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Many men experience performance problems at some point in their lives. Help him tackle the issue and get your sex life back on track. Susan Quilliam outlines the most common problems
Erectile dysfunction
What is it?
Commonly known as impotence, erectile dysfunction (ED) is the inability to get an adequate enough erection to have intercourse
Why does it happen?
Temporary ED is very common in young men, especially when they're anxious or have drunk too much alcohol. Smoking and some blood pressure and antidepressant drugs can cause impotency. Long term ED can be a combination of physical and psychological causes. ED may be a symptom of an underlying medical condition that requires treatment, the most common cause of which is diabetes.
What should he do?
The most important thing for him to do is relax - reducing anxiety often solves the problem. If this doesn't work, the next step should be a check up at the GP, as the problem may well be physical. If the ED is a symptom of a medical condition, such as diabetes, it's important to get a diagnosis. Your doctor will also be able to advise on treatments for ED such as Viagra and sex therapy.
How can you help?
Don't start blaming yourself. It's unlikely that his inability to get an erection is because he doesn't fancy you or he's having an affair. If your relationship is going through a bad patch, you should work at getting it back on track. If your relationship is fine, try not to add to his problems by worrying and getting upset.
Premature ejaculation
What is it?
PE is when your man comes so quickly that there's no pleasure in it for him - or for you.
Why does it happen?
What underpins PE is a man's inability to hold back his climax. Sometimes that's down to sheer arousal - he's so excited he can only hold out for a short period of time. But with really serious PE, a man might have such a hair-trigger reaction that he comes before he even touches his partner.
What should he do?
One way forward is for him to climax before intercourse - the second time he's more likely to be able to hold back. He also needs to learn to spot his body's signals leading up to orgasm, so he can take action. The best way is through practice. For a few weeks, he should regularly masturbate nearly to climax, at which point he should stop - then start again - thus learning to control his orgasm.
How can you help?
There's a neat trick you can try - during intercourse or masturbation. When he's about to climax, grip his penis firmly using two fingers and thumb of one hand - with your thumb underneath your fingers. Apply firm pressure until his erection subsides slightly - then you can both carry on.
Delayed ejaculation
What is it?
If a man has too much control over his climax, he may not be able to orgasm at all.
Why does it happen?
DE often happens with age - as men get older, they can take more time to come. Sometimes there's a physical basis for the problem, such as colostomy, spinal injury, multiple sclerosis or certain forms of medication. One of the main causes, though, is that a man is simply over-controlling his orgasm and can't let go.
What should he do?
If the problem's suddenly kicked in, it's more likely to be down to a single, physical, cause - so a GP check-up is necessary. But if your man has always had difficulty with climax, it may be that he is feeling anxious about sex and the relationship, and can't relax enough to climax during lovemaking. In this case, relationships counselling or sex therapy can help.
How can you help?
Your partner may find it useful to practise climax through masturbation; the more confident he is, the easier it'll be for him to orgasm during intercourse. If you feel able, you can help a lot. Start with him masturbating while you're in the room - back to back if he feels uncomfortable. When he can do this without nerves, join in by masturbating him yourself. Once he's really confident and relaxed with that - which may take several weeks - move on to intercourse.
Loss of desire
What is it?
When he's rarely or never in the mood for sex.
Why does it happen?
Loss of desire can be down to tiredness, stress and illness. Medications such as antidepressants and anticonvulsants can dramatically lower desire. But of all the sexual problems a man might have, loss of desire tends to be caused by emotional issues. A man who's feeling down about himself or about the relationship may not want to open up enough emotionally to make love.
What should he do?
Once he's ruled out medical causes, he needs to be honest with himself about his life - and willing to take action to solve any life problems. If work is stressful, he might need a job change. If he's been under family pressure, he might need to build bridges with certain relations. If the two of you have been having a hard time, he'll need to face that and work it through.
How can you help?
Try not to blame your man. Of course you may feel rejected because he doesn't want to make love - but nagging won't help raise his desire level. Instead, encourage him to open up about any emotional problems - listen, sympathise, support and perhaps suggest counselling. If the two of you are having problems and he won't go to counselling, go yourself; a couple can make progress if even just one of them goes to therapy.
Resources
The three major resources you may need to sort a sexual problem are:
Medical advice. See your GP or call NHS Direct on 0845 4647.
Relationship counselling. Relate is the main counselling agency for Britain. Visit www.relate.org.uk.
Sex therapy. This is counselling targeted at sexual problems - and it has a great success rate. Have a look at BASRT and also Partner Therapy or Emotional Bliss.
Talk about your health problems with other iVillagers on the Your Health message board
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