Shadow work refers to the process of exploring and integrating the unconscious aspects of our personalities—often the parts we suppress or deny because they don’t align with how we want to see ourselves. In the context of a couple’s relationship, shadow work can be highly transformative by fostering deeper understanding, intimacy, and emotional growth. Here’s how it can help improve a relationship:
Self-awareness and Accountability
Shadow work encourages individuals to confront their own emotional triggers, insecurities, and projections. By understanding their unconscious patterns (such as jealousy, fear of abandonment, or need for control), partners can take accountability for their actions rather than blaming their partner. This reduces conflict and allows for healthier communication.
Emotional Depth and Intimacy
When couples engage in shadow work, they access deeper layers of their emotional selves, fostering vulnerability. Sharing these previously hidden parts of oneself can deepen emotional intimacy, as partners feel truly seen and understood without judgment.
Breaking Negative Cycles
Repressed emotions and unhealed traumas often manifest in recurring negative patterns in relationships (e.g., arguments, withdrawal, or emotional manipulation). By identifying these patterns through shadow work, couples can break free from repetitive conflicts, improving long-term harmony.
Improved Empathy
Understanding your own shadow often leads to a greater capacity to empathize with your partner’s. When you can see why you react in certain ways, you are more likely to understand why your partner might have similar unconscious behaviours. This builds compassion and reduces resentment.
Healing Past Wounds
Shadow work helps couples recognize how past wounds (from childhood, previous relationships, etc.) are influencing their present dynamics. Healing these wounds allows them to create a healthier relationship dynamic in the present.
Enhancing Communication
By bringing unconscious emotions to light, couples can communicate more authentically. Shadow work encourages both partners to express their true feelings, leading to more honest conversations and fewer misunderstandings.
Acceptance of Differences
Many conflicts arise when partners try to change each other or feel threatened by each other’s differences. Shadow work helps individuals become more accepting of their own and their partner’s imperfections, reducing the desire to control or “fix” one another.
Releasing Suppressed Desires
Repressing desires, whether for freedom, creativity, or connection, can build resentment. Shadow work allows individuals to own their suppressed needs and desires, which can lead to healthier expressions of those needs within the relationship.
Increased Emotional Resilience
Doing shadow work can make both partners more emotionally resilient, as they learn to face difficult emotions rather than avoid them. This emotional maturity strengthens the couple’s ability to navigate challenges together.
Shared Growth
Engaging in shadow work together can turn the relationship into a safe space for personal growth. When both partners are committed to their inner work, the relationship becomes a powerful catalyst for individual and collective transformation.
In short, shadow work in a relationship promotes self-awareness, empathy, and healing, which all contribute to greater harmony and emotional intimacy between partners. It can transform unhealthy dynamics into opportunities for growth and connection.
The traditional archetypes described in the book King, Warrior, Magician, Lover (2018) can be highly relevant in the shadow work process for couples. Each archetype represents mature masculine energies (though these energies can apply to all genders) and their shadow sides. Integrating these archetypes in a healthy way can greatly enhance a relationship. Here’s how each one might be important in the processes described above:
The Lover: Emotional Connection and Intimacy
Key Role in Relationships: The Lover archetype embodies passion, emotional openness, and deep connection with others. In relationships, it represents the capacity to feel and express love, vulnerability, and sensuality. It encourages emotional attunement, intimacy, and shared experiences.
Shadow Aspects: If the Lover archetype is repressed or underdeveloped, a partner may become emotionally distant, fearful of vulnerability, or detached from their own needs. The shadow Lover can also manifest as addiction to pleasure or co-dependency.
Relevance to Shadow Work: Couples can use shadow work to explore fears of intimacy or emotional disconnection, allowing the Lover archetype to be expressed in a healthier, balanced way. This fosters deeper intimacy and connection in the relationship.
Key Role in Relationships: The King archetype is about leadership, responsibility, and creating order. In a relationship, the King archetype provides emotional stability and the ability to take responsibility for one’s actions. It also emphasizes fairness and nurturing.
Shadow Aspects: The shadow King can either be the Tyrant (controlling, domineering) or the Weakling (passive, irresponsible). If a partner operates from these shadow aspects, it can lead to either controlling behavior or a lack of engagement and accountability.
Relevance to Shadow Work: Through shadow work, individuals can integrate a healthy King archetype by learning how to balance leadership with humility and fairness, improving their ability to take accountability in the relationship and maintain emotional stability.
The Warrior – Boundaries and Protectiveness
Key Role in Relationships: The Warrior archetype embodies strength, assertiveness, and the ability to set boundaries. In relationships, this archetype is crucial for standing up for one’s needs, protecting the relationship from external threats, and fostering healthy conflict resolution.
Shadow Aspects: The Warrior’s shadow can be the Sadist (aggressive, domineering) or the Masochist (overly passive, a doormat). If a partner over-identifies with the Warrior’s shadow, they may either become excessively controlling or fail to assert their needs, creating an imbalance of power.
Relevance to Shadow Work: By confronting shadow aspects of the Warrior, couples can learn how to assert themselves without aggression, maintain healthy boundaries, and resolve conflicts constructively, which strengthens the relationship’s foundation.
The Magician – Self-awareness and Emotional Intelligence
Key Role in Relationships: The Magician archetype is linked to wisdom, insight, and self-awareness. In a relationship, this archetype facilitates emotional intelligence, problem-solving, and the capacity to see the deeper dynamics at play between partners. The Magician helps couples navigate difficult emotions and encourages psychological growth.
Shadow Aspects: The Magician’s shadow manifests as the Manipulator (using knowledge or insight for control) or the Detached Trickster (emotionally distant, withholding). Either extreme can damage trust and emotional safety in a relationship.
Relevance to Shadow Work: Through shadow work, individuals can integrate the Magician archetype by developing deeper self-awareness, understanding unconscious emotional triggers, and using insight to facilitate healing rather than manipulation.
Shadow work video by Teal Swan
Archetypal Integration in Relationships
To improve relationships, it’s essential to integrate each of these archetypes in a balanced and mature way. Shadow work helps reveal where each archetype may be out of balance (i.e., the shadow aspects) and enables couples to grow toward their mature expressions. When both partners work through these archetypal energies, the relationship gains:
Emotional intimacy and passion (The Lover)
Accountability, stability, and leadership (The King)
Healthy boundaries and assertiveness (The Warrior)
Self-awareness and emotional insight (The Magician)
In conclusion, the Lover is crucial for fostering emotional intimacy, the King for creating a stable and nurturing dynamic, the Warrior for ensuring healthy conflict resolution and boundary-setting, and the Magician for enabling deeper self-awareness and psychological insight in the relationship. Integrating these archetypes helps couples navigate shadow work and transform their relational dynamics.
Characteristics Of Men Who Have Delayed Ejaculation
In some way they don’t have a close connection with their own sexuality, or perhaps even with male sexuality in general. This is a bit like being cut off from oneself – it’s almost like a denial of part of you. And many of us know, it’s easier to deny a part of us than to face the pain it holds if it’s been wounded in childhood. In fact that’s a standard defense mechanism.
Because of the disconnection between what’s happening in the world and one’s awareness about oneself, it’s entirely possible that many men with delayed ejaculation may be completely unaware of what’s causing their ejaculatory dysfunction. And then it’s natural enough for a man to blame it on something physical like an insensitive penis. As you can probably see, changing a man’s perceptions when this threatens his very identity, or threatens his innate sense of security, is going to be challenging – to say the least!
And if a man can’t even sense the connection between events “way back when” and his current sexual problems in adulthood, the situation becomes even more complicated. One of things that can make delayed ejaculation even more difficult to deal with is the fact that our society has lost the normal rites of passage between boyhood and manhood.
Initiation rituals into manhood, and rites passage from one lifestage to another were commonplace in our history, but they hardly exist at all in our modern society. This can’t be helping the development of confident male sexuality. And the consequences of this are subtle and wide ranging. For example, being cut off from sexuality in this way may actually prevent a man from expressing his maleness – even from responding to sexual stimulation.
This kind of deprivation – for want of a better word – makes a man unable to express feelings and emotions around sexuality, to ask what for he wants sexually, and perhaps even to be unaware of what he needs or wants sexually. In the face of this difficulty you can see how a man could easily retreat into a place of wanting to satisfy his partner sexually, and indeed basing his sexual self-esteem on being able to do so. Hence, perhaps, the attention a man with delayed ejaculation may offer to his partner at the expense of his own (and felt and unwanted) sexual needs.
And there’s a level of inhibition which can go even deeper than this – I mentioned how men with difficulty in this area might be avoiding a loss of control at the moment of orgasm and ejaculation. (By not ejaculating, I mean.)
But there are many other possible explanations for difficulty or delay in ejaculating – shame or guilt about sex; fear of women; anger against women, which is not felt consciously but may be held in the unconscious; the memory of previous traumatic experiences; and many more besides. Such issues can be explored with the help of shadow work – a means of reaching into the unconscious and exploring historical patterns of behaviour. There are other practitioners who work with men in the same field of shadow work too if you prefer to explore these issues in single gender groups.
Advice For Men
It’s a common misconception, particularly on the Internet, that delayed ejaculation is a difficult problem to overcome.But if you really want to enjoy better sex, and you’re willing to try some simple treatment strategies, you’ll find it easier than you ever imagined to overcome this challenge.
Mostly men avoid treatment for delayed ejaculation because they feel too embarrassed, perplexed, perhaps even ashamed, about it. And that’s not too surprising. If you feel very different from other men – which is how a lot of men with delayed ejaculation do feel – you probably want to keep this “little secret” to yourself. Regrettably, however, a lot of men with this problem don’t talk about it even to their partners. And that’s where the trouble starts. You see, although delayed ejaculation is often described as hard to overcome, this is not true. It only seems that way because delayed ejaculation is caused by several factors combining together.
The first cause of difficulty ejaculating is your relationship.
Just how do you feel about your relationship with your partner? And how do you feel about the way you and your partner make love? And how is your relationship to your own sexuality?
