Men's Health Guide: How to Cope with Sexual Dysfunction and Improve Your Relationship

Sexual life is a crucial component of married life, and harmonious sexual relations serve as a bonding agent to strengthen marital bonds. Many early divorces are due to unsatisfactory sexual experiences.

Male Sexual Dysfunction

According to Professor Ma Yongjiang, a leading authority in andrology in my country, the incidence of male sexual dysfunction in the country is currently as high as 10%. This means that approximately 50 million men nationwide feel ashamed and distressed about their gender, and most of them have not received timely and proper counseling and treatment.

Currently, male sexual dysfunction in my country mainly includes six types: impotence, premature ejaculation, decreased libido, anejaculation, erectile dysfunction, and dyspareunia. Professor Ma believes that men with sexual dysfunction should proactively seek medical help, as a harmonious sex life is an indispensable part of a healthy life. This not only relieves personal suffering but also shows respect for one's wife's dignity. This has absolutely nothing to do with "vulgarity" or "pornography."

Erectile Dysfunction

Erectile dysfunction is defined as the inability to achieve or maintain an erection sufficient for sexual intercourse. It can be classified as primary or secondary: primary erectile dysfunction refers to the inability to achieve or maintain an erection sufficient for sexual intercourse. Secondary erectile dysfunction refers to the development of erectile dysfunction after previously having normal sexual function. Occasional, temporary inability to achieve an erection is normal. If, despite ideal sexual intercourse, the man still fails to satisfy the woman's sexual desires, this should be attributed to a lack of sexual knowledge rather than considering a few unsuccessful attempts (which can occur due to unfavorable environmental conditions, stress, etc.) as erectile dysfunction. In other cases, it is at most a temporary functional disorder. Indiscriminately labeling a man as "impotent" can have serious consequences. Therefore, the term "impotence" should not be used casually. In particular, some wives, due to a lack of sexual satisfaction, may casually say things like "You're stupid," "You're incompetent," or even make the judgment of "impotence" in the heat of the moment. This not only brings shame to the husband, but this "stimulation" can also become a cause of acquired erectile dysfunction.

According to statistics from domestic and international sources, approximately 85% to 90% of erectile dysfunction cases are caused by psychosocial factors, without any disease in the sexual organs themselves. There are many causes of erectile dysfunction, such as sexual repression during individual development, misunderstandings about sex, emotional disharmony, and interpersonal relationship problems. In marital sexual life, the sexual roles of both partners are crucial. If neither partner fully embodies the roles of "husband" and "wife" during sexual activity, sexual dysfunction often occurs.

How can mental and psychological factors cause erectile dysfunction? Suppose that, for various reasons, she missed the optimal age for choosing a partner and met her current husband in her thirties. During their courtship, the conflict between urgency and stability led her to completely dominate the relationship, a position that continued after marriage. Admittedly, her care for her husband was meticulous, down to the smallest detail. This is precisely why the husband developed a submissive mentality; in her, sexual love, romantic love, and maternal love were intertwined. This complex love instilled a sense of awe in him. During their first sexual encounter, the husband had an underlying desire to please, fearing insufficient sexual response, so he tried his best to demonstrate good sexual function. However, because he focused excessively on his sexual ability, he forgot the psychological experience and emotional exchange during sex, resulting in failure. While she secretly sought treatment for him, she expressed some blaming emotions. The husband also felt "incompetent" and desperately wanted to succeed in sexual intercourse, thus creating a major taboo in sexual life—"operational anxiety." This "operational anxiety" manifests as: during sex, the anxiety and tension caused by the fear of failure suppress the naturalness of sexual function, leading to failure; and the failure further exacerbates the anxiety and tension, creating a vicious cycle of "anxiety-failure-anxiety." If this continues for a long time, impotence will develop.

Therefore, erectile dysfunction may not solely be due to the husband's "impotence," but is also related to the wife's attitude. So, what should a wise and considerate wife do? She should refrain from seeking intercourse; instead, she should gently and tactfully dissuade her husband from making futile attempts. At the same time, she should express that she is content simply to be with her husband and receive his caresses. Generally, sexual activity should not be interrupted, but it is precisely this strategy of adopting a passive attitude that often yields the best results.

