) for many months to come.
It can be very difficult to remain supportive — after all, you have needs too — and I’m sure your own stress levels are, by now, almost as high as his.
Positive lifestyle changes such as taking up exercise, doing yoga or mindfulness meditation, eating healthily, losing weight and cutting back on alcohol and smoking will help you both to manage your stress levels and improve your body image.
And, of course, anything that improves health and boosts circulation will simultaneously improve erectile function.
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