An issue with erections

C. asks:

Hello, Dr. Sommers,

I am a healthy 26-year-old in a 1-1/2 year relationship. We have sex 1-2x per week. For the last 8 months or so, I haven’t been able to get an erection unless my girlfriend performs oral sex on me. When we roll around in bed it just doesn’t do it for me. Now I think about getting hard when we are together and of course it doesn’t happen…unless she goes down on me. It is creating a problem in our relationship that is otherwise flawless. I’ve looked into the sensate focus approach but it just seems silly because we see each other naked all the time. She is very good looking and I’m still attracted to her but just not sure why I can’t get aroused kissing her and rolling around naked. Viagra worked for a while but now has little effect helping me gain an erection. I can masturbate with no problem. Do you have any ideas that could help me?

Dr. Sommers responds:

Hi, C.,

You are quite right, as soon as you start thinking (worrying) about any aspect of sexual functioning you are sabotaging your ability to immerse yourself in the experience. Sensate focus can work very well, but in my experience you need a context, which a good therapist can provide. Further, if you have allowed any resentment to build up in the relationship this will interfere as well. My guess, in the absence of a proper thorough consultation, is that your nervous system has become conditioned to respond to oral stimulation. This habituation needs to be stopped. One way may be to start decreasing fellatio (or quit it totally for a while) and use manual stimulation (her hand or yours or both) to become erect, and then achieve intromission, or perhaps still supplying manual stimulation to part of the shaft, or clasping the base of the penis to obstruct venous return, this supporting erection.

Best of luck trying this. If you need a qualified sex therapy referral in your area, let us know.

Frank Sommers, M.D., FRCPC

Notice and Disclaimer:

Answers to questions are provided by a qualified psychiatrist/sex therapist on the understanding that these answers provide education and/or instruction, and do not constitute therapy or counselling. Any person seeking counselling or therapy should consult a local qualified professional.