Partner can't maintain erection for intercourse

Originally Published: June 22, 2001 - Last Updated / Reviewed On: June 12, 2006
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Dear Alice,

My husband is suffering from erectile dysfunction. He has been to many doctors, including a urologist, neurologist, orthopedist, you name it. After many diagnostic tests, it seems that nothing physical can be found. He used to have full erections almost daily. Now nothing. Although he can get hard, he cannot maintain enough for intercourse. What can we do at this point?

Desperate For Answers

Dear Desperate For Answers,

It can be difficult and frustrating for men and their partners to cope with erectile dysfunction, especially when the cause is unclear. At this point, it is important to be supportive and understanding of the situation and of one another. Erectile difficulties can cause feelings of inadequacy in both men and their partners. Each may internalize the situation, fearing that s/he is the one to blame. Therefore, open and honest communication with one another is an essential ingredient in strengthening your relationship as you work through this situation together.

Some men experience erectile dysfunction as a result of physiological factors, including medications that can interfere with sexual response, chronic illness (e.g., heart disease, high blood pressure, diabetes), physical disability, alcoholism, drug use, or injury that impedes blood flow to the erectile tissue. High cholesterol, which can limit blood flow through the atreries that supply the genital area, can also be associated with erectile dysfunction. For others, psychological concerns, including stress, anxiety, self-esteem, or fatigue are the source. Researchers believe that for many men erectile dysfunction is caused by a combination of physical, psychological, and cultural factors.

You mentioned that your husband's penis gets hard but that he cannot maintain enough of an erection for intercourse. A health care provider may want to know, does your husband have firmer erections:

  • during sleep or when he awakes?
  • if and when he masturbates? 
  • while engaging in other behaviors besides intercourse? 

The answers to these questions, as well as physiological tests like an ultrasound or neurological assessment, can help determine the root cause of ED. Depending on the cause, different treatment options are available. Treatments range from medication, to hormone replacement therapy, to vascular surgery, to sex therapy and/or couples counseling. It sounds like you have ruled out many physical factors, in which case it may be useful to consider psychological factors. Often, couples counseling and/or sex therapy (as a couple or individual) can identify factors related to ED, help with communication, and improve sex for both partners. For a sex therapist, check out the American Association of Sexuality Educators, Counselors, and Therapists (AASECT) web site and click on the "Locate a Professional" link.

For more information, check out the related Q&A below. And while you're determining the cause of your partner's ED, you can still be intimate with activities other than intercourse that you both enjoy. As an exercise, you can try focusing on non-genital sensations, such as kissing and cuddling. You can also pleasure by caressing, touching, and stroking one another, having oral sex, or incorporating sex toys into your sex play. What non-intercourse intimacies do you enjoy? What about your partner? Have you discussed all the things you like that don't require an erection? Enjoying each other's company might give you both the emotional support and physical intimacy you need to help maintain a spark and eventually get the fire going again. Good luck,

Alice