What is Erectile Dysfunction?
It's something most men don't want to discuss. It's the elephant in the room and yet it is so common. While the experience varies, erectile dysfunction is the leading sexual concern for men worldwide.
People experience erectile dysfunction in many different ways. Your erection may not be as hard as you'd like. Maybe you can't stay hard. It could be that you don't get an erection at all. Erectile dysfunction can come with feelings of lower sexual desire. It may be something you experience all the time or only sometimes.
Who Experiences Erectile Dysfunction?
Erectile dysfunction can affect anyone, although some men are more likely to be impacted than others. One certainty is that you are not alone. The numbers of men experiencing ED is estimated to reach 322 million globally by 2025. This can be an uncomfortable topic to share, so it's easy to think you're the only one. Currently, about 1 in 4 men experience ED, making it likely to affect someone you know or have met.
What Contributes to Erectile Dysfunction?
There are a few factors that contribute to erectile dysfunction, and it's often a combination of things, rather than just one. When trying to understand what contributes to ED, it's a good idea to consider the psychological, relationship, lifestyle and physiological influences.
It can seem unrelated, but what's going on in your mind significantly influences what happens in your body. For about 30% of men, there's a psychological factor contributing to their erectile dysfunction. Stress, depression, and anxiety all make it more challenging to get an erection by disrupting the feelings of sexual excitement in your brain. They send everything a little out of balance, including your erections. The tricky thing is that it can become a cycle, with stress, depression and anxiety leading to ED and the subsequent experience making you feel even more stressed, depressed and anxious.
Performance anxiety can come with, and sometimes before, erectile dysfunction. Men today are under enormous social pressure to be sexually gifted. The rise of porn culture sets an expectation of men to be rock stars in bed and sex to be the same as in movies. It's not just men that get performance anxiety; women do too.
In today's culture, men aren't always encouraged to talk about sex authentically. There are no 'how-to' classes. You just figure it out, looking to porn and peers for coaching. The expectations set aren't always realistic and can create performance anxiety.
Sex is physical and makes you highly aware of your body. If you have any body image concerns, sex might bring them to the surface. Feeling uncomfortable in your skin or worrying about how you look can fill your mind with negative thoughts, distracting you from pleasurable sensations and stopping you from being in the moment.
What we think impacts everything we do, and sex is no different. Your thoughts and beliefs around sex can increase your pleasure and engagement or lead you to withdraw from, and avoid, sex. A feeling that sex is bad, painful, wrong or a myriad of other negative things tells your body that you shouldn't be having sex. ED can be a way of your body following these instructions.
Arguments, tension and communication problems can be felt physically as stress impacts your body. Trying something new with your partner or being with a new partner might also contribute to erectile dysfunction. If you're stepping into a new space where you might be worried about lack of experience, being judged or making a good impression, nervousness can affect how your body responds.
As your relationship progresses, things shift. Life changes along the way with you and your partner changing in response. New stresses come up, and the way you connect and communicate with your partner might alter. The excitement and thrill of a new partner fade as your relationship continues and, while many good things grow from long term commitment, the sexual connection you feel can become different.
Sexuality and gender concerns may be something that you're going through. Questioning who you are and what you want. The best sex is authentic sex, and if your situation feels like you're not being true to who you are, it's natural for your body to respond to this.
Heavy alcohol consumption and smoking are two lifestyle factors that significantly increase the chances of erectile dysfunction. Another contributor could be whether you're getting enough sleep. Sex isn't at the top of the priority list for a tired body, and without sleep, your body experiences imbalances.
What you eat and how you exercise are fundamental to how your body feels and functions. The saying that you are what you eat is, literally, true. Our bodies continually replace cells. When your diet is less healthy, the unhealthy food you consume is what becomes your body.
Health issues can be related to erectile dysfunction, and it's a good idea to have these checked out by your doctor. Certain medications, including anti-depressants and blood pressure medication, could also be playing a role.
Aging happens to everyone and brings changes to your body. For men over 40, one of these changes is often ED.
What Are the Options for Erectile Dysfunction?
Depending on the contributing factors, there are several different options for erectile dysfunction.