These are just some of the many questions that help you understand the origin of ejaculation problems – if you want to go down that road.
Overcoming delayed ejaculation is possible without delving deeply into the psychology which lies behind it. If, for example, one of the issues which lies behind your delayed or retarded ejaculation is lack of intimacy between you and your partner, which in turn is leading to poor communication, you can establish greater intimacy by using some simple and practical techniques. This approach avoids the need to delve into the unconscious issues which might have caused your lack of intimacy in the first place.
In other words, this approach is about learning a new behavior which replaces the old one. So, as far as intimacy is concerned, there are some very good techniques you can use to develop a close relationship. Because once you feel physically close, it’s possible to be truly intimate.
How To Overcome Delays In Ejaculation!
So if you’re wondering how you’re going to be able to solve ejaculation problems, the good news is that this isn’t difficult. Using a treatment program (click here to find out all about it), at home in privacy, you’ll soon be able to enjoy sexual intimacy to the full. To start with, you’re going to train your body to respond more rapidly to sexual stimulation, so that you can reach orgasm more easily. That’s a matter of engaging in some delightful sensory exploration exercises with your partner, all of which are designed to increase your sensitivity to physical stimulation. And that’s important because, at the root of it, all sexual arousal is down to physical stimulation.
Emotional and mental stimulation is an important part of sexual activity, and it can certainly help you become more sexually aroused. However, the real key to sexual arousal is always physical stimulation. You see, sexual arousal is rooted in the body. To put it another way, the arousal which generates an erection, and so gives you the means to have intercourse, is rooted in the body. So part of the exercises you can use at home help you find trigger points on your body which provide you with greater arousal than you normally experience. Everyone has “erogenous zones” on the body, but very few people take the time and trouble to explore them in detail.
And that’s a shame, because they really can produce a great deal of physical arousal. For a man with delayed ejaculation, they can really help in the process of overcoming delays and reaching orgasm. And if you feel anxious about having sex, this anxiety can interfere with your sexual responses, meaning that you might find ejaculation difficult. By dealing with this anxiety and discovering way to really enjoy sex, it’s easy to significantly reduce the level of stimulation which you need to reach orgasm.
Spectatoring?
This isn’t watching erotic or pornographic images of other people having sex! According to sex researchers Masters and Johnson, spectatoring is “watching yourself have sex, accompanied by an anxious, internal, self-conscious dialogue.”
The internal chatter can include worries about one’s body (“I wonder what she thinks about my body”) or about one’s sexual performance (“She must be bored, I’m taking too long to come.” “Does she like the way I’m touching her?”) When spectatoring, a person is intently monitoring both their partner and themselves.
Not surprisingly, research shows that this is less satisfying than sex when you are “fully present”. Men and women alike who engage in spectatoring or internal dialogue during sex have fewer real orgasms and more fake orgasms than those who have less internal chatter.
This isn’t surprising, given that it’s hard to be orgasmic while worrying about what your partner thinks about you and your body. Thinking you “should” have an orgasm can lead you to pretend to have an orgasm. Yes – men (especially those with delayed ejaculation) fake orgasm too, as you may know.
We should now take a brief look at erectile dysfunction, for the benefit of those men for whom that challenge is associated with Delayed Ejaculation.
Stanley Althof of the Department of Urological Psychology, Case Western Reserve University School of Medicine, Ohio, has written an article in the International Journal of Impotence Research about research into the biopsychosocial obstacles to making love when a man is being treated for erection problems.
He introduces this article by making the observation that it is easy enough for a man to develop a man a firm erection. However, getting him to “make use of it” on a regular basis in a sexual relationship is not quite as straightforward. Dropout rates for any treatment for erectile dysfunction, including Viagra, have been found to fall within a range of 20 to 50%.
Bear in mind that this dropout rate is from a group of men for whom treatment has been successful. Clearly, understanding what promotes this dropout will be helpful in improving treatment.
Simplistically, it appears that psychological resistance of some kind on the part of the men, their partners, or both, contributes to a man continuing with treatment for erectile dysfunction (or not). The factors implicated include in ending treatment include: (1) the length of time that a couple have not had sex before treatment was available; (2) the man’s attitude to resuming sexual relationship with his partner; (3) a man’s expectations of how treatment will change his sex life; (4) his partner’s willingness and ability, both physically and emotionally, to recommence a sexual relationship; (5) how each partner views the impact of the medical intervention that allows them to start having sex again; (6) the quality of their relationship outside the sexual arena; and (7) any abnormalities or variations from the norm in the sexual arousal process for the man.
We know no single treatment for erection problems works for everybody, and not every patient is equally able to absorb the nuances and complexities of different treatment strategies. Here’s a video on the subject:
Video – erectile dysfunction
It’s possible, therefore, that sometimes treatment never even starts because a man does not have enough confidence to embark on the treatment, Perhaps some men fear there will be some unexpected and disturbing s consequences if they accept treatment. Like, for example, having to resume sexual intercourse with their partner: treatment can disturb a comfortable status quo..
A simple example of the education that is sometimes necessary is that many men do not know that the efficiency of drugs like Viagra actually improves the more you take it, at least up to the eighth dose.
Because of this, Althof makes the observation that the best way of analyzing why men stop treatment is to take the problem from a broad view, from a biopsychosocial perspective.
In this situation, a clinician will often prescribe an effective remedy for erectile dysfunction (perhaps Viagra) and then consider that the situation is resolved. However, this approach does not consider any emotional or psychological aspects arising from the treatment strategy or the man’s relationship.
For example, he may be consumed with performance anxiety, or depressed, or he may have unrealistic expectations of sex. Or he may have an unconventional sexual arousal process which includes sadomasochism, transvestism or some other paraphilia.
Also, a man’s partner’s ill-health or lack of interest in sex may preclude the resumption of lovemaking, or the quality of their relationship may be such that sex simply does not resume.
There are other factors which may be personal to either member of a couple or both of them. For example, their sexual script(s) or the length of time for which they have been sexually continent. Or, they may be experiencing stress with finance, children, family, or work pressure, any of which can get in the way of resumption of sex.
A typical profile of a man with erectile dysfunction
Althof presents a profile of a typical patient who presents for treatment of erectile dysfunction dysfunction at his own clinic. This summarized character is a 54-year-old married man who has actually delayed seeking help for two years. During this period he may have developed feelings of inadequacy, resentment, depression, and possibly performance anxiety.
Typically, he will have developed behavioral strategies which allow him to avoid confronting his sexual situation: he may have begun to go to bed before or after his partner, and he will provide plausible excuses as to why he cannot make love, for example being “too old” or “too tired”. Another possibility is that he may experience shame due to not being able to delay ejaculation.
Evidently the goal of this behavior is to avoid any embarrassment or failure during sexual activity. This will be especially true if the man is experiencing delayed ejaculation. However, the outcome is that the couple’s lovemaking frequency slowly dwindles. Maybe it declines to once a month, then it becomes even less frequent, and then stops altogether. He loses his sexual desire, and becomes involved with distractions such as his work, television, the children, or volunteering.
It’s not only intercourse that disappears – any kind of affectionate touch or anything else that may be perceived by his partner as a suggestion that he is feeling sexually attracted to her may also absent from the couple’s interaction with each other.
Video – how romance fades – the sex starved relationship
The man’s partner begins to wonder if she is still attractive, whether he still loves her, or whether he’s having an affair. Her experience of him may be that he is slightly depressed, preoccupied, irritable or defensive; and she may collude with him in avoiding sex so that the pain of feeling rejected is lessened, or the pressure to have sex is avoided.
While some men do actually come for treatment for erectile dysfunction at the request of their partner, others seek treatment without notifying their partner of what they’re doing. And in these cases a man may come back from his consultation with a prescription for Viagra, which results in him sporting an erection that he presents to his partner totally unexpectedly. In response to this his partner may feel a mixture of surprise and anger and some anxiety about what is expected of her.
He may also be experiencing anxiety about his ability to engage in sexual activity. It’s important to realize that in these circumstances a woman may feel as if she has been betrayed because the man’s erection is not a response to her attractiveness, but merely to the response to the medication.
It is further possible that she may not be able to lubricate or to become aroused adequately. This may be because of the difficulties that his actions have caused, or because she has simply moved into a menopausal stage of her life and her attitude to sex has changed.
With this background, clearly sex may not be particularly rewarding, and the motivation to try again maybe reduced – perhaps to zero. A man can summarize what happened by telling his doctor that the Viagra “did not work“.
It requires careful investigation by a practiced clinician to discover the level of fear and anxiety and other emotions that have arisen in the years when the couple were celibate, and to recognize also that the couple will now probably need help in restoring full sexual function to their relationship.
This summary of information about erection problems describes some reasons why a man may discontinue treatment for erectile dysfunction. However, it does not cover cases where an unconventional pattern of sexual arousal or lack of sexual desire plays a part. (Men may hide these aspects of their sexual life because of fear of humiliation or embarrassment.)
Since Viagra is not an aphrodisiac it will not induce an erection when there is a lack of sexual desire.
Althof claims that an integrated treatment approach which combines psychological therapy and pharmacological therapy is superior to an approach which involves either aspect of treatment alone.
Although it seems logical to assume this would in fact the case, Althof makes the point that designing suitable research project to investigate these issues is rather challenging. He refers to a report of an uncontrolled, combined treatment study involving only 57 men given both Viagra and psychotherapy.
Although the mean age of the patients was 53, the age range was from 21 to 75 years with the erectile dysfunction having existed for between one month and a rather amazing 38 years, with a mean of eight years. 78% of this limited sample had experienced psychotherapy for an average duration of two years.
The doctors assessed the origin of the erectile dysfunction as being psychogenic in 52% of the men, organic in 22% of the men, of mixed origin in 22% of the men; the remaining 3% of men had erection problems of uncertain origin. All the men received both Viagra and psychotherapy, and were seen at intervals ranging from weekly to every two months.
