You're revved up.  You're going a hundred miles an hour. You're just at that perfect moment to slide into place.  Bam! for no apparent reason—flat tire!  Or a dry, desert road appears where a smooth pavement mirage fooled you into riding along. How can you keep the sexual moment when things go wrong?

Erectile dysfunction can usually be treated with medications.  But the emotional impact on your self-esteem or your partner's feelings of desirability often collide in a wreck.  Jerry, a male patient in his early 40's struggled with ED on a random basis.  His urologist had found no physiologic basis for the problem and had offered a prescription for Sildenafil (Viagra).   But Jerry felt like he was anticipating failure if he took the drug, so instead he would take his chances.  Most of the time, if his erection failed, he would withdraw in angry, stony silence.  Occasionally, he would attack his wife for not being sexy enough to keep him hard.

Beverly was in peri-menopause at 48 and found that even with lots of genital stimulation, she was usually dry, a common problem at her age.  Anticipating her husband's disappointment in her aging body, she started making suspicious comments about younger women.  Not knowing how to incorporate artificial lubricants into their love-making without changing the mood, she would endure painful initial moments of intercourse that made her want to avoid sex altogether. 

Problems with sexual function are not the disasters in the bedroom.  Failing to be sexually flexible is the smashup that separates us from each other and from erotic, loving exchanges. 

When our bodies don't work the way we expected, our self-esteem often takes a hit.  We can panic.  We can set a pattern of anxiety in motion that produces more erectile dysfunction or more vaginal dryness.  Ironically, both conditions are exacerbated by worrying about them.  We can fear humiliation and rejection from our partner.  Sometimes, to get rid of the bad feelings inside, we throw a little mud onto a partner and blame them for the problem.  Partners too can enter the mix with their own self-doubt wondering if they were attractive enough or a good-enough lover.  Our spouse might get angry at us for not dealing effectively with the issue with both real and unrealistic expectations for our responsibility in the problem.

What to do?  First, for erectile dysfunction, keep your sense of humor.  Tell your partner that it might not be your night but you'd like to make hers.  Don't withdraw and don't make it about you; this is a love-making exchange.  Offer to be generous and give your partner pleasure and an orgasm.  If your penis doesn't work, usually your hands and mouth still will.  You can still be terrific in bed.  Ask directly for the stimulation for yourself that might be more effective.  Don't give up.  Maybe after the excitement of her orgasm, things will be just fine for you.  Ask her to hold you while you take over.  If you have a pill - take it and have a more extended exchange.  Also, men can have orgasms without erections. Go for it. Remind your wife that she is hot stuff by paying her compliments about her body and skill.  Use words to bridge the gap when your body might previously have spoken of desire.  In a non-sexual moment, discuss a plan for the future. An erection is NOT the measure of an experience for most women.  Your loving presence is. 

Vaginal dryness can make intercourse hurt.  Women can misinterpret when it's missing that they have no desire.  They worry that their partners will misinterpret their willingness to make love.  Worse, they can fear that it's evidence that they are not young and juicy anymore.  What to do?  Solve the problem and reassure your partner.  Tell him you are so glad to be making love.  Tell him you find his body sexy.  Keep an artificial lubricant handy.  Make it fun by teasing your partner that you're going to get juiced up and ready for them.  Make it sacred and asked to be anointed with the special oil.  Tell your partner you need oral sex because it will make you even wetter. Try flavored gels. Don't leave home without a sample size in your purse!  You may be lubricated on the inside of the vagina but not on your outer labia; use your own fingers or have your partner pull out the moisture before you have intercourse.  Focus on stimulating your partner for a while so that the lubrication has time to build. Sometime later over coffee, talk honestly about your fears of what your partner may be thinking. Talk to your doctor to find out if you would be a candidate for vaginal estrogen to plump things up.

Link for more help from Laurie Watson with Marriage Counseling  in Raleigh, Cary, Greensboro and Chapel Hill, NC. Laurie’s book Wanting Sex Again is available on Amazon!

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