There aren’t a lot of subjects that make men feel more uncomfortable than talking about male sexual dysfunction, but I have no filter and I don’t think there should be taboo subjects we don’t talk about, so I’m going to talk about it anyway, including some of my own experiences.
Pressure to perform
When it comes to heterosexual sex, the burden of initiating more commonly falls on men. Men act and women respond, not always but it’s certainly more prevalent. Men want to please their partners, they want to feel that they’re sexually attractive to their partners and that they satisfy them. With that can come a lot of pressure and anxiety.
He might worry about climaxing too soon or not being able to get an erection or whether he can make her orgasm, whether her previous partners were better lovers. If you think about all the jokes about men not being able to please their partners and the unrealistic expectations from pornography. It can be a bit of a minefield.
Of course women can feel pressure to perform too. Maybe she feels like she has to engage when she’s not in the mood. Maybe she worries that he might run off with another woman. She will worry about her body and if he finds her attractive and she might internalise it if he is having problems with premature ejaculation, erectile dysfunction or low libido.
Sex is an important part of a relationship. It bonds a couple together and makes them feel connected. Orgasm causes a flood of feel good hormones to be released into our bodies, oxytocin, that makes us feel bonded and dopamine that triggers our pleasure receptors and serotonin that makes us feel happy.
It’s a very natural thing and as normal as eating, drinking or breathing yet some how its personal nature makes us feel uncomfortable about talking about it, especially if there are problems.
Premature ejaculation
According to the NHS, premature ejaculation is where a man ejaculates (comes) too quickly during sexual intercourse but what does that actually mean?
How do you define “too soon”? That’s a very subjective call. Does it mean before penetration? Does it mean before a certain amount of time that is deemed acceptable or does it mean before his partner has reached orgasm?
According to this article, penis in vagina sex typically lasts between three and seven minutes, does that mean sub three minutes is premature ejaculation?
What if you take the barometer of your partner reaching orgasm? According to this article, only 25% of women consistently reach orgasm through penetration alone and only about half of women sometimes have orgasms through penetrative sex. 5% never have orgasms at all.
It seems to me that this is less a medical condition and more about the pressure men feel to meet unrealistic expectations. That is not to say that men shouldn’t care about making their partners feel good, there are multiple ways that can still be achieved even if it isn’t directly through sex. Most women enjoy clitoral stimulation. It’s all about both partners getting to know what works for them and enjoying the journey together, the responsibility should not just fall on one partner, it should be a shared experience.
When I was younger this was something that worried me a lot. Sex lasted a fairly average amount of time but I felt like I should be lasting longer and I would sometimes use desensitising gels but they would sometimes make it more difficult to keep an erection.
Now I’m older and better educated I’ve learned to just accept sex for what it is and just enjoy it without worrying too much.
Erectile Dysfunction
Erectile dysfunction is when a man is unable to achieve or maintain an erection for long enough to have sex with a partner. It can be caused by lots of different things. Sometimes it’s psychological, perhaps previous sexual abuse, performance anxiety or stress and depression. Sometimes the cause is physical. It could be circulatory or heart related problems so it’s important not to ignore it if it persists over a period of time.
Women will sometimes interpret this as him not being attracted to her, which only exacerbates the problem. The best thing to do if your partner suffers from this problem is to offer affection and assurance.
Viagra or equivalent medications can sometimes help but they only help when the problem is a physical one, not a psychological one and psychological issues are more common. For some men, the placebo effect of thinking that they’re taking something that will solve the problem will work but there are a lot of unrealistic expectations about what these pills actually do and what the results will be and that can leave men feeling even worse about their bodies.
Male body dysmorphia is a subject that is starting to get attention but it’s still poorly understood and seldom talked about.
I’ve never really had problems getting or maintaining an erection but there was a time where I found myself unable to ejaculate, which is not ideal when you’re trying to make a baby at the time. I would fake orgasm rather than admit it just wasn’t happening. In the end I worked out that it was anti-depressants causing the issue and within a couple of days stopping taking them my body’s response was back to normal. I’ve tried a few different anti-depressants and they all seem to have the same effect so I “came” (pun intended) to the conclusion that the psychological impact of sex was better for me than the anti-depressants anyway.