Counselling and Sex Therapy
Counselling and sex therapy (like we do at Sex Therapy - Perth) give you understanding and insight into factors contributing to your ED, and how to work through them. It's a safe, confidential and non-judgmental space to share your experience with someone who knows how to help and support you. Merely talking about it can be a huge stress reliever. Added to this, your counsellor can give you practical ideas to try at home.
Sometimes, couples counselling may be a good option. Together with your counsellor, you can talk openly about what you're both thinking and feeling. Your counsellor can give suggestions about things to try together, like low-stress positions and slowing down sex to let things build. Studies have shown that, for men with stress-related ED, having the partner involved in counselling resolves the problem 50-70% of the time.
Changes to your lifestyle can be effective on their own or together with counselling and sex therapy. This might include starting a regular exercise routine, sustaining a low blood pressure, shifting to a balanced and nutritious diet, maintaining a healthy weight, avoiding alcohol and cigarettes and learning stress reduction techniques.
Prescription medication is sometimes used for erectile dysfunction. The most commonly known options are Viagra (those little blue pills) and Cialis. When considering medication, it's essential to keep in mind that there might be side effects including flushing, visual abnormalities, hearing loss, indigestion, headache, body aches, dizziness, digestive issues, congestion and runny nose.
When You Need Someone Else to Talk to
For everyone, the causes of ED will be different, and so will the best and most effective paths forward. It's about understanding your situation and what's right for you. If you want to talk about what you're experiencing, whether it's concern about erectile dysfunction, communication, performance anxiety, sexual function, relationships or anything else to do with sex, we're here for you. Appointments with our experienced sex therapists are safe, supportive and confidential. You can book an appointment by going to our booking page or contacting us at any of the options on our "Contact Us" page.
Think about the sexual fantasy that turns you on the most. The one that makes your heart rate speed up and sends a thrill coursing through you. The one that fills you with anticipation and need when you think about living it out. Actually feeling those sensations, whether they’re the soft brush of silk, the sharp bite of leather or the warmth of skin. Imagine what it would be like to step into that space with your partner. Taking the journey together and discovering new shared pleasure.
Fantasy is important, it gives you insight into yourself, your needs and desires. It can give you a road-map to follow that leads to a place of deep satisfaction. Everyone has fantasies. Humans love to create possibilities in their minds, it’s part of how we learn and that’s exactly what fantasy is. A way of learning about your sexuality. And about your partners sexuality.
Granted, some fantasies are kinkier than others and not all of them are meant to be brought to life. There’s a difference between fantasy and reality. Regardless of where your fantasy lies on the spectrum, exploring it and sharing it with your partner has potential to increase the intimacy and connection you share.
Talking about fantasies with your partner isn’t always the easiest thing to do. There can be a fear of judgement and rejection. But when the discussion is had in an open-minded, genuine and positive way, the results can be…mind-blowing.
Create the Right Environment
Conversations that need trust and openness require the right environment. Set the scene by choosing a time and place that is comfortable, relaxed and unrushed. Bringing up the fantasy you have about being tied up and having hot wax dripped all over you while rushing through the supermarket, overrun by harassed mothers and screaming children, while have a very different result to sharing it over a glass of wine, in a quiet house, with privacy to explore.
Let the feeling of sharing and connection grow by encouraging your partner to share an opinion with you. It doesn’t have to be about sex, the important thing is helping them open up. When they do, take time to listen without jumping in with your opinion too quickly. This creates a feeling of acceptance, the warm glow that comes from knowing you’re truly being heard and paves the way for further disclosure.
Share a story about something sexually adventurous that someone else did, or something that you have read or seen. Let your partner see that you support the idea of pushing sexual boundaries and approve of trying new things.
Begin Discussing Your Fantasies
Lead into the subject slowly, letting your partner warm up to the idea of sharing fantasies. Rather than detailing your dirtiest fantasy straight away, start by connecting new fantasies with things you’ve already done together and enjoyed. For example, “Remember that time we had sex in the car? I loved that. We should try more things like that. Where’s a risky place you’d like to have sex?” or “It really turned me on seeing you dressed up in uniform for that costume party. What do you think about role-playing?”.
