Topic: intimacy

Question: Why can't I get an erection with my girlfriend?
I love my girlfriend so much. I get an erection even just thinking about her or seeing her. But the two times we tried to have sex I couldn't get an erection. We've only had sex once and it was a long time ago.    Why this is happening and what can I do about it?

Answer (from Brandon CoussensCouples Counseling, Premarital Counseling and Sex Therapy):
I want to be short and brief about this. First, If you can achieve a good erection at anytime without your girlfriend, your penis is fine. However, erections work through getting enough blood flow to the penis. If you are having any sort of mental related concern (anxiety, depression, stress, etc) it can cause your blood vessels to constrict and keep your penis from becoming erect. After reading your concerns, my questions would be: What are you thinking about right before and during sex?" "Do you feel anxious or nervous during that time?" Have you ever experienced not getting an erection before?" I am assuming it has do to with what you are thinking and their is a certain amount of anxiety you are having during or right before sex. If you want to work this out, I would encourage you to work on your thought process and learn to relax your mind and your body (meditation/relaxation exercises). Focus more on enjoying the experience through your 5 senses. What do you smell, take it in and enjoy it. What do you hear, take it in and enjoy it. What do you see, take it in and enjoy it. What do you feel, take it in and enjoy it. Calm yourself! Not having an erection is not the end of the world and happens all the time to men. If you freak out about it, it will happen more. Just relax, believe it is normal and try again and ENJOY the beauty in front of you!

Answer (from Cimberly R. NeskerRegistered Psychotherapist (3579)):
Sexual desire seems to be straightforward - I like someone and I become aroused at the thoughts of being intimate with them - but that idea does not always take into account other factors. Stress can have a huge effect on our body and how it performs.  When we are overstressed, for example, we often find ourselves ill at the same time.  Can you think of any part of your world that may be causing you some additional stress? Additionally, focusing on your erection may also be increasing the level of stress you feel about being intimate, which could also effect your ability to get and maintain an erection.  While this may seem counter intuitive, it makes sense in the word of stress!Finally, it's never a bad idea to follow up with your doctor, as well. You did not mention your age or sexual history outside of this relationship, but it is always a good idea to check in with medical staff to make sure there is nothing physically responsible for changes in our body, as well.

Answer (from Frank TheusMA, LPC, NCC, CSAT):
First off, I want to acknowledge the emotional pain you must be experiencing about not being able to experience an erection -- you're not alone. And, it took a lot of courage for you to post your query here. Below you will find excellent advice from skilled clinicians regarding your question and concern. If you haven't done so already I'd encourage you to checkout the Mayo Clinic's website on this very topic (http://www.mayoclinic.org/diseases-conditions/seasonal-affective-disorder/basics/definition/con-20021047).Once you've ruled out any medical-organic issues with either your PCP or Urologist I recommend you work with a Certified Sex Addiction Therapist (CSAT) and/or Certified Sex Therapist (CST) and do some psychotherapy around attachment/family-of-origin, intimacy, self-image, trauma history, sex history, pornography, etc. ). There is hope.

Answer (from Todd Schmenk, M.S., M.Ed.AQAL Therapies, Inc.,):
This is something I have
had to address with individuals often since working with couples is one of my
practice's focuses.  The answer can depend upon several reasons all which
tend to be explored while in session.  If you or your counselor utilizes
an integral approach, in which one of the main premises makes sure to check the
four irreducible perspectives (subjective, intersubjective, objective and
interobjective – also known as the four quadrants) in determining where the
challenges are, it then becomes possible to identify what might be contributing
to or causing the challenge as well as offering up ways to address the
situation.In this case, from the upper-right
or behavioral and physical perspective, we would want to make sure there is no
physical limitation or ailment meaning that you would need to visit your doctor
and have the basics checked (such as blood pressure.  We would also look at particular behaviors to
see if you are doing something with is effecting performance (such as
masturbating often or being influenced by pornography). Next we would look at the
upper left quadrant (thoughts, cognitions, identity, feelings) to look at what
is going on here both during sexual activities and at other times.  If you are worried about your job, your
family or under immense pressure to perform at work or while intimate, this can
contribute to your situation.  From there
we would turn to the lower left quadrant (cultural rules and tools) to see who
you have learned to interpret challenges that come up during sex and look for
ways to shift, update and/or reshape the way you view sex and its
challenges.  It would be here that we
would see whether one is even comfortable using a service like counseling based
upon how your family/culture of origin views the profession. Finally, we would need to
account for challenges that show up in the lower right quadrant (systems, laws,
rules of society) such as your economic ability to try services and products as
well as whether such services and products were even available.  Once we have rolled through these areas it
then becomes possible to look at which aspects might need to be looked at
further in a more meaningful way to help you change a perspective or if just
getting a blood pressure medication is all you need.To sum your question then
of why you can’t keep an erection we would need to look at your thoughts (look
at your actual thoughts during the act as well as before and after), look at
your behaviors, look at your physical body for issues, look at where you picked
up your rules and tools (culture) and look at your ability to access goods and
services.  They all contribute equally
and need to be taken into account.  So - as you can see, there is no one possible answer to this, but several.  I hope this helps.

Answer (from Dr. Meredyth LawrynceServing Clients Nationwide):
This issue could come from any variables. The pressure of being satisfying, or if you have experienced anytension. Do you have any uncomfortable thoughts or is anything from your past coming up?  Had you been socialized to believe certain things or did new beliefs come up?  What were your models of healthy relationships?  Was anything of substance coming up around the time this began? Some have found acupuncture to be helpful or even the Emotional Freedom Technique (EFT).