The dose of Viagra was altered so that the chance of the men being able to accomplish intercourse successfully was as high as possible, and the men were evaluated five weeks into treatment and again at 10 weeks after they had received the first prescription for Viagra.
Although the results of this study were limited and did not involve qualitative data, the responses of the men to the treatment did provide some qualitative data which was classified into one of seven categories, four of which indicated success, and three of which were variations of failure.
If you’re a man who can’t get aroused enough to ejaculate you have delayed ejaculation. This can happen to men of any age but is more common in older men. Some estimates suggest one man in twelve has this problem at any one time.
Is delayed ejaculation just something to do with growing older?
Not necessarily. There are many causes of delayed ejaculation, both emotional (mental / psychological) and physical. The latter include:
Excessive alcohol and smoking
Exhaustion
Damage to the brain or spinal-cord
Low testosterone levels
Liver or kidney failure
Multiple sclerosis and other diseases of the nervous system like Parkinson’s disease
Radiation therapy to the testicles or prostate for cancer
Having had a stroke
Prostate or bladder surgery
Delayed ejaculation isn’t something you should expect to happen as you get older. Certainly older men need more physical stimulation during sex, but that does not mean you have delayed ejaculation. The crucial determinant for a diagnosis is that you can’t ejaculate at all.
What causes delayed ejaculation?
There are some well known illnesses which cause delayed ejaculation. These include
Diabetes
Hyperlipidemia (high cholesterol levels)
High blood pressure
Hypogonadism (a disorder of the testicular endocrine system)
Atherosclerosis (hardening of the arteries)Certainly some of these effects can be remedied by taking medication to keep the condition under control.There are many medication on the market which cause erectile dysfunction as a side-effect. These should be discussed with your doctor in case there is an alternative available.
What’s the most likely cause of delayed ejaculation?
A common cause of delayed ejaculation is damage to any of the tissues of the the penis or pelvic region through atherosclerosis, vascular disease, and neurologic disease (damage to the nerve cells).
Surgery (especially prostatectomy and bladder surgery for cancer) are likely to damage nerves and arteries near the penis, and this can cause delayed ejaculation. Needless to say, any injury to the pelvic regions in general or the penis, spinal cord, prostate and bladder in particular, can lead to delayed ejaculation by harming nerves, smooth muscles, arteries, and fibrous tissues of the corpora cavernosa.
Many common medicines such as drugs to treat blood pressure, antihistamines, antidepressants, tranquilizers, some appetite suppressants, and even anti-acid drugs may produce delayed ejaculation as a side effect.
But the really important thing to know is that psychological factors such as stress, anxiety, depression, low self-esteem, and sexual anxiety caused by fear of sexual failure, are at the root of a large proportion of delayed ejaculation. And to make this more complicated, men whose delayed ejaculation is caused by physical problems usually have emotional reactions such as stress, anxiety, guilt, depression. And finally, other causes of delayed ejaculation are smoking, which may affect the blood flow in the veins and arteries of the penis, and hormonal problems including low testosterone.
Many cases of erectile dysfunction are caused by problems in the relationship. Sexual problems can grow to the point where they cause a man to suffer from loss of his erection. Sexual therapy is most effective when both sexual partners go to therapy. Some of the emotional causes of erectile dysfunction include:
Feeling stressed from work situations, family circumstances or other life events
Being nervous about sex, anxiety caused by a bad experience such as shame or humiliation, or a previous case of impotence
John Tomlinson and David Wright investigated the impact of erectile dysfunction on men and their partners, as well as investigating the effects of treatment with sildenafil.
They conducted their study on 40 men who had erectile dysfunction and attended a clinic in the British National Health Service; they investigated the men’s experience of erectile dysfunction and their expectations of sildenafil, and its impact on both them and their relationships. In the abstract of their paper they state, perhaps unsurprisingly, that erectile dysfunction caused marked distress in all the men who experienced it, and also had a profound effect on their self-esteem and their relationships.
Sildenafil seemed to cause a great improvement in the men’s well-being when it worked, but if sildenafil did not work, men developed an even lower level of self-esteem, the treatment failure perhaps serving to confirm their lack of self-worth. This clearly means that professionals who prescribe sildenafil need to be conscious of the possible consequences of this course of treatment.
In the body of their article the authors go into more detail about these issues: they start by making the observation that despite a high prevalence, and plenty of awareness about the importance of emotional and psychological issues as cause of the ED, there has been little research into the impact of the condition and the effect of its treatment on either men who suffer from it or their partners.
For example, studies into the quality of life experienced by men with ED have often involved the use of questionnaires that have not always been sensitive to the impact of ED on a man’s well-being; for example, one review of over 400 scientific studies on the frequency of impotence and ED simply dismissed the psychological impact of the condition by stating broadly that “Erectile dysfunction is a common condition… [and]… has a negative impact on the quality of life,” but failed to elucidate what the impact might be.
Despite this unsatisfactory body of work, some studies have been more sympathetic to men suffering from the condition.
For example, the Sexual Dysfunction Association discovered that just over 60% of men who took part in an online survey agreed that ED reduced their self-esteem; just under 30% reported that their relationships had been adversely affected; and just over 20% claimed that their relationship had come to an end simply because of the erectile dysfunction.
At the time of this review — 2004 — there was considerable social stigma around the condition, with impotence serving as a prolific source of jokes, the social stigma thereby inhibiting men even more from either confiding in others or obtaining treatment from healthcare professionals.
It’s interesting to reflect that sildenafil has now been around for many years, and in that period of time what’s become very clear is that the initial assumptions made for the drug — i.e. that it was a “cure-all” for erectile dysfunction — were unrealistic; a proportion of men who take the drug find that it does not work for them.
The focus of this study was on the men themselves rather than on their partners, but it does provide interesting insights into the effect of the condition. As mentioned above, 40 men who had been prescribed sildenafil at a men’s health clinic agreed to take part in an exploration of the psychological impact of ED and its treatment.
These men were selected from 302 referrals to the clinic in a 12 month period: these referrals were divided into two groups, one consisting of men for whom sildenafil had been successful, and the other consisting of men where the use of sildenafil had not produced a successful outcome.
It should be made clear at this point that whether or not treatment was successful was determined by the patient’s interpretation of the criteria of success provided by the authors of the paper: success was defined as achieving successful vaginal intercourse, while failure was defined as an inability to complete the act of intercourse because of failure to generate an erection which was firm enough to penetrate the man’s partner.
From the men in each of these groups, 20 were selected to take part in the study, making a total of 40 participants. The men ranged in age from 22 to 72 years, although the median was just under 52 years. All the men had been prescribed sildenafil at the men’s clinic, with an introduction to the treatment method which ensured that their existing expectations were not altered by the consultation.
By using a system of semi structured interviews, the two authors of the paper were able to explore a whole range of issues around the men’s experience of both ED and taking sildenafil. The men were interviewed by the same consultant who had prescribed medication for them, with the interviews being audiotaped, and conducted in line with a protocol which was flexible enough to allow the inclusion of new issues raised by any of the participants.
The data gathered were subjected to a thematic analysis, so that any themes which emerged during the course of the initial interviews could be explored in greater depth in subsequent interviews. It’s hardly surprising that most men’s first reaction to the experience of erectile dysfunction is a sense of being emasculated.
Both sex therapists and the layman alike know that being able to maintain an erection and being able to adequately one’s female partner is regarded by most men as a fundamental cornerstone and indicator of both virility and masculinity. This is expressed by the men’s clear association between being able to obtain an erection and being a man. It isn’t only the penis that’s a fundamental sign of masculinity; the ability of that penis to become erect is just as important, if not more so.
In many cases a man who cannot get an erection will experience depression. If he is not already in a relationship, a man may find his ability to form new relationships appears to be severely diminished: the logic seems to go something like this; “If a man can’t get an erection, he’s not a man, therefore no woman would have any respect for him; in any case it would be pointless trying to chat her up because if he were able to get her into bed he couldn’t do anything about it.”
This is representative of a clear decline in the men’s sexual self-confidence, which interestingly enough not only impacted on their sexual relationships, but on their day-to-day relationships with other significant people, including work colleagues and friends.
Often this loss of confidence would be disguised externally, while the man felt internally that he wasn’t as good as the men around him. Unsurprisingly, this led to a common sense of isolation and despondency; a feeling which was made worse by the prevalent belief that erectile dysfunction is a condition which only affects men over a certain age, thereby leading younger men with ED to infer that they were “old before their time”.
It’s equally unsurprising that erectile dysfunction caused these men to feel very concerned about the impact of the condition on their relationships. It is a common characteristic of men to believe that they have a duty to satisfy their partner sexually, so it’s no surprise to hear that about a quarter of the men in the study thought that they were letting down their partners by their inability to engage in sexual intercourse.
To make this worse, around 40% of the men felt unable to discuss the condition with their partners, probably because they found it easier to avoid the issue or because they felt demeaned by their inability to obtain an erection.
It’s interesting that many of the men in the study believe that the administration of sildenafil would cause them to gain an instant erection without any difficulty immediately before sexual intercourse started; in general the expectations were too high, including for example the belief that sildenafil would produce a full or uncontrollable erection, or that it would have a 100% success rate. Like the media reporting of the drug’s possible impact on ED, the expectations of the men before treatment appeared to be unrealistic.
Those men for whom it actually worked felt pleased and even elated at their ability to achieve an erection — this is the real impact of what these men termed “a return to manhood”: a sense of well-being and confidence; a sense being able to satisfy whatever sexual needs his partner expressed; a recapturing of a sense of manhood and masculinity.
It is therefore no surprise that when treatment with sildenafil was unsuccessful, the men’s perception of the failure was massively impacted by their previous expectations. If, for example, they had believed that all that was necessary to achieve a firm erection was to take one pill, their hopes would fall, and then if a second failure ensued, they would report feelings like bereavement, grief for the loss of their masculinity, or even a sense that they would never be able to have sex again.
The researchers report that “considerable disappointment” was a common reaction to the failure of treatment, and some men in the study for whom sildenafil was ineffective felt devastated; others regarded the treatment as a failure because they hadn’t understood there needs to be a certain element of planning in taking sildenafil, and they felt that sex had become unspontaneous, planned, or clinical.