Your partner will likely be just as nervous about judgement and rejection as you so don’t jump to a “no” if they suggest something that you’re not sure about. Stay open and see where it leads. More fantasies will be shared when you’re supportive and even ones that don’t turn you on can give valuable insights about which boundaries to push, and how to do it.
The Feeling Behind the Fantasy
When thinking about fantasy, it seems logical to think it’s the specific act you want to experience. But there’s more to it than that. What really makes a fantasy light your desire is the way it makes you feel. Powerful. Vulnerable. Naughty. Taboo. Desired. In control. Out of control. The physical activities in your fantasy are a means to an end. They open the door to a feeling that turns you on.
After you and your partner have talked about what you’d like to do, talk about how it would make you feel. Delve into what the fantasy gives you. For example, “The idea of being watched while we have sex sends me through the roof. There is something so liberating and freeing about it, it makes me feel naughty, desired and sexually abandoned. What is that turns you on about that idea?” or “I love thinking about you tying me up and blindfolding me. It makes me feel vulnerable and exposed. Like anything could happen and I’m not in control”.
The feeling is the driver of your fantasy. When you discover how you and your partner want to feel, you’re one step closer to experiencing it in a safe and consensual way.
Discover More Fantasies
The knowledge you’ve gained by uncovering the feeling behind your fantasy can help you find more fantasies that you and your partner will both enjoy. Focus on feelings that you are both turned on by and come up with a sexual act you can try that will give you both those feelings, while not going too far beyond your boundaries. You can start small and work your way towards kinkier acts, by doing this you can discover if you like the reality of the feeling as much as the fantasy. For example, “Having sex somewhere really risky and getting caught turns me on as a fantasy but I don’t know if I’d like the reality of getting caught. Maybe we could try something similar. How about having sex in the car?” or “Thinking about watching you with another woman feels voyeuristic and indulgent. I love that. But I’m not sure I’m ready yet. Why don’t we go to a strip club and I can watch you getting a lap dance?”.
Hopefully you and your partner are both feeling relaxed and turned on at this point. Ready to explore. Let your imaginations roam together and see how creative you can get. There might be something you’ve never thought of that fills you with sudden lust when you hear it. Together, choose something you want to try and make it happen.
Reinforce What You Like
While you and you partner are engaged in whatever kinky, debaucherous, sensual, connected experience you’ve chosen, tell your partner how you’re feeling. Let them know how much you enjoy what they’re doing, how they look, how they feel. Check in and see how they are feeling, whether they are loving it as much as you are and if there’s anything you can do to make it better. Communication is key, through words and actions.
When the fun is over (for the moment) reinforce the things you told them while caught up in the heat of the moment. After having boundaries pushed, there’s often a feeling of vulnerability that follows and some love and acceptance goes a long way towards reassuring your partner. It also increases the chances of more sexual exploration in your future. Asking for what you need is always ok so remember that if you need a bit of comfort, tell your partner. Sending a naughty text, telling your partner you can’t stop thinking about how hot it was, is another good way to encourage more adventures.
When You Need Someone Else to Talk to
If you need to talk to someone about what you are dealing with, whether it be concerns about communication, fantasies, sexual function, relationships or anything else to do with sex, we are here for you. Appointments with our experienced sex therapists are safe, supportive and confidential. You can book an appointment by going to our booking page or contact us at any of the options on our contact us page.
This week is Men’s Health Week, an opportunity to discuss and think more about men’s health concerns and the unique health issues experienced by men.
You’ll probably hear lots about mental health, depression, prostate cancer and heart disease. These are some of the everyday things that impact men, and they are so important to talk about. Men are over-represented in the numbers for suicide, cancer, diabetes, heart disease and lung disease. 11% of WA men experience a high or very high level of psychological distress last year. 1 in 4 men will deal with depression at some point in their life.
But there are so many other things that men don’t discuss; topics that can be uncomfortable and embarrassing but impact men’s mental health and wellbeing. It’s time to talk about sex and the unique sexual issues that men deal with.
Why Talk about Sex and Men's Sexual Health?
