Men’s Sexual Problems

Men’s Sexual Problems

Men, in general, talk about their sexual conquests but not their sexual concerns. They tend to keep up the strong male image, including the impression that they are fantastic in bed and that they have no problems (except they “can’t get enough”). Yet, males usually feel responsible for sex – for approaching the woman, arranging the place, skillfully handling the foreplay, and producing both orgasms. Moreover, too many macho males think sex is all that really matters in a relationship; sharing feelings and problems, being tender and caring, doing things together that she likes to do, getting to know each other deeply, etc. are seen too often as silly women’s stuff. These men just don’t get it: good loving is not in the penis, it is in the heart and the mind. If sex were just coming to a climax, then we’d just masturbate. Sex is a mental-interpersonal process, not just a brief physical act. With males having all these responsibilities, misconceptions, and sexist attitudes, the truth is men have a lot of sexual problems.

The males who have a hostile, chauvinistic attitude towards women are responsible for much of the rape, abuse, and harassment of children and adult women. About 2 million girls are sexually abused by a father, brother, or other relative every year, another 3 million by rapists and child molesters. By 16, 20% of all girls have become victims of incest. In addition, about 25% of all college women become victims of rape or attempted rape, 60% of the time it was on a date. These statistics reflect very serious sexual-hostility problems in men. Sexual abuse is discussed in chapter 7 because it is selfish aggression, not love.

On confidential questionnaires, half of all males say they are not happy with their sex life (many complain about their wives). Most do not seek professional help, but in the privacy of a therapist’s office, the most common problems of males are “I can’t get it up” and, essentially the opposite, “I come too quickly.” Most males have had a few experiences with a weak or partial erection, especially when drinking, tired, rushed, lacking privacy, or with a new partner. Anxiety is a common factor here. When the male is unable to get an erection over 25% of the time, it is called “impotency.” Reportedly, most erection difficulties start with a physical problem, such as diabetes, drug and alcohol use, and high-blood-pressure medication. So, see an urologist. There are injections for impotency if it can’t be cured any other way. Psychological reactions to impotency add to the problem, of course. Most of the cases with erection problems can be helped by physical and psychological treatment combined.

An average, normal male has several erections every night, even at age 65 the penis is erect an hour and a half every night! If erections do not occur after being checked and treated for physical problems, then psychological treatment is needed. Most therapists treat an erection problem by –

    1. Teaching the male to satisfy his partner without using his penis &


  • Having the partner stimulate the penis repeatedly (without intercourse or ejaculation) until the male gains confidence it will work. The relationship may also need to be worked on. A variety of psychotherapies are effective about 2/3rds of the time, reflecting the role of psychological and interpersonal factors. But don’t overlook the physical causes; they are important.


Anxiety is when for the first time you can’t do it a second time; panic is when for the second time you can’t do it once.

Ejaculating quickly and intensely could certainly be considered a sign of potency, rather than inadequacy. But if either partner wants the female to climax during intercourse with stimulation only being provided by the penis, then quick ejaculations are a problem, called “premature ejaculation .” Almost all males occasionally ejaculate sooner than they’d like. Perhaps 20% of males consistently have difficulty controlling their ejaculation, but only 20% or less of that group seek help with the problem. It can be changed.

Several things might be helpful with premature ejaculations:

    1. Use a condom to reduce the stimulation,


  • Have one or two drinks before sex,



  • Think about other things,



  • Ejaculate twice (usually premature ejaculations are no problem the second time),



  • Satisfy the partner in other ways and, then, both enjoy the male’s quick, powerful climax,



  • Avoid deep thrusting by letting the tip of the penis massage clitoris and play at the opening of the vagina or by leaving the penis fully inserted and concentrate on rubbing the pubic areas together (whatever feels good to the female),



  • Stop stimulating the penis before reaching “the point of no return” and relax a moment, and



  • Use the squeeze technique. The latter method involves squeezing the penis (fingers on top and thumb on bottom) right behind the head or near the base. This is done just before reaching the “point of no return” (when ejaculation can’t be avoided). A hard squeeze reduces the urge to ejaculate. In this way the female partner can teach the male to keep an erection.


There are other male problems, such as being unable to ejaculate in the vagina or taking a long time to do so. These are rare but treatable, usually by a sex therapist. There may be relationship problems. But, a desensitizing process might be tried first involving these steps:

    1. Masturbating alone thinking of your partner for a week or so,


  • Masturbating in front of partner during the next week,



  • Being masturbated by partner for another week or so, and



  • Being aroused by partner to near the point of ejaculation and then inserting the penis in the vagina. After successfully ejaculating inside the female in this manner several times, the fears usually disappear. This procedure is successful in about 75% of the cases.