Below, we quote a scholar's helpful advice for couples where the husband has erectile dysfunction: External conditions (housing, bedding, etc.) should meet the man's requirements. After learning of her husband's desires, the woman can discreetly arrange everything. Sometimes, she only needs to change her own body position to make it more convenient and comfortable for her husband, such as placing a pillow under his lower back or removing the pillow from under his head.

If a husband enjoys his wife touching and stroking his penis, the wife should gladly do so, even if it means overcoming unfounded prejudices. The stronger the stimulation, the more the husband will feel that his wife is doing this for him.

To reduce the husband's difficulty at the start of intercourse, the wife can personally guide the penis into the vagina. This has several advantages: first, the increased stimulation increases the likelihood of an erection; second, the husband avoids the "danger" of failure during penetration; and third, a full erection is unnecessary, especially when the vaginal opening is already open and there is vaginal lubrication (or a lubricant can be used).

The woman's position and actions should encourage the vagina to grip the penis. If the penis slips out during friction, neither the husband nor the wife should get angry, but rather look forward to a better outcome next time. The earlier the next intercourse begins, the greater the chance of success.

The woman should take full responsibility for all the inconveniences related to contraception. Sometimes, the mere thought that the wife is already taking birth control pills can resolve a husband's sexual dysfunction.

The man should not focus on whether or not he achieves an erection, but rather on the woman. He should focus on caressing, enjoying her embrace, and appreciating her body. The less he thinks about erections, the greater the likelihood of achieving one.

The date and time of intercourse should not be predetermined. Since the man's sexual desire is low, intercourse should occur whenever he feels even the slightest desire and there is a possibility of success. Preparation should be completed early. The conditions are complex, but extremely important. For the man, even one successful sexual encounter can potentially solve all the problems.

The duration and intensity of foreplay and other methods of sexual stimulation should be determined by the man's condition, not the woman's desire. The woman will be rewarded a hundredfold for making such a sacrifice.

The woman must skillfully guide the foreplay. While observing the man, she should figure out what truly arouses him and ignites his sexual fantasies (fully naked or partially naked? With the lights on or in dim lighting? etc.). In some cases, the woman's motives may be excellent, but if she reveals too much about them, she may extinguish the spark of desire in the man.

The more care and consideration the woman shows, the easier and faster the man's sexual desire will be restored. The woman should reassure the man that he will not be sexually impotent, while also not showing that her patience has run out. In short, her behavior should not give the man the impression that everything is deliberately planned and prepared.

The above discusses adjustments to the couple's sex life after erectile dysfunction occurs, focusing more on the woman taking the initiative to eliminate the man's anxiety and tension. All of these are worth trying.

From a psychotherapeutic perspective, it's crucial to help men with erectile dysfunction understand that willpower alone cannot achieve an erection, as it's a reflexive response. Many men with erectile dysfunction experience this firsthand, but preventing them from attempting to induce an erection through various mental or physical methods is extremely difficult. As treatment progresses, they will discover that erections occur precisely when they don't think about them or have no intention of achieving one.

A closely related issue is that many men with erectile dysfunction, once they achieve an erection, are eager to engage in sexual intercourse, fearing they will miss the opportunity. As a result, increased mental stress and renewed anxiety lead to a rapid loss of the erection. In such cases, when the penis responds to sensual contact and remains erect, the woman should intentionally stop stroking the penis, allowing the erection to subside. The man will then have the opportunity to see and regain an erection upon re-engagement.

After undergoing "sensate focus" therapy and achieving sufficient erectile function through caressing and aimless touching, both partners should extend the principles of "sensate focus" to genital contact. If possible, penile insertion into the vagina should be performed in a woman-on-top position, with the woman inserting the penis. This reduces pressure on the man, as he doesn't need to decide when to insert. Furthermore, in this position, it's easier for the woman to insert the penis into the vagina. In this way, most of the two potential distractions for the patient with erectile dysfunction are eliminated. After the above treatment, the patient should be informed that erections may sometimes subside during sexual activity, but it should be remembered that erections are a reflex, and their intermittent nature is normal.