AAMFT Consumer Update
Male Sexual Problems

Couples today expect more out of sex and intimacy than in any point in history. As we live longer our expectations for conjugal bliss continue to grow, far exceeding those of prior generations. Current divorce rates highlight how rarely our expectations are fulfilled. So if you are like most people— you are having sexual difficulties or simply want better sex and intimacy—you will be interested in what follows.

The good news is that men with sexual difficulties can anticipate more acceptance and better options than ever before. This has come about, in part, by women openly acknowledging their own sexual problems (e.g., lack of arousal and lubrication, difficulty reaching orgasm, low desire, and pain during sex). Likewise, more men today recognize the terrible burden of traditional male stereotypes. And more women refuse to silently endure years of frustrating and non-intimate sex the way their mothers did. For these and other reasons, couples today are increasingly open to new sexual information and/or consulting a therapist. Here is information about both:

Men’s Sexual Problems

In the narrowest sense, male sexual difficulties involve getting or keeping an erection, ejaculating too rapidly, or difficulty reaching orgasm. What is hard enough, fast enough, and time enough (or too long) is best decided by the people involved, rather than by a clock or some arbitrary standard. When you are deciding, keep the following in mind:

• Most men experience difficulty with erections, rapid ejaculation, or delayed ejaculation at some time, and this is entirely normal. When it is frequent or pervasive, one partner or the other usually decides this is a "problem."

• Uneven sexual desire and dissimilar preferences in sexual style are normal and inevitable in long-term relationships. It is how you handle these that makes the difference.

• Do not confuse the average guy with the Energizer © Bunny. Many men have low sexual desire, too. Just like women, lots of men know what it is like to feel pressured by their spouse’s larger sexual appetite.

• Men’s sexual difficulties usually decrease intimacy, too. When either partner has frequent dysfunction or low desire, both partners eventually retreat during sex into separate mental worlds of worry and frustration. Mind-reading during sex is not quite "the most intimate thing two people can do."

Sexual Difficulties Are Normal

You do not need sexual dysfunctions to fall into this, either. Sexual boredom, lack of intimacy, low desire, and passionless sex are common and inevitable developments–potentially, mid-stages in the evolution of your relationship. Underneath common sexual difficulties, the natural processes of self-development are often playing out. While not enjoyable, they do not necessarily mean something is going, or has gone, wrong. Knowing this can help you relax and appreciate your relationship in new light.

Actually, sexual difficulties can be "beneficial" if you heed them as a wakeup call: There is more to sex than removing inhibitions or learning new techniques, and a great many things cause sexual performance problems and low desire. Do not blame everything on "hang-ups," sexual incompatibility, or the signs of aging or disease. And do not reduce current sexual problems to things from the past—it may be the natural growth processes of your relationship at work in the present. To get the sex, intimacy, desire, and passion many of us want, there is a lot of growing up to do.

Embarrassment is understandable but neither necessary nor helpful. Part of growing up involves addressing sexual difficulties like an adult. When men finally realize the real issue is not about sex, but rather, about whether they will continue to apologize for themselves, they often step forward as acts of personal integrity. At its best, resolving sexual difficulties helps both partners see themselves and each other in some new way. This process deepens your capacity for intimacy and strengthens your bonds of love.

Sexual "problems" can turn out to be odd blessings. When things finally become insurmountable and intolerable, some couples seek a therapist who helps them have better sex, intimacy, and a better relationship than they had before their "problem." Some of my own clients, initially embarrassed about seeing a therapist, proudly revealed what they learned to a trusted friend or a valued grown child.

Treatment Options

Men with sexual difficulties in prior generations had fewer options available. Treating erection problems with surgically inserted silicone rods, vacuum pumps, and injecting drugs into your penis left much to be desired. Early versions of sex therapy seemed mechanical and technique-oriented to many couples, too. Today, erection difficulties, rapid ejaculation, delayed ejaculation, and low desire are all treatable problems. Advances in intimacy-based sex-and-relationship therapy and more convenient medicines, like Viagra, offer far more effective and pleasant solutions than ever before. Even now, new medical miracles are on the horizon. But better genital function alone will not solve problems lying dormant in your relationship. There can still be some relationship repair to do.

When To Get Help

You probably do not have to worry about seeking help prematurely–the overwhelming tendency is to struggle along in secrecy for as long as possible. If things do not seem to be getting better, a marriage and family therapist can often be of help (especially one trained in treating sexual difficulties). It is always appropriate to consult your physician for a medical evaluation, too. Therapists can collaborate with physicians when medical treatment is indicated.

Parents’ Sexual Relationship is a Family Matter. Parents’ sexual relationships are and should be private, but their impacts on their families—both bad and good—never are. Imagine a man who struggles with rapid ejaculation, or erectile difficulty, or decreasing sexual desire. Ask yourself: Is he more likely to over-react to normal authority challenges from his adolescent son, or to downturns in his income, or to his wife starting a new career?

Children monitor their parents’ relationship with a hawk-eye. Lack of affection between Mom and Dad is as big an event as walking in on them smooching. When parents have a solid emotional and physical relationship, the household ambiance makes everyone more available to each other. Kids may complain about parents getting "mushy," but they are being blessed with a wonderful template that serves well in later life.

References and Resources

Passionate Marriage: Keeping Love and Intimacy Alive in Committed Relationships. By David Schnarch, Ph.D. Owl Books (1998). This book describes couples’ bedroom behavior and therapy sessions to show how sexual problems can trigger personal growth and enhance intimacy eroticism, and desire. A revolutionary look at adult sexual relationships with specific suggestions for couples.

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Marriage and family therapists are mental health professionals who treat a wide array of disorders, working with individuals, couples, and families. Marriage and family therapy clients report that they are highly satisfied with the services they have received, and research shows that marriage and family therapy is a cost-effective, short-term, and results-oriented form of treatment.

The American Association for Marriage and Family Therapy (AAMFT), the professional organization representing marriage and family therapists, believes that therapists with specific and rigorous training in marriage and family therapy provide the most effective mental health care to individuals, couples, and families. This brochure is courtesy of:
the AAMFT.

Visit the AAMFT TherapistLocator.net, a public service of the AAMFT. There you will find information about a range of problems facing today's families, and you can search for a qualified family therapist in your area.