All in all, the study revealed that most men with ED are more deeply shocked than most health care practitioners have previously understood, with their sense of self-esteem and their sense of masculinity being particularly devastated. It doesn’t matter what the cause of ED might be, its impact is more or less the same in every case — a severely damaged sense of masculinity, a profound reduction in a man’s feeling of self-worth, and a reduction in his sense of value to his partner, as well as a profound loss of self-esteem about his place in wider society.
The researchers conclude from this that it is not adequate to treat a man in isolation; details of his sexual relationship should be obtained, and perhaps as later researchers have demonstrated, the partner should be involved in decisions around treatment and explanations of what may be expected.
The men for whom sildenafil did not work at this time probably didn’t receive advice and counseling which would have given them a higher chance of success, because subsequent work has demonstrated that it can take up to 8 doses for sildenafil to have its full effect, and that persistence is often necessary for treatment to become effective. At this time, men who didn’t have this information might experience one or two failures of treatment, which would have the undesirable effect of reinforcing their sense of worthlessness.
A study in Western Australia on male erectile dysfunction found that one quarter of men had erection problems, and one in twelve had severe erectile difficulty.
The study was conducted by sending postal questionnaires to randomly selected men in the electoral roll. In summary, before we look at the detail of the study, these are the basic facts: 42% of questionnaires were returned to the researchers, so the sample was to some extent self-selected. Among adult men in WA, the occurrence of any erection problem and severe erectile dysfunction was, respectively, 25.0% and 8.5%.
As you might expect, the frequency of erection problems increased with age. Astonishingly, thirty-eight percent of married men and men who had partners experienced erection problems (severe erection problems 19.1%). There was little difference between white collar and blue collar workers; the most disturbing fact of all was that the vast majority of the men had had erection problems for over a year, but only a meagre 14% had asked for or received any treatment.
Erectile dysfunction (erection problems) means that a man is consistently and perhaps recurrently unable to achieve an erection hard enough for penetration and sexual intercourse. The researchers wanted to conduct a survey on erection problems among men in Western Australia, and used the Electoral Roll for June 2001 as the source for the men they questioned.
They selected men by age and location, using 14 random samples of 302 men in and outside Perth. They sent out a reply-paid questionnaire by mail and in it asked questions on medical history and medical treatment, social status, sexual behavior and sexual function. The men were classified as blue or white collar workers and assessed for social deprivation. The data was collected using the International Index for Erectile Function, which is also called the Sexual Health Inventory for Men.
4,228 questionnaires were posted, and 1,580 (89.3%) returned with a full set of answers. These 1,580 men were aged between 20.1 and 99.6 years. For the purpose of this study they were grouped by age. Erection problems occurred in 25% of the whole sample, and and an astonishing 8.5% of these men reported severe erection problems.
Both the frequency of occurrence and the severity of erection problems increased very significantly with age, particularly after a man reached 50 years of age. But even 15% of the young men aged between 20 and 29 years had erectile problems – and surprisingly, this was less than the men in the next older age groups.
Perhaps unsurprisingly, there was a decline in sexual activity in men of 60 years and older; over 70 years of age, sexual activity declined sharply. But a significant number of the men over 60 (42.6%) and over 70 (25.7%) were sexually active.
There are many interesting facts in this survey beyond those related to erection problems. For example, while about three quarters of the men were married or living with sexual partners, only three quarters of these men were sexually active.
Of the ones who were sexually active, just over 60% said they were having sex on a regular basis. Of the other quarter who were not living with a wife or partner, 53.9% were sexually active – and indeed 39.2% of these men said they had sexual intercourse on a regular basis.
A majority of the men were employed, though 36.8% had retired on grounds of age and 6.8% had retired on the grounds of ill-health.
The highest incidence of erectile problems occurred in clerical, sales, and service workers, but the occurrence of erection problems wasn’t really much different between blue collar and white collar workers. What is less surprising is that erection problems occurred most often in men from economically deprived areas. We know stress is a potent factor in causing a loss of a man’s sense of male power, so there is nothing surprising about that.
Most of the men (a massive 89.1%) with erection problems had had their difficulties for more than 1 year, and a whopping 74.8% had had erection problems for more than two years; unbelievably 12.2% said they had been suffering for more than 10 years. And the longer it went on, the worse it got. Yet only 90 men (a meager 14.1%) had ever looked for and got any treatment.
Most studies on erection problems have looked at men aged between 40 and 70 years, but this study covered a much bigger range. To this extent, then, it represents the entire spectrum of adult men in WA. You have to assume that this is typical of the results in much of the Western World, and it is truly shocking.
When you look at the detail, it seems odd that men in the 20 – 29 age group appeared to have more erection problems than the 30 – 39 years age group. Possible explanations include commonplace stress of early adulthood such as new relationships, new work responsibilities, and stress linked to leaving home. Among men aged between 40 and 69 years, erection problems occurred in 33.0% of men, while sever erection problems occurred in 8.6%. In fact, the age of a man is far more important than any other factor in determining whether a man has an erection problem.
Both the frequency and the severity of erection problems increase with age. And since the older age groups were under-represented in the study, the true frequency of erection problems and of severe erection problems in men may have been higher than the recorded levels of 25.1 and 8.5%.
[These figures are so high they seem hard to believe….but this is what the study found.]
Australian demography is changing rapidly, and the proportion of men aged 65 years and older will increase dramatically in the years to come – which means erection problems will pose huge clinical and socioeconomic burdens on healthcare providers and social support services in the years ahead – if men choose to seek help, which currently they are not doing.
The majority of the participants in the Western Australia Men’s Health Study, from where these results are taken, were married or had partners, even though an astonishing 25% or more of these men were not enjoying an active sex life. Of the men aged 70 years and older, a fair proportion remained sexually active.
All these findings matched the results from the Global Study of Sexual Attitudes and Behaviors, a large scale project in which over thirteen thousand men from 30 countries were asked about their sexual behavior. Over 84% of men in this study aged between forty and eighty said they’d had sexual intercourse within the 12 months preceding the study. Among the men who were sexually active, about half said they had sexual intercourse regularly.
When the authors compared men who had never been married with those who were married or had partners, they found, perhaps unsurprisingly, that having never been married was significantly associated with an increased chance of having erection problems; in short, fewer married men have erection problems than non-married men, though which is cause and which effect remains unclear.
Analysis of the results of the study also showed that being separated or divorced may be one of the predisposing factors for erection problems. (Though once again, of course, whether the erection problems were a cause of, or simply unrelated to, separation and divorce, is unclear. In other studies, it has been shown that men with severe erection problems are much more likely to be single, without regular sexual partners.
Erection problems have previously been associated with lower socioeconomic status. The current study demonstrated that erection problems occurred in a smaller proportion of men who were in full- or part-time employment compared to the unemployed.
Clerical, sales and service workers had the highest frequency of erection problems, although there were few other correlations of note between erection problems and occupational group. There was no difference between “blue collar” and “white collar” workers in this respect.
Of the 468 men in the study who reported on the length of time for which they had endured erection problems, 47.9% had had the problem for between one and five years. This matches other studies in the general population, where 55% of men with the problem were found to have had erectile dysfunction of one sort or another for this period. The current authors’ observation that men who had had it for longer also had more severe problems is neither surprising nor novel.
In spite of erection problems being a common and often long-standing condition, only 14.1% of the men with erection problems had ever received any treatment. This suggests that there is an urgent need for sexual education and awareness information at every level. And certainly, if it’s true that the longer the erection problems continue, the worse they get, then men with any erection problem should get professional assistance as soon as possible so that therapeutic intervention can be started in the milder stages of erectile dysfunction.
It’s also important to remember that erection problems may indicate cardiovascular and endothelial disease – so once again, there is a clear incentive for erection problems to be comprehensively investigated. In this study in WA, erectile dysfunction was found to be apparently under-diagnosed and grossly undertreated. Whether or not this is true – and if it is, whether or not it applies to the rest of the world – remains to be seen. The Journal of Sexual Medicine
Volume 5 Issue 1 Page 60-69, January 2008
To cite this article: Kew-Kim Chew MBBS, FRCPEdin, FRCPGlasg, Bronwyn Stuckey MBBS, FRACP, Alexandra Bremner BSc(Hons), GradDipAppStats, PhD, Carolyn Earle BSc, PGradDipHithSci, Konrad Jamrozik MBBS, D Phil (2008) Male Erectile Dysfunction: Its Prevalence in Western Australia and Associated Sociodemographic Factors The Journal of Sexual Medicine 5 (1) , 60–69 doi:10.1111/j.1743-6109.2007.00548.x
Why do men use the term “having sex” while women often say “making love”? Does this just mean that men and women attach different importance to intercourse?
And even if some women like sex for its own sake outside a long term relationship, do women generally prefer sex to be with someone they love, whereas will men generally take it wherever they can get it?
Something that seems to back this up is that in surveys, men claim many more sexual partners than women. Does this mean a small number of highly sexy women have sex with a lot of men, or does it just mean that men are lying?
If the men are lying, could it actually be that both men and women would prefer to be in a long term commitment where their sexual and emotional needs are met? I don’t know. And maybe that’s the point – for women, there more often needs to be an emotional aspect to the connection as well as a physical one, whereas for men it just isn’t as crucial in making that decision about whether or not to have sex with someone.
A gay friend once said how unfair he thought it that gay men had been stereotyped as promiscuous (although of course there is a lot of truth in that assertion); he said that if there were places where straight men could have gotten sex as easily as gay men in the heyday of the sexual liberation of the seventies and eighties, pre-AIDS, there would have been a queue right around the block.
For men, there is something extraordinarily arousing about seeing a woman desperate for the culmination of lovemaking, begging her man to put his penis inside her, or to tease her by stimulating her even more with fingers and tongue.