Dealing With Specific Sexual Problems

There is a tendency to think “I’m the only one who has this sexual problem or thought.” In a society were youth and beauty are worshiped, one may also think “young people are great in bed; old people have sexual problems (or no sex at all).” In reality, about 30% of all males and 40% of all females sometimes lack sexual desire, 37% of college students have trouble occasionally getting an erection or getting lubricated, 30% or more of sexually active college women don’t orgasm regularly, 23% of college men ejaculate too soon, and 20% or more of both sexes have doubts about their sexual adequacy. So our sexually liberated society hasn’t freed us from sexual worries, it may multiply them. But, there’s hope, 75% of the elderly, who are still sexually active, say lovemaking gets better with the years.

It is no wonder we have sexual problems. Sexual activities by children and young people, even private masturbation, is described negatively and forbidden–even considered a serious sin. It is estimated that 11% of men and 23% of women are sexually molested as children. 22% of women have been forced by a lover to do some sexual act they didn’t want to do. Sexual experimentation may give little pleasure and lots of distress, including rejection, guilt, and unwanted pregnancy. In short, our sex drives are a testimony to our physiology and raging hormones (and to the emphasis on sexual seduction in our entertainment), not to our wholesome child rearing, our enlightened sex education, or to our psychosexual history.


Of course, everyone has heard of the “mid-life crisis.” Sometimes, about age 40, “sexual burnout” occurs. This is when sex with a long-term partner becomes boring, the relationship seems emotionally empty, and both may feel tired and sexually hopeless or inadequate. Barry McCarthy, a psychotherapist, reports that many couples seeking counseling have devoted very little time to improving their sex life or their relat

ionship. Yet, many seeking therapy (80%) have found the time to have affairs, hoping to spice up their sagging sex lives or to stimulate their flagging sexual energy. Also, keep in mind that when a sexually burned out couple gets a divorce, both will frequently go through a torrid love affair with a new lover (so it’s psychological, not physical) and then find that the same sexual problems are gradually reappearing with the second partner (Kolodny, 1983). So, we aren’t just animals operating on instincts either; “our mind is our biggest sex organ.”


Lack of Sexual Interest

A few people experience very little sexual drive, even in new romantic relationships. But most of us are obsessed with sex in the early infatuation stages of a relationship. We eagerly spend hours every day touching, kissing, holding, fondling, and sexually arousing our new love. Yet, after a few years, the burning interest wanes. Sex becomes routine. Why? We don’t understand it, but it happens to all of us to some extent, e.g. the frequency of intercourse declines from once a day (for a short while) to once a week years later. It is an expected transformation. The change is so gradual we hardly notice it. Suddenly we realize that the person who once drove us crazy can undress in front of us and we hardly notice. Some people go for weeks without wanting sex, some reject their partner’s advances.


Part of the problem is that many of us think everyone else (except our parents and the other “old folks”) is having hot sex every night, and probably “getting some” on the side as well. Thinking that way, we may feel we are not as sexual as others. However, a recent objective survey found that less than 8% of us are having sex more than four times a week. Two thirds of us have sex “a few times” per month or less. The remaining 30% of us have sex only a few times a year or less. So, Americans aren’t as sexually obsessed as we may think.

Inhibited sexual desire is the most common sexual problem, about 50% of all long-term relationships have a partner who lacks interest. In 15-20% of the cases of serious loss of interest there are physical causes, so check this out with a medical specialist. For instance, in menopausal women the lack of androgens causes a loss of sex drive so estrogen-androgen therapy is needed. Also, when men have trouble getting or keeping an erection, which could certainly cause a lack of interest, almost half the time there is a physical health factor or cause. If sex is not enjoyable because a climax can not be reached (see later discussion), intercourse may be avoided. Much of the time, however, the simple lack of interest is caused by psychological factors: depression, feeling up tight, fear of pregnancy, stress at work, feeling unattractive, fear of intimacy, anger towards the partner, a power struggle with the partner, old beliefs about sex being dirty, traumatic experiences, guilt about extramarital interests, a fear of not being able to perform sexually or, most commonly, “feeling tired”. Several sex therapists have described ways of solving the problem of low sex drive or “inhibited sexual desire”

If sex has just become boring, spice it up and make a production out of it. Once a week go out to dinner, go dancing, go to a comedy club, with the clearly stated intention of being seductively romantic and then coming home with plenty of time to make love. At other times when you are just at home, get showered and dressed in sexy outfits before going to bed–and spend some time smooching before intercourse. Try having sex in different places or at different times, perhaps in the morning or right after exercising. Give each other a bath and/or full body massages. Read together a book about sexual techniques, then talk, as needed, about how your sexual enjoyment can be increased. Look at each other during sex play and tell your partner how wonderful it feels and looks as you are making love and climaxing. Talk, talk, talk, until someone says “let’s not talk so much” and kisses you. Learn to enjoy this fantastic “gift” of life.


