Sexual concerns in relationships are common and can affect emotional closeness, communication, and self-esteem. Exploring these issues can lead to healthy, respectful, and fulfilling connections.
Common Concerns
Little or no desire for sexual relations
Different levels of desire for sex between partners
Disgust or distress with having sex or even thinking about it
Failure to become aroused before sex and/or the inability to stay aroused until the sex act is completed
Impotence in males. This means not being able to sustain an adequate erection.
Premature ejaculation in males. Ejaculation comes too quickly and both partners are not satisfied.
Delay in or absence of orgasm in either the female or male
Pain during intercourse
Painful, sustained erection
Causes
Psychological factors. Examples are:
Sexual trauma from things, such as rape, incest, past sexual embarrassments or failures
Worry or anxiety about sexual performance
Guilt or inner conflicts about sex, such as when a person’s sexual needs, wishes or thoughts go against family, religious or cultural teachings
Depression
Relationship problems and/or lack of communication of wants and needs between sex partners
Feelings of inadequacy
Physical conditions. Examples include disorders that involve:
The heart and blood vessels. Less blood can flow to the genitals. Even the arteries and veins in the penis can be involved.
The nervous system, with a condition like multiple sclerosis.
The body’s glands, such as with diabetes.
The use of any substance that alters the sexual response. These include some medications including some anti-depressants, drugs, alcohol and/or smoking.
Surgery. For example, prostate surgery can result in impotence.
Injuries, such as ones that cause damage to nerves used in the sexual response or that result in scar tissue that interferes with sensations felt during sex.
Treatment
When a physical condition is found that causes the sexual concern or problem, treating it can get rid of or help with the problem. For example, several treatments exist for impotence. These include:
Oral medications, such as Viagra, Levitra, and Cialis
Special vacuum devices
Self-injections of a prescription medicine and penile implant surgery for men
If no physical condition is found to be at fault, measures to deal with psychological causes can help. These include therapies of many kinds:
Individual counseling
Counseling with both partners
Sex therapy
Behavior therapy
Men Only:
Women Only:
Men & Women:
Self-Care
Exercise regularly.
Get enough sleep.
Eat healthy foods.
Follow your doctor’s advice if you have a chronic illness, to help prevent possible problems with sexual satisfaction.
Practice safe sex to prevent sexually transmitted diseases.
Don’t ignore signs of illnesses.
Limit alcohol and other drugs. A little alcohol can act as an aphrodisiac. Too much, however, can lead to unsafe sex, an inability to become aroused, violent behavior, etc.
Use lubrication to improve vaginal dryness and avoid painful sex.
The following things can help enhance the desire for sex:
Make a point to spend at least 15 minutes of uninterrupted time with your partner each day. If you can’t meet face to face, call each other.
Remember to express affection every day.
Plan to spend part of a day alone together at least once a week. Make a date to take a walk, go out for dinner, or do activities you both enjoy.
Schedule a weekend away together.
Go to bed together at the same time. Tell yourself that what you haven’t accomplished by a set time can wait until the next day.
Relax by giving each other a massage or taking a shower together.
Don’t worry if your sexual encounters occasionally fail. Fatigue and stress are known to cause temporary impotence, a decrease in vaginal lubrication or the inability to have an orgasm. Don’t let yourselves become preoccupied with performance. Take pleasure in being together. Enjoy hugging, kissing, and caressing.
Question 1
Does impotence occur with any of the following?
Prostate surgery
Medication for: High blood pressure; Allergies (antihistamines); Depression; Anxiety; Muscle relaxation; Any other prescriptions or over-the-counter medicines
Drugs. Excessive use of alcohol. Cigarette smoking.
Question 1
Is intercourse painful with or without any of the following?
Heavy, painful periods. Abnormal bleeding from the vagina. Itching and burning around the vagina. A yellowish-green vaginal discharge.
Chronic pain in the abdomen or a dull and constant ache on either or both sides of your pelvis. A large, painless ulcer-like sore (chancre) or painful blisters in the genital area, anus or mouth.
Question 1
Does it hurt to have sex and are any of these present?
The urge to go to the bathroom very badly or passing urine a lot more often than usual. Burning or stinging feeling when passing urine. The feeling that the bladder is still full after voiding.
Bad smelling urine. Bloody or cloudy urine. Pain in the abdomen or over the bladder. Stomachaches or feeling like throwing up.