Most women are not turned on anything like they could be, and they do not get the pleasure from sex that they could, and it seems one of the reasons for this is that men do not know how to turn them on. The level of sheer primal desire a woman can feel during sex makes it so much better for both partners – actually, that is an understatement of woeful proportions.
Now, are you dying to know how we achieve these incredible levels of sexual fulfillment? The answer is to spend enough time making love before the penis goes into her vagina with simple techniques that stimulate her whole body – things like sensuous massage, but especially genital massage around her vulva, clitoris and lastly inside her vagina – especially on her G spot.
This, more than any other single thing, turns a woman on more intensely than anything else. But you can make love to your beloved in many ways: a look across the breakfast table that says “I’m glad you’re here”, a shared moment of intimacy, a kiss on some part of her body when we wake up snuggled more-or-less together, the murmured words “I love you” in a quiet moment, the surprise bunch of flowers, or romantic weekend away. And of course just being there for her, and doing things for her, and sharing parts of your lives.
Sex and Love – Mistakes Men make During Sex
If you thought the path to sexual happiness was simple, look at this list of sexual blunders made by men when they’re enjoying sex. If any of them seem familiar, you need to sharpen up on your bedroom etiquette! And this link takes you to 6 sex mistakes women make.
1) Thinking her vulva, clitoris or breasts are the first places to go when you enjoy sex
A woman is more likely to be irritated than sexually aroused when a man heads for her breasts and vulva after a bit of kissing.
Be sensitive and touch her sexual areas only when she’s sexually aroused. If you go for her breasts when you get her into bed and twiddle her nipples like you’re tuning a radio receiver, you’re not going to get the right signals.
Passionate kissing is an art form which eases you both into the main event of sex and cultivates intimacy. Learn how to kiss your woman, and do it well.
That wouldn’t include sticking your tongue between her teeth and wiggling it around like you’re trying to clean her teeth.
3) Being too rough when you touch her sensitive parts and erogenous zones
Men like to have a firm touch applied to their penis. But if you approach her clitoris with the same as you apply to your penis when you’re treating Mr. Happy to a quick morning massage, she’s likely to howl with pain – and then she’ll probably kick you out of bed. The clitoris has twice as many nerves as the penis, so it’s very sensitive. Treat it accordingly.
4) Not stroking her body as well as her mind
A woman’s biggest sex organ is her mind. That is where she gets much of her sexual pleasure. The next biggest is her skin. If you were thinking of anything else, think again. For her, sex is all about making connection. And that includes skin to skin connection. An hour spent massaging her will awaken her to her need for sex and almost certainly guarantee she has an orgasm one way or another.
So ensure you focus on putting your sexual energy into your fingers while you massage her. That means not thinking distractedly about the baseball game while you’re oiling her up.
5) Locking onto her nipples like a teething suckling child
Tempting though it may be to suck on her breasts, she’s not going to want you reminding her of the last time a teething child bit into her nipple.
Kiss all around her breasts and gently work towards her nipple, licking it with your tongue and maybe sucking it between your lips when she’s really aroused. If she likes what you’re doing, you’ll know by her moans of pleasure.
6) Biting or blowing on her ear or her neck because you think it’s sexy
Very few women seem to find this exciting. Your time would be better spent searching out her sensitive zones elsewhere.
7) Leaving a kiss bite on her neck – or anywhere else it can be seen
If you’re an adult, this is a no-no. If you need to know why, you’re obviously under age and you shouldn’t be having sex.
8) Not shaving (your face!) before sex
Think back to the last time you gave oral sex to a woman with a few days’ stubble around her vulva. Now imagine that stubble brushing back and forth on your face in the mad throes of passionate kissing. Enough said?
9) Not washing your armpits and genitals before you make love
Even if you have what the French call a tart’s wash, make sure you’re a smell-free zone when you enter the bedroom. (In case you need to know – that’s washing your penis, balls, ass, and armpits.)
10) Forgetting that real foreplay starts a long time before sex begins
No woman wants to be taken for granted. If you touch her lovingly all day, show how much you love her, and take the trouble to make sure she knows you’re thinking of her, she’ll be ready to melt into your arms in the evening. Leaving loving little notes where she’ll find them is also a good idea. But make sure they are romantic!
11) Penetrating her vagina before she’s ready
Yes, we know you want to get into her. But hold on. Take your time, let events move at their own pace, and only pluck the fruit when you know it’s really ripe and dripping juice.
So as you finger her clit, you can check out her vagina. If it’s moist and open, she may well be receptive to a finger on her G-spot. Start gently and apply a firmer touch as you go. If you don’t know what the G-spot is, go check it out on Google.
12) Going straight to her clitoris during oral sex cunnilingus or masturbation
Most women just find this irritating – and very uncomfortable too, if the clit isn’t aroused and slippery.
Work from around her labia, the lips around her vulva, towards the clitoris as she gets more aroused. Even then, a subtle touch along the shaft of her clitoris around to the side of the clitoral head may be better for her.
13) Stopping when she wants you to keep stimulating her clit till she comes
If she’s almost at orgasm she certainly won’t want you to stop whatever you’re doing, whether it’s with your penis, your fingers or your tongue.
Since cunnilingus is hard on the tongue, we suggest you make sure your hands are ready in reserve if you get a bad case of cramp. If she’s not saying much, she may be lying there silent because she’s got lost in her excitement, not because you’re licking ineffectively at her vulva.
But then again, how would you know? She may be so excited by what you’re doing that she shows it by pressing her vulva more firmly against your mouth, in which case carry on with your stimulation.
If she gives off an aura that she’d rather be cooking the dinner, you need to think of something else. Like asking her what she wants, maybe?
14) Undressing her like a clumsy young man
Listen up guys: you don’t have to take her bra off with one hand blindfold in the dark while you kiss her. That’s what a guy who’s having sex for the first time tends to think Indeed, she might well appreciate it more if you let her disrobe. Nothing about an underwear fumble is funny, especially if it interrupts the romance. Let her take off the clothes you don’t know about and when you do help, make it look like you’re delicately removing her garments rather than pulling at her clothes like you can’t wait to fuck her – even if you that’s true.
15) Looking like a klutzy clown in the bedroom
Nothing is more comical to a woman than a man wearing his underpants and socks. Why this should be so remains a mystery, since it seems so natural to a man to undress like that. However, if you don’t want her to take pity on you, take off your socks first.
16) Expecting her to shave her pubes for you
Yes, we know you like the smooth look around her vulva, but if she’s not into shaving, don’t put pressure on her to smooth it out for you. There are few things less comfortable than itchy stubble in the pubes. If you want to see more and have easier access to her pussy, ask her to lightly trim the hair.
17) Entering her vagina without asking her first
Such a controversial idea! And yet so nice – occasionally, at least – to be romantic and ask “May I enter you?” This can be a very exciting and loving way to go if you’re looking deep into her eyes.
Needless to say, that’s most likely to happen in the missionary, which, by the way, remains everyone’s most popular position for sex.
And then again, there are times when you can just sense the moment for penetration – but always remember not to let your judgment be affected by your desire to fuck here. Yes, we know it feels very nice. But be a man – and make sure she’s ready first.
18) Probing around her vulva or her clit or anywhere else with your penis if you can’t get in
This will turn her off at once – guaranteed. If you can’t find the way in (it happens) on your own, tell her what’s going on and ask her to guide your penis in. There’s no shame in that, but acting like a clown can ruin sex for you both.
And anyway, think how much time you’ll save if she just puts it in for you.
If you want anal sex in any position, ask her, don’t just force your penis into the wrong opening “By accident”!
19) Pumping away with your cock without regard for her pleasure
Now you’re in! Hurrah! But what will you do next? Pump away heartily till you ejaculate? Bad idea…..surely you’ll want to show a certain consideration for her pleasure? Start with slow and shallow thrusts.
When you make love, she’ll like it best if you act masculine and strong: be confident, know what you’re doing, be considerate and gentle at first, and work up to harder and more vigorous thrusts if she makes it clear that’s what she wants (as in “oh, yes, fuck me harder!”).
20) Expecting her to willingly offer her rear end for doggie style sex
It’s a male thing, the desire for rear entry sex. Mostly. Then again, there will be times when the mood takes her and she just wants the naughty, raunchy feeling of rear entry sex.
In between, you might get it on your birthday, if you’re lucky. And if you do persuade her to indulge you, don’t make the mistake of slapping her rump like you’re spurring her on to buck harder and faster.
21) Thrusting too hard when you have a long, long penis
If you happen to have a big penis, restrain yourself as you thrust, or you might hear her shriek as you hit her cervix. This will not, probably, be a shriek of sexual pleasure. It may, however, signal the end of your pleasure for the moment.
22) Rapid ejaculation – premature ejaculation to you – is not the mark of a good lover
Very few men have the endurance that allows them to really satisfy a woman who enjoys vaginal intercourse and thrusting against her G-spot. You can improve your endurance with self help exercises, but if you just can’t be bothered, at least have the consideration to keep going for at least long enough to give her some satisfaction.
Do some research on how to stop rapid ejaculation and you might last a bit longer in bed.
Delayed ejaculation is not the gift of the gods that you might think. Your partner won’t see it as any kind of blessing, either, when her cunt is bone dry, she’s bored out of her mind and you still aren’t anywhere near ejaculating.
So if you are one of the men who have trouble reaching orgasm caused by ejaculation problems, then this treatment for retarded ejaculation will help you have a normal sex life. The quicker you get treated, the sooner she’ll be able to enjoy sex with you!
24) Losing your hard-on when you put the condom on
If you’re one of the many men who find that Mr Happy goes to sleep when the condom makes an appearance, it’s back to Google for you. Try a search on “losing erection when putting on a condom” and see if there are any tips to keep your erection.
25) Not giving her oral sex to orgasm
I haven’t yet met a man who didn’t like the idea of going down on a woman, so any reservations must be about her scent or taste. If she’s a bit ripe, then suggest a shower as part of foreplay.
Remember that oral sex is actually a pretty sure fire way to orgasm for many women, especially those who can’t reach orgasm during intercourse or who are pre-orgasmic.