At least 1 in 4 men will experience problems with their sexual function in their lifetime. When it comes to sex, if something doesn’t quite go to plan, it can affect our confidence, happiness, sense of pride and self. And it can create distance in our relationships.
There are many different sexual problems men may deal with. They all have an impact on our lives, health and happiness in different ways. Some common ones include:
Dealing with these sexual function problems, as well as the underlying considerations that impact them, can have an dramatic impact on a man's happiness, vitality and overall well-being. It can affect his relationships, his feelings of being a dad, a husband, a lover, and co-worker as these concerns can impact a guys sense of self. These problems are common and there’s a lot that you can do to deal with them.
Be proud, be loud, and give yourself the opportunity to talk about what you’re dealing with. If you are experiencing sexual concerns, you are not alone. There is absolutely nothing wrong with you and there is support out there for you.
If you need to talk to someone about what you are dealing with, whether it be concerns about sexual function, relationships or anything else to do with sex, we are here for you. Appointments with our experienced sex therapists are safe, supportive and confidential. You can book an appointment by going to our booking page or contact us at any of the options on our contact us page.
We often take the definition of monogamy for granted. Most people agree that being unfaithful or cheating is wrong. However, it's rare that couples sit down and have a real conversation about their personal boundaries and definitions of monogamy and infidelity.
Monogamy means different things to different people, so it's wise to discuss and negotiate what monogamy should look like when you and your future partner or spouse are committing to a relationship or marriage.
You aren't alone in this. We've put together a guide to help you discuss and define the boundaries around monogamy in your relationship.
Find a Time and Place to Have the Conversation
Before you talk about your relationship, you need to find a safe space. We recommend having this conversation when you are sober, at a low-stress time and in a private place.
Some of the topics discussed can bring out jealousy, anger or sadness. One partner may feel watching porn is a form of cheating, while the other has no idea and watches it weekly. Having conflicting views on monogamy and betrayal can be painful and confronting, hence the need for a safe space. Take breaks if needed and fight against the Four Villains of Communication.
Is Thinking It the Same as Doing It?
Some people believe thoughts are the same as actions. Thinking sexual thoughts about others may be okay with one person and upsetting for another.
Would you be upset if your partner was thinking about other people? Does your partner want you to share these thoughts? Imagine you find your new coworker sexy. Do you tell your partner? Is that something either of you wants?
It helps to discuss when these thoughts are appropriate for sharing? It may be as soon as possible, or it could be never. Would you want to know if your partner was inching closer to acting on thoughts?
Does Fantasising Spice up the Bedroom or Entail Betrayal?
Imagine your partner sees someone at the bar and later fantasises about them while you're in bed together. Should they keep it to themselves, or do you want to know? Could you share in the fantasy together and use it as fuel for the bedroom?
The key behind answering these questions is whether or not it would help or hurt to share the fantasy. Would you or your partner's feelings get hurt if they knew you were fantasising about these things? Does it feel threatening? If so, it's crucial to respect these boundaries.
Can You Discuss Your Deepest Sexual Desires?
Do you want to share and discuss your sexual desires with your partner? Determine if you want to share your deepest and sexiest desires. It might be something you want to hide or something you want to share with your partner.
It's also important to discuss whether you tell your partner when you are aroused or turned off. And whether you will have sex when your partner is aroused but you aren't, and the other way around.
Many people want to try things in the bedroom they haven't done before, or with either current partner. Some common examples include bondage play, pegging and anal. You might think or know your partner isn't into that type of sex, and you're afraid you'll be judged for sharing your desires.
If you two want to begin negotiating these boundaries, discuss what the conversation will look like, as well as when you will have it. This can be a difficult topic for many people for many reasons, not the least of which is past trauma.
Is Flirting Innocent?
Would you be okay with your partner flirting with someone else? Would they feel the same if you did it? Flirting can be innocent, or it can bring up feelings of betrayal.
This topic can get you into hot water and it's something that often comes up in sessions with our counsellors at Sex Therapy Perth.
Even if flirting is harmless, you may need to clarify with whom and where flirting is and isn't appropriate. Can you flirt with friends or coworkers? Are bars and clubs okay? You may be okay with some places and people, but not with others.
