What Kind of Sexual Problems?
Dr. Sheafe, first, let me unequivocally state that I enjoyed having sex, however I believe that I am experiencing problems. I am involved in a new relationship and the drive that I normally feel is not quite there. I have not talked to my new girlfriend about it yet because I am not sure if things will get better. I would like to know what causes sexual problems.

“Normally a Stud Muffin’”
Pueblo, Colorado

Well Stud Muffin, I am going to assume that you’re better at sex than you are at asking questions! What exactly does “experiencing problems” mean? What kind of problems? Mental problems…erection difficulties…other physical ailments…for how long? Mr. Muffin, do you understand my dilemma! You haven’t told me anything specific so I don’t have anything to work with. I am forced to give a broad-spectrum answer to your vague question but I’ll give it a shot!

There are as many causes for sexual problems as there are humans and they are just as varied and complex. Some may be simple and stem from a reversible physical problem. Others can be caused by serious medical conditions, difficult life situations or emotional problems. Some have a combination of causes. There are many issues that can contribute to sexual problems; relationship problems can cause people to not communicate their sexual needs or wants to their partner. Emotional problems such as anxiety and depression can also affect sexual functioning. Lack of knowledge about sexual stimulation and poor communication between partners can also be the issue. It is important to address your feelings. Do not allow too much time to pass before you begin to communicate about the issue. Opening the dialogue can began with something as simple as discussing how she is experiencing sex with you. Converse honestly and openly and express your concerns. Ask for her input and get feedback. Even if there is a problem, things have a chance to improve and get better if you take the first steps: converse, communicate, convey & connect!


He’s Avoiding Sex at All Costs!
Dr. Sheafe, I have been married to my husband for over 14 years. Over the past 2 years he avoids intimacy at all costs. He has come up with every imaginable excuse to avoid having sex with me, some are really classic: I forgot to walk the dog…I have to sit in the den because my acid reflux is acting up (this would be a pretty good one but he doesn’t suffer from acid reflux)…I hear a rat in the attic let me check the trap. I mean this man must think I’m really a dummy. I’m sure he is not cheating on me because I’ve followed him and I check his emails and cell phone. I think he’s incapable of rising to the occasion and too ashamed to say anything. This is obviously a problem for me. I’m only 36 years old and still hot to trot. I was listening to a few women on speaking about this, but I was embarrassed to ask about it. I think this may be my husband’s problem. What is erectile dysfunction and what can I do?

“Hot to Trot”
Greenwich, Connecticut

Well Hot to Trot, from your statements, I’m not convinced that erectile dysfunction (ED) is his problem. He might be going to the attic or the den to fantasize and masturbate about someone else. Maybe you are the problem. First, why are you following him and invading his private space by checking his emails and phone calls. Isn’t this slightly childish after being married for so long? Have you done all you can do to keep your sex life exciting. Are you grossly out of shape? Do you walk around the house in unattractive house coats? Is your mouth or your nagging a turn off? After 14 years of marriage for most couples certain complacency arises that starts to seem normal until situations like this arise. I would first take a look at those things instead of jumping to the conclusion that he has a physical problem. Now, if erectile dysfunction is the actual problem then he has to visit a physician. With the new medications, for most men this is a relatively easy fix. Perhaps the most publicized advance was the introduction of the oral drug Viagra in March 1998. ED is treatable at any age and more men have been seeking help and returning to normal sexual activity because of improved, successful treatments for ED.

To specifically answer your question, ED sometimes called "impotence," is the repeated inability to get or keep an erection firm enough for sexual intercourse. Impotence may also be used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm. Using the term erectile dysfunction makes it clear that those other problems are not involved. ED can be a total inability to achieve erection, an inconsistent ability to do so or a tendency to sustain only brief erections.

In older men, ED usually has a physical cause, such as disease, injury, or side effects of drugs. Any disorder that causes injury to the nerves or impairs blood flow in the penis has the potential to cause ED. Incidence of ED increases with age. However, it is not an inevitable part of aging.


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