Many readers write to me about sexual problems. And almost all of them ask me to reply confidentially, rather than in this column. I understand this. Sexuality is the most private part of our lives and one which we are most reluctant to share with anyone, even a doctor or counsellor.
The biggest sexual problems shared with me relate to an inability to have orgasm. This creates a double problem. Not only are we missing something ourselves, but we also feel we are letting our partner down by not meeting their needs. This week I will talk about men’s sexual problems. Next week I’ll discuss women’s.
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Men tend to have two sexual problems. They either climax too fast, referred to as premature ejaculation, or they can’t achieve a climax, maintain an erection or even get an erection.
Premature ejaculation can be helped in several ways. The man needs to focus on relaxing and using deep diaphragm breathing rather than short chest breathing. The less tense he is, the longer he’ll last. He needs to focus on the emotional closeness of his lovemaking, not on the physical sensations. He needs to sense what is happening in his body, but not panic about it. If he senses he is getting close to ejaculating and wants to postpone this, he can withdraw and his partner can gently but firmly squeeze his penis and delay his orgasm.
Man’s worst fear
Not maintaining, or worse, not even getting an erection is one of the scariest and most upsetting things that can happen to a man. Sometimes it’s strictly emotionally based. Fear and anxiety block the normal sexual excitement. The biggest sex organ in any person is his brain. It ultimately controls what happens everywhere else.
But often, particularly in middle-aged and older men, there may be some physical factors. Some medications, particularly those for high blood pressure, can seriously affect a man’s erection. Many older men experience some degree of leakage in those blood vessels that cause the penis to maintain its erection. As a result the erections are not as hard or do not last as long as when the men were younger.
Regardless of any physical problem, a man’s sexual ability falters more if he is anxious and upset about it. The more a man focuses on his enjoyment of being with his partner, rather than on his body’s lack of performance, the better that performance turns out to be. But the more he expects perfection and gets anxious, the worse it will be.
Some devices can help men with these problems. A vacuum pump can assist in forcing blood into the penis. A plastic or rubber ring around its base helps retain the erection. But if a man feels ashamed and personally responsible for what is really a blood circulation problem, he may refuse to consider such aids.
There are ways other than intercourse to stimulate and show sexual affection. Hands and mouths can be used in intimate ways, if both parties feel comfortable with it. If physical problems rule out normal intercourse, couples may want to explore these other ways to stimulate or satisfy each other. The New Male Sexuality by Bernie Zilbergeld (Bantam 1992) and The New Joy of Sex by Alex Comfort are two books that outline understanding your body and your sexual needs and those of your partner.