Funnily enough, in the Victorian era, women were often diagnosed with a mental health condition they referred to as hysteria. The cure was prescribed orgasms and in fact, the demand for the prescription service was so high that eventually doctors got tired of administration and invented the world’s first vibrator instead so I’m not the first person to observe the mental health benefits of sexual activity. You can read about this, and a film covering the topic here.
Low libido
There is an assumption in society that men want sex all the time. Men, on average, do have higher sex drives than women on average and that is because in both sexes, testosterone plays a big role in sexual desire and men produce as much as ten times more testosterone than women.
This assumption can sometimes lead to female on male sexual assault not being taken seriously. It can also cause problems in relationships. In Michele Weiner-Davis book, the sex starved marriage, she describes low male libido as one of our very best-kept secrets.
It may be temporary, it may be a psychological factor like depression, stress, anxiety or even just tiredness but for some men, they just don’t have a strong desire for sex, which can make their partners feel neglected or unfulfilled. It can be harder for a woman to understand if they’re used to previous partners that have all had higher sex drives. Men are much more used to being in the position of having to initiate intimacy and getting knocked back. It’s much more difficult for a man to have sex if he is not in the mood than it is for a woman, an erection is essential and sometimes we conflate an erection with consent to sex and those two things are not the same either. Erections can happen at embarrassing times for men, especially when they are younger.
For men with a low libido, it’s important to find out why. It could be a previous negative experience that needs to be dealt with, feelings of shame or guilt or it could be that he needs a more gentle approach to get him in the mood. Drugs, alcohol can effect libido too.
Infertility
It seems to me that people that don’t want to have children are often very good at reproducing yet other couples that desperately desire starting a family have much more trouble. Infertility can be very cruel.
Not being able to conceive a child can make men and women both feel like failures. it challenges our own sense of masculinity or femininity. It makes us fear abandonment by our partners and can cause arguments. No man, even a man that doesn’t want to have children, wants to be told his body is not producing high enough quality or quantity sperm to make a baby.
It can be a bitter pill to swallow, especially as a man watches other men in his age group become fathers. It’s not something we like to talk about.
When my wife and I started trying for a baby I took a fertility test that came back with not a great result but we actually ended up getting pregnant within three months, unfortunately we miscarried the baby and subsequent failed attempts to get pregnant made me feel inadequate to the point where I had to give up for my own mental health.
At the time, comedian Rhod Gilbert presented a documentary discussing his own experiences with infertility. It’s a much more widespread issue than we care to admit.
Porn addiction
Being addicted to anything is bad. If a behaviour becomes so compulsive that it takes over and prevents participation in a functional life, then it is a problem.
These days porn and sexual imagery is everywhere and often children are exposed to it before they have the maturity to handle what they’re dealing with. For some men, it can become addictive and prevent them from forming normal healthy relationships with the opposite sex (or the same sex if that’s what they’re attracted to).
Like many addictions, it often requires increasing stimulation to maintain the same level of dopamine release and that can lead to more risky behaviour.
I’m no prude. I do not believe that pornography should be banned, for many consenting adults it can be useful. I do not believe that the human body is something people should see as shameful or dirty. Sex is part of life and I see little difference between visual forms of pornography that are often preferred by men and literary erotica often preferred by women. 50 shades of grey did not become a best seller for it’s deep storyline or the quality of the writing, it simply tapped into a common female sexual fantasy. We are sexual beings and there is nothing inherently wrong with that.
Cultural Stigma
Lots of the things I’ve talked about in this article are the butt of jokes in our society. It’s actually healthy to laugh at things we can’t control at times. I’m a fan of gallows humour but I’m not a fan of sexual shaming. We should be more empathetic, more understanding and less cruel and we should talk about these issues more so people know that they’re not on their own in what they’re going through.
Everyone has something they don’t like about their body. It takes courage to admit it but the more we do, the less power these things can hold over us.
Rant Over 