If all you’re interested in is getting her to suck your cock and you won’t do the same in return, reading these tips isn’t going to help you much anyway.
26) Failing to give her pleasure if you have premature ejaculation
By the way, you should make sure that your woman has an orgasm before you do. She doesn’t want to lie awake next to you as you snore gently after a big orgasm while she’s still frustrated because she hasn’t come.
We men lose interest in sex once we’ve come – so make sure she comes through oral sex or masturbation before you enter her. That way, she gets to have an orgasm, and you can enjoy her vagina when it’s aroused and tumescent after she’s come.
Don’t just penetrate her, thrust and ejaculate before going to sleep. How boorish can you be? And if you are interested in preventing premature ejaculation, make sure you do something about it.
27) Trying to make her give you fellatio by forcing her head down
She decides if she wants to give you oral sex, not you. Forcing her head towards your penis is as bad as forcing your penis towards her vagina when she says “no”. If she doesn’t seem to be interested and you’d like a bit of oral pleasure, just say to her: “Could you just do something for me….”
And when she is giving you fellatio, keep your hands off her head. That way you’ll avoid the temptation to grab her and start giving her an involuntary lesson in deep throat technique. However, stroking her hair gently is acceptable.
Trying to make it look like you’re stroking her hair when all you want to do is move it so you can see her gobbling you is not nice.
28) Ejaculating in her mouth without checking first
The taste of your ejaculate is very much an acquired taste; unfortunately it’s one that few women like to acquire. A great way of getting around this is for you to have her keep going with her mouth until the last minute, then tell her that you’re going to ejaculate.
She can then move back and complete the job with a well-lubed hand.
You’ll get just as much sensation, while she’s spared the taste of your semen. But “accidentally” forgetting to tell her you’re going to come is not good etiquette. if you want to experiment, try eating some pineapple before she gives you a blow job. It’s said to improve the flavor of semen.
29) Looking at hard core pornography
Yes, I know some women like it, but most porn available today is pretty abusive of women, and a lot of it’s lacking any sense of morality.
You can make a choice which side you’re on for or against the abuse of women who feature in porn – and a difficult choice it is, since most of us can so easily shut off a sense of right and wrong when turned on by fairly disgusting porno. The fact that porn turns you on and gives you a good orgasm doesn’t make it right to look at it, though.
If you want her to share it, ask her first, and get hold of some romantic sex movies that will appeal to her emotions as well as her sex drive. (And this spare you the shame of knowing you’re part of the porn problem.)
30) Apologizing for the size of your penis
She isn’t interested in the size of your erect or flaccid penis, even if you are. All she wants is to feel loved and cherished. Remember that 99% of women want a caring lover, not one with a large penis. The other 1% aren’t likely to be your kind of girl anyway.
31) Telling her what your last lover did for you
White lies may be best. When she asks you if her butt is too big, what do you say? Enough said. Your current lover is the most gorgeous, sexy and desirable one you ever met. Your past lover didn’t come close. Even if she doesn’t really believe it, that’s what she wants to hear.
32) Suggesting her best friend joins you for sex
Threesomes can be very arousing, in fact, but they nearly always end in tears. What usually happens is that surprising jealousy bites someone’s butt and then the fireworks start. So be sure, be very sure, you know what you’re doing before you try this one.
33) Making her do all the work during sex
Changing sex positions is great, but asking her to sit on you every single time you have sex seems a bit one sided. Vary your sexual positions, have fun, and make sure you do equal work. And don’t use one position over and over – that can get very boring.
34) Trying to slip it in her “accident”
If you do want to experiment with a bit of anal sex action, go slowly. And discuss it first. She’s not likely to believe your penis is poking her rear end by accident. And even if she’s seen you drive around aimlessly when you’re lost, rather than ask for directions, she won’t believe you when you say you lost your way en route to her cunt.
As for her anus in general, well, when you’re fingering her clitoris, and your finger is in her vagina, you may find that a little anal stimulation goes down well. Use your little finger to press gently at her anus as your other finger plays with her G spot and you stimulates her clitoris.
This may get her more excited if she’s on the verge of coming. But if you try this before she’s so aroused she’s stopped caring what you’re doing, you might turn her off completely.
35) Photographing or videoing your lovemaking
This is not a good idea. Instead link your video camera direct to your television set without recording the images so you can see yourself having sex on the TV now, and not view the pictures on the internet in a few years’ time.
36) Getting into a sexual rut
Making changes when you have sex will keep your sex life exciting and passionate. You’ll be surprised just how exciting it is to try different sex positions from time to time.
Every sex position puts a different pressure on the penis and vagina, and lets you see your partner’s body in a new way, or allows you to see yourself entering your partner’s body. Variation is good! Search on Google for “sex positions”.
37) Not romancing her
Men put up with romance to get sex. Women love romance because it shows how much their partner loves them. Ah. Truly, different strokes for different folks!
The romantic game is deeply rewarding for most men (i.e. nothing feels better than seducing and winning a woman – except having sex with her), and romance is part of that process. If you can be romantic when you’re a couple, then you show yourself to be a good lover, a kind companion, and besides all that you stand that much greater chance of getting regular, passionate sex.
38) Watching too many porn films
Don’t copy the moves you see in pornography. They aren’t to most women’s taste. If you don’t know why, well, maybe you need to mature a bit before you actually make love to a woman.
39) Deafening her by shouting in her ear when you ejaculate during sex
This is an easy mistake to make in the missionary position when you’re holding her close. Remember not to let the world know when you ejaculate. Bury your face in the pillow or something if you’re prone to uncontrollable vocal ejaculations as well as physical ones.
40) Talking dirty without checking if she likes it
Dirty talks makes sex good! The first time she tells you to fuck her hot wet cunt you’ll see what I mean. If that hasn’t happened yet, and you’d like it to, encourage her to say a few rude thing when you’re making love, perhaps by trying them out yourself first, and see how it goes.
You might be surprised – when a woman’s feeling aroused, she’s often ready to do things that seem quite out of character.
41) Ejaculating on her when she least expects it
Ejaculating between her breasts or on her vulva or between her buttocks can be incredibly exciting, but it’s a good idea to ask her first. She may be less impressed with your ejaculation than you are, especially if it involves the need to clean up bits of herself.
42) Not cleaning up after sex or dropping the condom on the floor
Sex involves two people – so does the clean up. Keep tissues handy, offer her a warm towel to clean herself if you aren’t using condoms. If you are, don’t drop it on the floor as a little souvenir for her to find later!
43) Not telling her how beautiful she is and how much you love her
Tell her you love her. There are lots of other men who’d be very happy to be where you’ve just been. If you don’t express your appreciation, they might just get in there.
If you have difficulty reaching orgasm during intercourse, or you find yourself thrusting away until both you and your partner are sore and frustrated, you may well have delayed ejaculation. This is also known as retarded ejaculation, or male orgasmic disorder, and it affects a very high number of men…. about one in twelve at any one time.
You can find an effective, easy and quick treatment for delayed ejaculation on the internet – for example, for men who do not wish to see a doctor, this powerful delayed ejaculation treatment can effectively end the problem with self-help treatments.
For women, there is advice on how to relax your sexual responses, become more familiar with your body and its sexual responses, and learn how to relax into orgasm and reach orgasm during sex.
Want To Last Longer During Sex?
Would you like to choose when to ejaculate during sex? Want to develop complete ejaculatory control? Like to take your lover (and yourself) to the highest levels of sexual pleasure? Look here.
The nature of love
Accepting, respecting, admiring, adoring: these are some of the important aspects of loving. “Home,” said one man who was interviewed in a study of successful marriages, “means you can expose your weaknesses without shame, can brag a little without fear of misunderstanding, and can make mistakes without being ridiculed.”
In other words, in his home and in his marital relationship he had the satisfaction of being accepted for what he was.
Accepting a person for what he or she is means having no reservations. It certainly does not mean being blind to shortcomings but on the contrary means being aware of them and accepting them too within the relationship.
And this includes not overlooking things which you really wish were different about your partner – including losing weight and dieting if they are obese or fat.
It is in the love relationship that people remove their “character armor,” but do not do so unless they are sure that without it they are unreservedly accepted by their partner.
To want to fashion the other person into a particular mold is not love but possessiveness. Love is fully accepting one’s partner without reservation despite the fact that they are not the same as one’s ideal.
When couples make love for the first time they often expose their nakedness to each other with some trepidation, both afraid that they will fall short of the other’s ideal of physical beauty.
Yet to accept the naked body, with all its imperfections, is truly to love.
People who are casual about sex do not, of course, appreciate or experience the significance of nakedness, for they do not sense the identity of the body and its vulnerability, and they are inclined to be, as Rollo May has written, “more wary of psychological and spiritual nakedness than they are of the physical nakedness in sexual intimacy.”
Extended Orgasm Pleasure
There are many simple methods by which you can enhance the duration of your orgasms and the amount of pleasure you feel. Indeed, orgasms lasting over an hour may be achieved.
And though you may think this is unlikely, think of this: the average orgasm – even for women (whose orgasmic capacity is greater than men’s) – consists of a mere ten or so muscular contractions lasting a few seconds. But the process of learning how to enhance orgasms is fairly simple…. and you can read more about them on this website.
Desire, Excitement, and Arousal
Two people making love – or, if you prefer, having sex – might enjoy an experience something like this: first of all they felt chemistry between them, an electric spark of attraction.
Then they kissed, and arousal grew, her panties becoming damp, and his erection mounting. Kissing gave way to feeling each other up, fondling, caressing, and his erection became harder and she lubricated more.
Continued stimulation led to sucking, more kissing, mutual pleasuring and eventually lovemaking.
At first sight, this looks like a simple process, beginning with desire and ending in a mutual orgasm, but the fact is that in both men and women, sexual arousal is composed of three distinct phases: desire, excitement, and orgasm.
We shall examine each of these more closely on this site where the nature of love is explained in detail.