Are Emotional Connections with Others a Deal Breaker?
Having different kinds of emotional connections with people is natural and healthy, including friendships and relationships. What happens when you feel sexually attracted to a friend of your gender preference? Is an emotional connection with a man more okay than with a woman? When should you share this information?
Even if you two decide to keep this stuff to yourselves, there's still more to be negotiated. You may agree to stop spending time with people you feel attractions for. You might put restrictions on friendships and relationships, such as only hanging out when in a group or with the other partner.
Some couples agree to spend only a specific amount of time with the friend. Others want to know every time their partner sees, emails, texts, or messages the friend. Some negotiate what can and can't be talked about when with that friend. Can you share about struggles in the relationships, or is that off the table?
Lights! Camera! …Action?
When it comes to spending time with others, especially those you're attracted to, it isn't possible to cover every possible scenario. You probably won't be stranded on a desert island for months with a handsome stranger, for example.
It's possible to negotiate the basics and go from there. Discuss actions ahead of time. Most of the time, it is not better to ask for forgiveness instead of asking permission.
Actions you might want to negotiate as part of your agreement include:
- Social media
- Meeting up for activities such as lunch, hiking, and other hobbies
- Holding hands
- Sharing relationship issues
- Discussing personal problems
What Happens when there's an Outside Connection?
You need to discuss whether what will happen if you or your partner feels a strong emotional or sexual attraction to someone else. Is an open relationship a potential option? Some people want total sexual and emotional monogamy, while others are open to possibilities.
Open relationships require guidelines that you both follow. They require thought, open discussion and agreement if they are to work well. You will need to talk about how you'll deal with jealousy, what is allowed and what isn't, sleeping arrangements and much more.
Sex and intimacy are integral parts of every relationship and negotiating your sex life is a big part of negotiating monogamy. This goes everywhere from sensual touch to how often you make love to how you have sex to whether and how you play with others.
There are many topics that fall under sex, and it would be impossible to list them all. But, we can list the most typical our couples come in to discuss:
- Love-making initiation – who, when, where
- Contraception and protection - condoms or no condoms?
- Sexual acts allowed outside of the relationship and whether details are divulged
- Sex after childbirth – if and/or when
- Lovers of the same gender
- Threesomes, foursomes, orgies, swinging
- Sex when children are home. In the next room? When the baby is in the same bedroom?
- Strip clubs, sex workers and brothels
Falling in Love with Love, or with Someone New?
Falling in love is one of the best feelings in the world, but the meaning of love can get confusing when you love more than one person. Ex-partners and lovers can bring up a lot of feelings, including love and jealousy. Many people get back with exes. Do you want to know if your partner has cheated in past relationships, and do you want them to know if you did?
Does Detachment mean the End?
Everyone knows someone who's fallen out of love. We call it emotional detachment, and it happens more often than couples admit. How do you bring that up in your relationship? Do you try to reconnect afterwards? How? Couples therapy may be on the table. You will also need to discuss how and when you will know it's time to reconnect.
Some level of independence is health in relationships. Each person needs time to themselves, but there is also housework and essential tasks that need to be discussed. This includes childcare, chores, family visits, and finances. Having these discussions now will help you prevent detachment or resentment down the line.
Renegotiation: The Final Frontier
The final step in negotiating monogamy is agreeing upon the conditions under which someone can call a renegotiation. There may come a time where the agreements that you made no longer work and one of you wants a change.
Renegotiation helps avoid breaking rules and breeding mistrust, feelings of betrayal and even the end of the relationship. Discuss when and how one of you may call for your relationship agreements to be renegotiated. It's wise to set a date in the future for you to sit down and discuss how the current arrangements both work for you.
Negotiating Monogamy in Your Relationship
If you and your partner are having a difficult time negotiating monogamy in your relationship, our Perth location offers relationship counselling. Book an appointment with us online, call, or stop by to speak with one of our friendly office staff.
Do you have any questions about negotiating monogamy? Are there any topics you aren't sure how to tackle? We are relationship therapists, so feel free to reach out to us and make an appointment. You can visit our bookings page for more information, we look forward to hearing