Dear Editor,

I have been an avid reader of Parents for ten years. I am 30 years old and married. My husband suffered an accident and injured his pelvic area and because of these injuries his sexual urge began to dwindle and finally stopped altogether. I am kindly requesting you to address this issue in this column so that I may get some knowledge since I want a loving and fulfilling marriage.

Parents’ reader

Some injuries to the pelvic area can interfere with sexual functioning leading to a disturbing condition known as impotence. Other causes of impotence include fatigue, obesity, alcohol, drugs, diabetes, hormonal imbalance, depression, negative feelings and poor sexual learning experiences. Whatever the cause of impotence, results are usually the same – inability of the man to achieve or keep an erection sufficient for intercourse.

In physical terms, the erect penis contains four or five times the volume of blood it has when flaccid. When the man experiences impotence, the vascular reflex mechanism fails to pump in sufficient blood and hold it there to make the penis firm and keep it erect. At times the man may feel aroused and desire to make love, but his penis does not erect. Another person suffering from impotence may be in the process of making love when his erection disappears.

While impotence can be discouraging to the man suffering from it and his partner, the good news is that most of those who take constructive steps towards facing and resolving the problem will regain their sexual powers. Their relationship may be even better afterwards because solving impotence problems requires the kind of loving cooperation from the man’s partner, which can greatly strengthen the couple’s mutual understanding and enrich their expression of love.

Irrespective of the underlying causes of impotence, the situation is made worse by the man’s thoughts. Although every man at some time or other loses an erection, seldom does it become a persistent problem for those with positive mental attitude toward sex. In many cases, the experience of erection loss can set up a vicious cycle of failure/anxiety/more failure/more anxiety until impotence becomes the conditioned mental response to sex instead of the pleasurable experience it should be. Anxiety can narrow into panic as the condition continues, and the more the fear and psychic pain, the more the man escapes by ‘turning off’ from sex. He virtually tries to expunge sex from his life, not only to his own frustration but also of his partner’s.

Impotence that changes a couple’s sex life must be dealt with as soon as possible to save the marriage. It is however important for the woman to realise that impotence is extremely devastating to the man because its cuts away his self-esteem where he is most vulnerable. Impotence involves the organ of his body which most represents his manhood and threatens his ego with the thought that he can no longer satisfy the woman he loves.

A man may feel inadequate and the result of impotence is both frustrating and humiliating. A couple experiencing impotence must see a doctor for help. The man will be given a careful physical examination and a complete urological and endocrinological study may be required. For instance, undiagnosed diabetes or abnormal imbalance could be at fault or exacerbate an injury problem. Physical causes for impotence can be readily detected and some dealt with medically.

Beyond all other impotence factors, there could also be the added problem of a man who is too intensely preoccupied with his ability or inability to achieve and maintain an erection. He is pressured by the fear of failure. He concentrates on his bodily reactions like a spectator at his own lovemaking until self-consciousness destroys all joy, abandonment and sensation of pleasure.

He may try, without success, to command the sexual reflexes, but they respond only to desire and stimulation. He becomes like a person who can’t do anything right and therefore pays attention to his failures and not his successes. Self-consciousness is always self-defeating. It always produces an unsatisfactory state of affairs especially in the lovemaking process. It opens the door to fear of failure, the true villain behind the scenes, and any cure must first deal with fear.

How a woman with an impotent partner reacts and behaves will greatly determine the success of a cure. She may feel rejected and take the blame or react with hostility. She may try to understand the problem and want to help in the most mature and loving way possible. The latter will produce positive results. When a man is impotent, his partner may be the one who holds the key to the cure. The cooperation of a loving partner in restoring a man to sexual vigour cannot be overstated. A woman must be ready to work with her partner, remain loyal and caring, and be more concerned about him than her own ego.

The status of the relationship before the impotence happened will also determine how well the problem solving goes. A woman who is insecure in a relationship may view the partner’s impotency as a personal rejection of her. She may also take it as proof of her own inadequacy as a woman, when it may in no way reflect her partner’s disinterest in her. In fact, men are more apt to fear of failure with the woman they love, while they could perform effectively with a woman they are indifferent to.

Love and erection are not synonymous words. A frustrated husband may have a great deal of desire for his wife but no accompanying erection. A woman in such a situation must learn to think rationally about herself, her husband, and the situation facing them. When she refuses to put herself down and instead puts herself at her husband’s disposal as they work together for a cure, she will take significant steps toward the kind of emotional maturity, which will make her far more desirable than ever before.

Some of the women who complain most about their partner’s not being able to satisfy them sexually turn out to be the least cooperative when it comes to working together to solve the problem. A woman should not be hostile to her partner as this is self-defeating. In helping her partner she will do great service to herself and will perhaps find the love she inwardly longs for as she learns to give.