Many people think that there is only one “normal” or “natural” position for intercourse, the “man on top” sex position. And if the physical structures of the partners’ bodies or their genitals place them at a disadvantage in this position and prevent the fullest pleasure in sex activity, they may never even find out that they could do much better in other sexual positions.
In reality, any and every type of foreplay or sexual position is permissible and acceptable, regardless of foreplay and position. Of course, sexual expertise and delight are not a guarantee of a happy relationship because a premature ending to lovemaking caused by man’s inability to control his arousal is devastating to a woman. No surprise that one of the most popular searches on the web is for tips to control premature ejaculation.
A quick climax to physical intimacy (in other words, premature ejaculation!) can deprive the woman of the fulfilment which is her reward from loving her partner. She will perhaps feel that her partner either does not take her needs into account or that he is selfish. And a man who reaches climax with no control often feels like he is a failure in bed.
None of this is helpful for the relationship, especially if the matter is not honestly discussed. However, the fear and shame associated with sexual problems is massively stressful, and the two partners often carry on even though this important dysfunction continues to erode trust and respect. If you recognize this, you must indeed change things!
First of all, you must speak about it openly: this means you tell your partner what you are feeling. Unfortunately, the fact is our research shows as few as ten percent of couples talk to each other about intimate problems. So, to help you discuss your thoughts, feelings and emotions around sex, we have some tips to help you:
1) Reveal your emotions – don’t use the tactic of avoiding responsibility by blaming your spouse. Having the ability to listen without judging means you’ll experience much less resistance – and your partner is probably going to be very much more willing and able to listen to what you want to say without judging you.
2) Don’t project your feelings – having the courage to accept that you are “in this together” is essential to eliminating mutual distrust. Only when you are able to accept that your lover’s actions and feelings are an honest reaction to the issues you face, and that they are entitled to think, feel and act as they do, will you begin to respect each other as you really are.
3) Don’t wallow in self-criticism. Doing something is more constructive. This may require getting the support of a therapist. Or it may mean something as simple as reserving a time every week to speak to your partner about your worries.
4) If you have trouble opening up about difficulties with your love life consider the things you want to “bring to the table” beforehand. Preparing like this is essential in achieving the respect of your partner. It’s also helpful to know your limits in any talk about sex. That way you are be much more likely to avoid concessions you regret.
5) Be clear about why you are raising the issue. It’s often challenging to have full awareness of what’s behind our emotions, and it’s likely you might only fully realize the real issue as you talk about the issue. And, if you are clear what you would like to change, you are more likely to get it. The more genuinely you show yourself, the more honestly you talk about what’s going on for you, the closer you will feel as a couple.
Secondly, work as a couple on a proven self-help solution for treating male sexual problems. You can discover much more about how to do this by reading a good book which will allow you to see how all of these problems come form our early experiences in childhood and young adulthood. Here is the one I recommend: King Warrior Magician Lover It is available in the UK (previous link) and the US (this link).
Techniques To Help You Have Better Sex
When you have a clear intention to control premature ejaculation, and when you have a clear set of techniques which will allow you to achieve this goal – those techniques will include dedicated focus, visualization, and perhaps sensate focus – then you are very likely to be able to achieve this goal.
Now, think of the reward that you get from sex. And now imagine how much greater that reward could possibly be if you were not only able to control your ejaculation, but you were also able to give a woman an orgasm during intercourse, or indeed if you were able to experience the thrill and excitement of G spot orgasm and female ejaculation.
What I’m doing is just bringing to your attention the fact that there are techniques that you can use to improve the quality of your sex life enormously. Whether you wish to control delayed ejaculation, premature ejaculation, or erectile dysfunction, there are ways and means of helping yourself to overcome emotional and practical problems during sex.
Yet at the end of the day, improving your sex life in this way such a personal decision that almost nobody can encourage you to do it apart from you yourself. It’s a notable fact that most men with premature ejaculation don’t respond to pleas from their partner to delay their ejaculation – so they’re not likely to do it without the internal motivation necessary to seek and achieve a better life.
Whether that better life is achieved by improving one’s relationship with oneself or one’s relationship with the world or one’s relationship with one’s partner, the truth of the matter is that gaining a fantastic sex life is always a matter of intention.
How To Pleasure A Woman
Video – how to please your girl in bed
It’s not always easy, knowing how to please a woman in bed. You need some help, some advice, some knowledge of what women really want.
And by “turn on”, we mean get her (or you) ready for sex. That would mean lubricated and wanting to be penetrated in the case of a woman, and erect and ready for penetration in the case of a man.
So – if you have time on your hands, so much the better. Twenty minutes of time before you even look for penetration. And in that time, you are going to stroke, kiss, tease, kiss, stroke, tease… and use your fingers, tongue and lips, as well as the whole of your skin, to give your partner an orgasm. Yes, give her an orgasm. That’s because sex doesn’t finish when a woman comes.
So you are going to do things differently – you are going to take account of her needs. But why, you may be asking, does she need an orgasm before penetration?
Well, because (as you may have noticed) a woman will rarely come from intercourse alone.
And even if you provide additional clitoral stimulation, by using a vibrator, or your fingers, as you make love to her, you may well reach orgasm before she does. And then, where does that leave her?
Answer – unsatisfied. Aroused, but hanging on for an orgasm.
Sure, you might say, she can take care of herself. Well, yes. She can. But is that really what you want to have happen here?
The first and perhaps the best way of doing this is to use oral pleasure – and I don’t mean by that simply cunnilingus.
What I mean is using your lips and tongue to kiss every part of your woman’s body, sensitively and delicately, particularly around the breasts and vulva. Such intimate contact will excite her – without a doubt.
But when you move from the intimate contact of lips on skin to lips on genitals or breasts or nipples, she’s going to feel arousal increasing and her desire to sexual contact will mount quite rapidly.
It’s a cunning technique which allows you to arouse a woman AND at the same time stay aroused yourself.
(But at this point I need to mention the fact that erections come and go during lovemaking. If you lose your erection during lovemaking, it really doesn’t matter. It’ll come back again quickly and easily, as soon as you’re in a position to penetrate your partner.)
The key to teasing your partner is to give her a level of stimulation which arouses her so much that she is ready for penetration.
You can tell this quite easily by sipping a finger into her vagina just as she starts to get really aroused.
One method which you can use to good effect here is to offer her oral pleasuring on her clitoris whilst you finger the inside of her vagina. This is a great way for you to give her the greatest pleasure as you make love.
Go for the upper wall as she lies on her back – that’s the G spot. Certainly of all the techniques recommended by sex experts on the Internet, and indeed by women themselves in forums where they discuss what they want, this seems to be the featured and favorite technique that brings a woman off time and time again.
It’s the intensity of arousal at the point where she finally comes which makes her orgasm extremely satisfying and pleasurable for her.
And what makes her arousal so high? It’s teasing and skilful manipulation of her feelings which you, as a man, can provide for her. Does it take a lot of imagination to make foreplay last for 20 minutes?
Well, up to a point it does, but you can do it! Don’t forget that the reward for you is a woman who reaches orgasm when she is highly aroused.
This in itself is hugely exciting for most men – after all, you’ve brought her off!
What makes it even better is that once she’s achieved orgasm, she won’t lose interest in sex in the way that you probably do.
Indeed, she’d probably be more desirous of penetration, for you to enter her, when she’s come. That way she will enjoy lovemaking to the full.
In fact she is quite likely to be desperate for penetration, and consumed with desire to feel the fullness of you inside her. (With a force equal to your desire to be in her. Felt that, have you? Then you know what she wants, too.)
After she’s come, the soft warm wetness of her vagina will be deeply rewarding and intensely pleasurable to you. And, provided you’re able to last long enough, you may or may not be able to bring her to orgasm again.
Sure, this is not guaranteed, but it really doesn’t matter even if you don’t take her to a second orgasm during lovemaking. Think of it as a bonus.
However, what you must do, is to look her in the eyes as you make love. Allow her body to follow your movements. (Coital alignment is good for this.) And, above all, if you’re able to, say her name at the moment of orgasm!
(Better – shout “I love you, my darling [insert name]” as you come. It will have extraordinary effect on her…..)
By doing these things you demonstrate yourself to be a man who is quite exceptional in his lovemaking skills and abilities.
You demonstrate sensitivity to her needs which most men won’t even think of showing.
As you can well imagine, this is going to establish a much stronger relationship and a more powerful bond between you.
But it also makes her happy both inside the bedroom and outside the bedroom.
Truly, you can improve the quality of your relationship immensely by offering her the sexual pleasure and satisfaction she craves.
And all it takes are the simple techniques for pleasuring which I’ve described above.
Don’t be a log in bed – stiff and wooden – and don’t stick to the same old routine. Sexual adventure can include all kinds of things: talking dirty; taking the initiative by rolling on top of him and getting into the woman on top position then riding his penis fast and hard till he comes; dressing up; having spontaneous sex anywhere that takes your fancy; and so on, and on, and on…..there are, by the way, many more tips for better sex here and a description of how women can enjoy fully orgasmic sex here.
2 Go on a romantic break and Have sex morning, noon and night
Men are ready for sex pretty much any time of the day from the morning’s wake-up call with an erect penis to the before-sleep nighttime sex session, while women often have one preferred time of day. So if you’re a morning person, why not try sex at night? If you like sex in the afternoon, try it in the morning. It’s all about variety!
4 Dress up for him
Most men are very visual. Whatever you think of your body, he’ll like to see it dressed up in sexy lingerie, and he’ll get aroused faster and harder if you tease him a bit. Act like a seductress for a change, then suck his penis, fuck him and leave him breathless!
7 Be assertive from time to time
While most men like to lead during sex, from time to time they would really appreciate their partners taking the lead.
So seduce him when he arrives home, lead him to the bedroom, strip him, make him lie there while you suck his penis, then masturbate in front of him before mounting him and riding him to orgasm. He might be surprised, but he won’t object!
