A reader writes:
I dunno if this is something you can even cover on here, but how does a married couple struggle through Erectile Dysfunction? My husband refuses to see a doctor because he claims he’s just “not interested” in sex anymore, but no man in his right mind would say that without there being an underlying reason.
Our marriage is in a great place, he and I communicate regularly, and he’s very physical with his shows of affection. When it comes to sex, however, he absolutely has performance issues and bristles whenever it gets brought up.
And truth be told, it’s been an issue since we were first married. We’ve been married 7 years now, and sex has gone from happening daily for the first few months of marriage, to maybe once a week, to barely once a month, to nothing for well over a year.
I’ve tried bringing this (admittedly) touchy subject up a bazillion times in a bazillion different ways, but he just refuses to talk to a doctor, and it’s beginning to hurt our intimacy (in more ways than one).
I should probably also mention that I’m pretty fit for my age (30), would like to think I’m attractive, and am a thoughtful lover.
He’s known about this issue for years (as he used to attempt taking pills for it), but he’s since stopped and refuses to get checked. I’m actually quite worried it’s symptomatic of an even graver health issue given he’s so young and it’s been an issue for so long.
A Common Problem
It’s extremely frustrating to be in a marriage where your husband isn’t interested in sex. While the cultural stereotype is that sexless marriages are caused by a frigid wife leading to a frustrated and unloved husband, about 1/3 of the time it’s the wife who desires sex and the husband who constantly “has a headache”. Women can feel just as unloved and frustrated when sexual intimacy leaves the marriage as men do.
While women can have sex without necessarily being in the mood for it, that’s far more difficult for men. If the penis isn’t cooperating, intercourse isn’t going to happen. Even if he wanted to have sex for her sake, physically, this may not be possible. Lack of male desire can put a serious strain on a marriage.
Causes of Erectile Dysfunction
A husband’s lack of desire is generally caused by a one or more of the 3 ‘P’s: Physical issues, Psychological issues, and/or Pornography.
The best known causes of erectile dysfunction are physical problems. The penis is made of erectile tissue which is spongy, vascular tissue that is mostly empty space. When it fills with blood, the penis is erect, when it is empty, the penis is flaccid. Getting an erection involves a complex series of hormonal and cardiovascular reactions to get the tissue to engorge with blood and remain hard.
One cause erectile dysfunction is circulatory problems—the blood cannot fill the penis. Erectile dysfunction is a symptom of a large cardiovascular problem, such as high blood pressure or arterial disease. Viagra was originally developed as a high blood pressure medication until doctors discovered it had an interesting (and lucrative) side effect. Usually circulatory problems are more common in older men. In younger men, physical problems with erectile dysfunction are very often associated with obesity. Obesity causes type 2 diabetes, which impacts circulatory and nervous function, plus it can lead to an imbalance of estrogen and testosterone, which can kill male sexual desire.
Less common are hormone issues, such as hypothyroidism and hyperthyroidism, and other congenital problems. Another possibility is a drug interaction or side effect. Lack of sexual desire is a common side effect of many anti-depressants.
Physical problems are less common in younger men and when they do occur, they are often associated with other physical problems, such as obesity. If your husband is in otherwise good physical health and isn’t on any medication, then the problem probably isn’t physical.
The most important sex organ isn’t the penis, the circulatory system, or the endocrine system, but the brain. Confidence is key to male success, and that includes in the bedroom. It’s no coincidence that the word “impotent” can refer to both erectile dysfunction and a sense of powerlessness.
Society puts a tremendous amount of pressure on men to be sexual all the time. Men are supposed to always want sex, whenever, wherever, whoever, whatever. If a man has a lower sex drive, even if there is nothing physically wrong, he may feel like less of a man and put pressure on himself to perform. Unfortunately, stress is a real “boner killer”, making it less likely that he will be able to do so. This creates a vicious cycle where the man worries about performance, fails to perform, then worries even more. Eventually, some men just give up and avoid sexual intimacy, much to the frustration of their wives.It’s not just stress about sexual performance that can cause a lack of sexual desire. Stress outside the bedroom will cause the same problems, as will depression. The problems inside the bedroom only make the problems worse.
Another psychological cause can be a negative view of sex. Some men see sex as something wrong and dirty. They see it as something shameful that men want and that “good girls” don’t. (Unfortunately, some well-intentioned Catholics can unwittingly promote this view by dwelling excessively on sexual sin and misinterpreting St. John Paul II’s discussion of what it means to “use” one’s spouse.) This may lead them to show little sexual interest in their wives—even to the point of acting out sexually outside the marriage—even though they may still value the platonic aspects of the relationship.
Past sexual abuse is a common cause of sexual dysfunction in both men and women. While sexual abuse is more common in women, a tragic number of men have been abused. If this is an issue, please get help.
Stress has been around forever, as have poor eating and exercise habits. So why are doctors seeing an “epidemic” in erectile dysfunction in young men?
Pornography, too, has been around forever, but it’s never been as easily accessible or as “hardcore” as it is now. Never before have men been only a click away from a virtually unlimited supply of any sort of sexual stimulation they want.
Let’s set aside the morality of pornography for a moment and talk about it’s strictly physical and psychological effects. Pornography isn’t simply sex on (digital) film, it’s an exaggerated and unrealistic form of sex on film. Real sex is awkward. Porn is choreographed and edited. Real sex is best when it’s intimate and enjoyable. Porn sex is about whatever films best. Real sex can be great no matter what your body is like. Porn involves perfect—and often fake—bodies. Porn isn’t reality. Porn is an artificial fantasy packaged and sold to consumers.
Porn is what is called a supernormal stimulus. A supernormal stimulus is “an exaggerated version of a stimulus to which there is an existing response tendency, or any stimulus that elicits a response more strongly than the stimulus for which it evolved.” Humans have an natural response to sexual stimulation. Porn is an exaggerated form of sex that elicits an exaggerated response. Over time, the brain normalizes the exaggerated stimulus, leaving the normal stimulus uninteresting by comparison. Even if a man knows that porn isn’t real sex, he will react more strongly to and begin to prefer the artificial stimulus of pornography to real sex. In fact, he may have difficulty becoming aroused by a real woman because his brain has become used to the exaggerated stimulus.
One or More of the Above
These problems aren’t mutually exclusive. Sometimes men may be struggling with multiple problems: For example, a man may have physical issues (poor health) which causes psychological problems (depression, stress) and leads to pornography (increased stimulus, no expectation of intimacy). It may appear on the surface that he is preferring masturbating to pornography to sexual intimacy with his wife, but this may overlook the real issues that are driving the behavior.
It’s NOT Your Fault
Many women think that they are responsible for their husband’s erectile dysfunction. They may think that if they were prettier or acted sexier or were a better lover that their husbands would not have a problem. I think this is because often wives feel that their own desire changes based on their husbands’ behavior and assume their husband’s desire changes in much the same way. But this is not the case for most men. While marital problems certainly don’t help with sexual desire, erectile dysfunction is almost never due to something that the wife is or is not doing. If the problem is physical, then it’s his responsibility to take care of himself. If the problem is psychological, then he’s probably dealing with issues that have nothing to do with you (and trying to be “sexier” may make things worse by putting more pressure on him to perform). If the problem is porn, then he’s chasing a fantasy and no real woman would be able to catch his interest.
So What’s a Frustrated Wife To Do?
Knowing the causes of erectile dysfunction isn’t much help if you can’t do anything about then. If it’s his problem and he won’t do anything about it, then you may understandable feel frustrated and helpless.
So what steps can a frustrated wife do if her husband has a problem and won’t get help? That’s the subject of Part 2 of this series…