A woman who is mature, stable and sensitive and acceptant of her husband’s needs can work wonders in their relationship and even without intercourse, there can be a good deal of mutual pleasure as well. The starting point is for the couple to admit that they have a problem – a couple problem – which can be solved. As they move toward finding a solution, they will be ridding one another of the buildup of feelings of inadequacy. The solution to most impotence problems involves three lines of approach – talk, touch and teasing.

Talk refers to reestablishment of broken communication lines, lines that have been battered down by periods of indifference and frustration. The woman must help her partner to put his fears into words. When the conspiracy of silence is broken and the man is able to express how he feels, that is one hurdle out of the way. When each is open to the feelings of the other, a climate of understanding and tender togetherness grows.

Touch refers to physical communication, which may also have broken down as each moved to his own side of the bed after periods of frustrations. The couple must begin again to enjoy the fun and pleasure of affection, of cuddling and caressing, and sleeping close together. Even when there is no intercourse touch brings a feeling of security accompanied by inner satisfaction, sometimes much greater than sexual satisfaction.

Teasing suggests the kind of sexual relationship, which can begin to develop even though the husband is still unable to gain an erection. The couple should agree to spend time together pleasuring each other without any demand for intercourse. The man should use new communication lines to tell his partner exactly what gives him pleasure. As long as both understand that her body is available to him for his pleasure and his body to her, they will find ways of fulfilling each other.

For example, they can enjoy caressing each other in love play without expecting anything further. At this point, the woman should demand nothing of him in terms of arousal. They should simply relax together in a warm, intimate setting while he learns to let his body take over with proper responses. In this setting of leisurely erotic stimulation without sexual intercourse, the penis may get erections that wax and wane. This will remove fear from the man, as he discovers that once an erection is obtained, it will come back if it goes away. To observe the erection come and go is an important part of the training process for both the man his partner, as they gain experiential knowledge that with loving cooperation the erection will always return.

When the time seems right the man should find delight in satisfying his partner by stimulating her clitoris. When he feels ready for intercourse, the woman should be prepared to insert the penis in her vagina. Even if it is partially erect, she can help him ‘stuff’ it in her vagina, and the subsequent stimulation will often increase and maintain erection. The male-above position is usually the most satisfying and stimulating position for most men experiencing difficulty with erection.

The lovemaking process should never be rushed. There is enough time to regain full sexual pleasure and the love play should be carried out in the most pleasurable, leisurely and sensual manner. The woman should wear her most appealing nightgown, which in most cases is no gown at all, and the husband should use the endearing names he once called her. Pet names can be very sexually stimulating.

Once gentle stimulating and erotic encounters have turned the tide from a flaccid penis to an erect one, remember that success breeds more success. The couple should realize, however, that fears of failure in sexual performance could come back at anytime, perhaps when the man is in stress-filled situations. However, if both remember there is always a cure when they turn to each other, sharing their fears, finding comfort and pleasure in each other’s body, relaxing and refusing to demand any performance from the man, the problem will be resolved in time.

A woman must be careful not to make the man feel inferior. She should never put him under pressure and never judge his sexual performance. She must be responsive and seductive, yet not come on too strong in her actions. A loving couple can together make the most of their sexual relationship when problems arise and sometimes find far more pleasure in each other than they ever did before the difficulty developed.

While you may not have any feelings below the waist because of injury or other causes, remember you have a lot of sensations in other parts of the body – the breasts, back, arms, shoulders, face, head, neck and mouth. You can give each other a great deal of pleasure by stroking those areas. Remember lovemaking is an erotic menu filled with many possibilities. Creative lovers don’t limit themselves to foreplay and intercourse.

7  Steps to restoring sexual responsiveness

Talk to your doctor frankly and openly. Get the best medical advice you can on the physical aspects of sexual interaction and your problem. Include your partner in the discussions.
Don’t hesitate to consult a sex therapist. Most doctors have not been trained in sexuality problems, nor are they experts in dealing with personal psychology and relationships issues. Consider talking to a sex therapist.
Don’t react to illness or disability by withdrawing into yourself. Fear of burdening others, shame, and anger about having a disability or being unable to sexually perform can isolate a man or woman. It is important that you learn to share your feelings.
Think about sex. Read erotic stories, watch videos. Indulge your fantasies. Don’t remove sexual thoughts from your mind. Keep dreaming and thinking about it.
Masturbate. By exploring your own sexual feelings without concerning yourself about your partner, you can rediscover your sexuality.
Be affectionate. Even if you do not feel up to having sex or are not able to have it, do not withdraw from physical expressions of affection. During times of stress, you and your partner need physical contact, kissing, hugging, and cuddling and holding hands.
Have a positive attitude. When you do make love, don’t worry about functioning and performance. The attitude you take about your sexuality is far more important than any physical limitation you may have.