Obviously, some of the time, a personal-interpersonal problem will have to be solved before the sexual juices can flow naturally. If there is friction between two people, usually the sex drive immediately drops but it will automatically reappear as soon as the conflicts are resolved. Talk to each other about minor irritations as well as major problems. It has been shown that relationship therapy can improve a couple’s sex life and sex therapy can improve their relationship. See the discussion above for improving the marriage.


When a couple are miffed at each other, males and females often have differing notions about how to get emotionally back together. 35% of males think making love is the best way to make up (65% of women strongly disagree). This disagreement reflects, in part, how the sexes view intercourse. Males see sex as a way to establish a positive love relationship, e.g. early in a courtship the male will say, “don’t just tell me you love me, show me by having sex!” Sex proves to him that she likes him. A female knows sex doesn’t prove he loves her, so she wants to be chosen, valued, wooed, and loved first, usually by talking, touching, and doing things together, before having sex which to her only confirms an already established love. Otherwise, she may feel sexually “used” (”he’s only interested in sex”). So, after being miffed, the wife may reject her husband’s sexual advances (his way of making up), resulting in his seeing her as asexual, cold, and sexually manipulative (”you have to be nice to me first”). They are at an impasse unless they see what is going on and both give in, namely, he should verbally and in non-sexual ways express his affection and willingness to “straighten things out.” She should try to understand and accept his interest in sex as a sign that he wants to re-establish a warm, loving relationship.

Hajcak and Garwood believe that sex is frequently undertaken (without conscious awareness) to satisfy some other need, such as loneliness (”no matter how many people I go to bed with, I still feel lonely”), affection, intimate sharing of feelings, reassurance of being loved, escape from sadness or boredom, and maybe even to express anger. If sex doesn’t meet those other needs, then for such people, sex isn’t achieving its purpose and they come to believe their sexual relations are poor. These authors try to help people meet the other needs in more appropriate ways–or at least get the other needs out of the bedroom. Good sex only meets our sexual needs, not curiosity or achievement needs and perhaps not even loneliness or intimacy needs. We have to discover and deal with the underlying extraneous needs we are trying to meet by having sex .

Other interpersonal reasons why sexual interest is low include this kind of thinking: “he/she has more (or fewer) sexual needs than I have, so I’ll let him/her decide when we’ll have sex,” “he/she turned me down last time, I didn’t like that, so I’ll just wait,” or “I’m tense and not very horny, I don’t want to give him/her the impression I’m interested.” When these kinds of inhibitions have been openly disclosed and discussed, the sexual drive–of moderate strength–will probably return.


Probably the most common device for increasing sexual zest is the VCR and adult films. This is apparently effective and enjoyable stimulation for many people. But some people prefer their partner become interested in and sexually excited by watching (and interacting with) them rather than someone else on tape. Moreover, if a person is already unhappy with his/her body or insecure about his/her love making, watching beautiful, well endowed people making (or faking) wildly passionate love, could increase his/her self-criticism and inhibition. Each person has to figure out what turns him/her on; then compromises have to be made with the partner.


Besides improving the relationship, having stimulat

ing sexual thoughts, and reducing the negative emotions, the self-helper with a low sex drive should concentrate on re-learning how to enjoy sex, so he/she will have an increased interest in sex. Usually a method called “sensate focus” is used by sex therapists. This involves getting undressed with your partner, which can be sexy itself, but refraining from touching his/her genitals or breasts, thus, removing the pressure to perform sexually. While nude, each person lovingly touches and is touched, savoring the sensations (note: you aren’t attempting to sexually arouse the partner). In fact, sex isn’t permitted during the first few sessions of this exercise. In the next phase (a few hours or sessions later), the breasts and genitals are included and touched. Each partner must show the other what feels good by guiding their partner’s hands. Intercourse is still prohibited. In the final stage, the massaging and fondling leads up to the woman getting on top and playing with the penis, guiding it to, around, and away from her clitoris and vagina. The idea is to focus on and enjoy the sexual sensations but remain comfortable and without any pressure to perform. Eventually, intercourse occurs naturally.