9 Let him masturbate between your breasts
Whatever you think of men’s sex drive (hopefully you appreciate it!), it isn’t going away. And when you’re horny, don’t you get pleasure from rampant raw acts of lustful pleasure? Sure, of course you do. So now think of your male partner, and you begin to see things from a male perspective.
10 Give him a quickie each week
At least one bout of uncomplicated sex keeps a man happy to romance and give you foreplay the rest of the time. You know what? Men really do like raw sex without all the lovey-dovey add-ons – if not all the time, certainly a fair amount of the time. So get your lube out, look at him seductively till he gets the message, then let him put his penis in you and thrust until he comes.
It’s not insulting to you as a woman (in fact it actually honors his sexuality), and while it may not be romantic, it will certainly give him great pleasure.
11 Don’t ever use sex as a weapon
A very bad mistake. Decent men don’t do this, and women only do it because they believe they lack power elsewhere in the relationship.
That’s probably not true, and even if it has some truth in it, using sex to retaliate is the wrong answer. Few things are more alienating to a man than manipulative feminine strategies. And this is the worst of them.
12 Men like to be respected and appreciated
And women like to be cherished. You stand a great deal more chance of getting that from him if you tell him what a good lover he is and behave as though you respect him.
Even if he needs to improve his sexual skills, there are ways of telling him that will make him want to do it better, and ways of telling him that will make him think you are criticizing him.
13 Be assertive
Ask for what you want during sex in a straightforward way and he’ll respond much better than if you pout or whine. Take it from me, most men would much rather their partner had a lot more male-type energy alongside her female energy.
Among other things, this means asking for things straightforwardly, not playing games, and being assertive and energetic during sex.
Teach him how you like him to pleasure you during sex – and assertiveness also includes being confident enough to show him what you like and don’t like. After all, if you’re going to play with his penis the way he likes, hadn’t you better show him what to do with your clitoris?
14 Deal with sexual dysfunction
Sexual problems are many and varied: for men, they consist mostly of erectile dysfunction and ejaculatory disorders, including delayed ejaculation and premature ejaculation.
15 Women come first
If he comes quickly, and he can’t improve his performance, then adapt. Get him to go down on you until you come, then make love. He (and his penis) will appreciate your swollen, wet and warm vagina, and you’ll enjoy the post-orgasmic stimulation of your G spot while you feel emotionally connected.
Heck, you might even come again. this is a surefire route to mutual pleasure in bed – and it’s a way most men can understand and appreciate if they’re looking for a way to please a woman during sex.
16 Act out your sexual fantasies
Remember that acting out your fantasy doesn’t mean it’s ever going to become a reality. Keep it in the bedroom and respect what he tells you – then tell him your own fantasies and act them out as well.
17 Don’t ever fake orgasm
Having his penis in your vagina is probably not the best way to achieve orgasm for you (if you’re one of the 75% of women who don’t come during intercourse).
So don’t pretend that it is. Get an orgasm before he penetrates you, and enjoy the friction and fullness when he thrusts. If you come, it’s a bonus.
18 Enjoy oral pleasure
You have no idea how important this is to your man. First, it feels unbelievably good; second, it means you accept him and the very sense of his maleness without reservation.
19 Try many new positions and keep novelty alive
Honestly, trying new positions is what makes a relationship stay passionate – you need a constant stream of sexual novelty to fend of boredom – possibly this is more true for men than women, but it’s still incredibly important to both sexes.
The best way to do this is to use a reference manual like the ancient Kama Sutra or a site like this: sexual positions for you!
20 Keep your Kegels going so your vagina is tight
Men have a visceral response to the sight, smell, taste and feel of the vagina. They want to explore it with fingers, eyes and tongue, but more than anything they want to penetrate it with their penis and thrust deep into you – making you feel good too.
That’s how a satisfying, mutually pleasurable sexual relationship should be, uninhibited and lusty!
For him, a lot of the pleasure is in the friction, so if you think you have a loose vagina, tighten it up with Kegels or keep your legs closed during sex so you grip his penis. That way sex will feel much better for him.
20 If you need some ways to treat erectile dysfunction look here. When your erection needs a boost, you can get all the information you need, with hundreds of tips for better sex, including complete information on the causes and treatment for erection problems.
And so the demand for effective treatment for erectile dysfunction is going to increase in years to come. One of the major ways to treat ED is pharmacological agents, i.e., prescription drugs like Viagra and Cialis.
The frequency of erection problems is high: even among normal men it is estimated that about 1 man in 12 has an erection problem. Among diabetic men, the frequency is much higher – up to 50 % of men with diabetes have some kind of erection problem.
What is erectile dysfunction (ED)? How is it treated with drugs?
Erectile dysfunction is defined very simply: a man can’t get an erection hard enough to sustain sexual intercourse. There are other related conditions, such as diminished libido (low sex drive or lack of desire), low testosterone. Also, delayed ejaculation, or DE – see a good book on this here – or premature ejaculation may be associated with erection problems. (Read more about delayed ejaculation here.)
ED or erectile dysfunction increases in frequency in the older age groups. This can be caused by circulation problems, nerve problems, hormonal problems, psychological issues, or prescription drugs. But most often it is down to a combination of one or more of these factors. (Which are also called, in the order referred to above, vasculogenic, neurogenic, endocrine, psychogenic, and prescription drug induced.)
There’s no hard and fast classification of what constitutes and erection problem, or a definition of erectile dysfunction. The condition itself ranges from an erection that is not firm enough for intercourse to an erection which allows penetration but then fades away. Alternatively and erection may not last long enough for intercourse to be completed.
By contrast, one of the main avenues of treatment over the past ten years has been by drugs such as Viagra. The rapid response and effective action of these drugs is important. They represent an instant treatment for a man who is unable to have sex, and thereby provide a rapid boost to self-esteem and sexual self-confidence. This will reduce the feelings of anger, depression and low self-esteem so common among men with ED.
How does drug treatment for Erectile Dysfunction (ED) work?
The erectile chambers of the penis consist of two longitudinal structures (each called a corpus cavernosum) which run along the length of the penis from its base to the coronal ridge. These corpora cavernosa are made up of spongy tissues surrounded by smooth muscle.
Normally, a degree of muscle tone keeps the muscles fibres slightly tense, thereby preventing blood flowing into the expandable tissues. When the muscles relax, blood may enter, and the tissues swell, which has the effect of squeezing the veins leading blood away from the penis.
(The veins are squeezed between the rather inelastic tunica albuginea which surrounds the whole of the erectile tissue and the corpora cavernosa.) With blood unable to drain away, the penis becomes erect. This process is far from simple, and involves many chemicals, nerve impulses and interacting somatic and chemical factors. Disruption to any part of the process may cause a man to develop erectile dysfunction.
Causes of erectile dysfunction
Vascular
The most common factor is vascular: a problem with either the veins or the arteries of the penis. Clearly either impaired arterial function (arterial insufficiency) or a leaking vein (veno-occlusive erectile failure) may contribute to erection problems. Such problems originate in conditions such as hypertension, hyperlipidemia, diabetes and smoking.
Neurological
But neurological problems are also a common cause of impotence. Nerve impulses resulting from sexual stimulation cause the release of nitric oxide and prostaglandins in the base of the penis. These substances then cause the smooth muscles of the penis to relax and allow blood to flow in, thereby causing an erection to develop. Injury to any part of the nerve network that promotes these chemical actions can render a man impotent. Such damage can result from groin injury, prostate surgery, MS, and neuropathy associated with diabetes.
Hormonal
Testosterone declines with age – as most men over 50 years of age will know – and this reduction in blood testosterone may result in fewer night-time erections and a lower level of libido. There are also a number of medications which may produce high prolactin levels, which antagonizes the action of testosterone. See below for more on this.
Medications
These include SSRIs (prescribed for mood disorders) and ranitidine (prescribed for stomach acid problems). In addition, some antihistamines, antidepressants, antihypertensives, sedatives and anxiolytics (anti-anxiety drugs) have been all been blamed for causing erection problems.
Stress, anxiety and other psychological factors
Stress and anxiety can produce erectile dysfunction by raising blood catecholamine levels – these stress hormones oppose smooth muscle relaxation.
Purely psychological factors may include fear of sex, fear of women, fear of pregnancy, fear of failure and so forth. The inability to get erect causes much anxiety, which in itself is likely to cause erectile failure at the next sexual situation, thereby perpetuating and compounding the erectile dysfunction.
Treatment Options for Erectile Dysfunction
Treatment may involve both the man and his partner: ED is generally not a problem that occurs in isolation.
You can enjoy a better erection by engaging with your partner in a series of exercises which resemble those prescribed by the professional sex therapists. These are described in this book on erectile dysfunction, which you can get from Amazon.com and Amazon.co.uk
Penile prostheses and erectile dysfunction
These are inflatable or semi-rigid devices which are implanted into a man’s penis in place of his own erectile tissue. There has historically been a fairly high failure and infection rate. A more modern form of surgery for impotence is surgery to improve the flow of blood to the penis. This can be successful when the surgeon is experienced and the patient is properly selected.
A penile support sleeve to improve erectile firmness
A support sleeve may allow penetration of a soft penis into the vagina but who knows how much pleasure it gives either partner? Read more here.
Pharmacologic agents and the treatment of ED
Vasoactive agents like Viagra and Cialis will relax the blood vessels of the penis and permit the accumulation of more blood in the corpora cavernosa.
Other drugs used from time to time to treat ED have included Yohimbine, which is an alpha-2-adrenergic blocking agent. The effectiveness of Yohimbine as a treatment for erectile dysfunction has not been proven, and as it tends to promote anxiety and high pulse rates in susceptible men. It is really a treatment of limited benefit, especially now that Viagra has been proven safe and successful.
Psychological or physical erectile dysfunction?
Psychological issues are probably involved in all cases of erectile dysfunction: if not before it develops, certainly after it has done so! But for erectile problems that have a purely psychological origin (e.g. anxiety, nervousness, anger), the onset of erectile dysfunction is sudden and unexpected. In the case of physical erectile dysfunction, in other words that caused by an underlying physiological problem, the onset may be more gradual.