cCouples Therapy Center of NJ

What to do About Erectile Dysfunction


Sex in Marriage - Couples Therapy Center of NJ

Although it is something that can be so difficult to talk about, it IS something that many men struggle with. Erectile Dysfunction is a problem that compounds itself, meaning that one instance  is a disappointment and also may cause concern that at the next opportunity it will happen again.  That anxiety is part of what causes erectile issues.  If another instance occurs, the anxiety is fueled, contributing to the next occurrence.  It becomes a circle that builds upon itself.

Erectile Dysfunction could be caused by a medical issue such as cardiac problem, hypertension, diabetes, a spinal cord injury, cancer, hormonal levels, some surgeries (radical prostatectomy), radiation, some anti-depressants, and a history of or current addiction to substances.  As always, the first thing to do is discuss this with your doctor.  But if you do not have any of those issues, you’re left wondering if it’s psychological.  Take this brief quiz to help gain insight:

Rate the quality of your erection on  a scale from 0 (none) to 10 (rock hard) during the following:

  • Upon waking in the morning
  • When fantasizing
  • When masturbating
  • During ‘outercourse’ (formerly known as foreplay)
  • During intercourse or attempts at intercourse

If your numbers vary significantly from one of these situations to the next, it is likely a psychological issue.

So, if you determine it is something going on in your mind only, what can you do about this?

  • Change your perspective! What do think qualifies as ‘sex’? There is no one right answer, and sex can have a variety of meanings to different people. Communicate your meanings to your partner and, together, try broadening your definition. Perhaps sex can mean any contact that is both pleasurable and connects you with your partner.  If only penis in vagina counts as sex, but your erection has been variable, then for those times it does not ‘work’, you and your partner are left feeling as if you failed.  Or perhaps feeling… disappointed, less than, not attractive or skilled enough. Instead, allow yourself to just enjoy closeness and feeling good.
  • Change the language! If we changed the word and thoughts of ‘Foreplay’ to ‘outercourse’, we have a very different perspective on these activities.  Foreplay implies that there is something else to follow.  If you broaden your definition of sex, there may not be anything that follows outercourse and you and your partner still had a good time being together, and enjoying pleasure in various ways that may or may not include vaginal penetration with a hard penis .
  • Change the goal! Touch one another without the goal of having an orgasm a certain way.  Often, the goal of orgasm fuels anxiety with thoughts about failing to meet the goal. Instead, simply enjoy what your senses are telling you: what it feels like to touch, to be touched, to play, to be dominant or passive, take in scents and sights and tastes, and enjoy the feeling of connection. If the goal is revised to be in a special moment of being alone together with your partner, you will always meet it.

If you are struggling with issues around ED or other issues around intimacy, we can help! Please contact us at 908-246-3074, or

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