What is erectile dysfunction when with a partner?
Erectile dysfunction (ED), when you are unable to get or keep an erection suitable for sexual intercourse or another chosen sexual activity, is a common problem for many men. It may be due to physical causes (in the body), psychological causes (in the mind) or a mixture of both (see our factsheet ‘Erectile dysfunction’).
This factsheet specifically covers ED which happens only or mostly when you are with a partner. If you can usually get an erection spontaneously or when you are masturbating alone, but you can’t get one when you are with someone else, then this factsheet should help.
What might be causing this problem?
All types of ED, including those that only happen with a partner, may be due to physical causes (in the body). In particular, ED can be an early sign of heart disease (see our factsheet ‘Erectile dysfunction and the heart’) or be associated with diabetes, so it’s important to have a thorough checkup by your GP
If you get the all clear physically, then the cause of your problem is likely to be psychological (in the mind). For example, you may be physically able to get aroused (‘turned on’), but when you are with a partner; your erection is affected by your mind and emotions, your feelings about yourself and/or your partner or partnership.
Possible psychological causes include:
- Things you’ve learned in childhood about sex with a partner being shameful or wrong
- An unhappy or traumatic sexual experience that means you are anxious when being sexual with a partner
- Having sex with a partner you are not attracted to
- Having sex with a gender you are not attracted to (for example having sex with a woman when you are more attracted to men)
- A fear of being erect or climaxing when with someone else, or worry that you may be hurting your partner when penetrating them, particularly if your partner has had sexual health issues that might make this painful
- A fear of emotional commitment (this is more likely if the problem happens with long-term partners)
- A need for more emotional commitment then you’re getting (this is more likely if the problem happens with short-term partners)
- A fading of love towards your partner (this is more likely if you were able to get an erection with this partner but now can’t)
- Using pornography so much that it has become difficult for you to get aroused when having sex with a ‘real life’ partner
- Worry that because you haven’t been able to get an erection with a partner in the past that you won’t be able to do so now
- Pressure from a partner to ‘perform’
What should you do next?
If you haven’t already had a medical checkup, then have one. ED is associated with a number of health problems, and although it is less likely that the cause of your problem is only physical, medical issues may be making the problem worse. There are various options available for treating ED and your doctor can advise you on these (see our factsheets ‘Oral treatment for erectile dysfunction’, ‘Injection, urethral and topical treatments for erectile dysfunction’ and ‘Vacuum pump treatment for erectile dysfunction’.
You can also think about what psychological issues may be causing your problem. Begin by asking yourself how you feel about sex in general, about sex with partners in general, and about sex with this particular partner. If your erection problems usually happen within short-term relationships, then try to make friends with a partner and build up some trust before you have sex.
When you do have sex, tell your partner that you want to take things slowly, which will help remove the pressure to have an instant erection. Stop trying for an erection when you are with a partner, but focus instead on kissing and cuddling. At least for a while (maybe one month to start), stop trying to get an erection and simply enjoy being close, giving as well as receiving pleasure. If you do get an erection with a partner, don’t try to push things towards orgasm, just relax and let your erection come and go. Be interested in what is happening rather than trying to make something happen.
If you still are having problems, then even if you’re not aware of any unhappy feelings about sex, it may be helpful to see a sex therapist (see the following section on ‘Sex
therapy’). If you think your erection problems may be due to sexual issues that your partner is having, talk these through and perhaps agree to see a sex therapist together.
What is sex therapy?
Sex therapy is talking therapy where an individual or couple work with an experienced therapist to assess and treat their sexual and/or relationship problems. Together they will identify factors that trigger the problems and design a specific treatment programme to resolve or reduce their impact.
Sex therapy is considered highly effective in addressing the main causes and contributing factors of sexual difficulties. And it helps people to develop healthier attitudes towards sex, improve sexual intimacy, become more confident sexually, and improve communication within the relationship.
Sex therapy can also be used in combination with other forms of treatment. Your GP or another health professional on the NHS may be able to refer you for sex therapy (depending on area), or you can contact a therapist directly and pay privately. It is important to make sure that they are qualified and are registered with an appropriate professional body. You can find more information on sex therapy in our factsheets ‘Sex therapy’ and ‘How to find, choose and benefit from counselling support’
Does this problem mean there is something wrong with your relationship?
Even if you are finding it difficult to get an erection when with a partner, there may be nothing wrong with your relationship (see the previous section on ‘Sex therapy’).
What is the Take Home Message?
Being able to achieve an erection alone but not with a partner can be frustrating, but help is available.
Where can you get more information?
The Sexual Advice Association is here to help. We cannot give individual medical advice, but we can answer your questions on any sexual problems and put you in touch with local specialist practitioners. We also have a number of factsheets and booklets on sexual problems and related issues for men and women that can be downloaded from our website or requested. Please feel free to email us or phone our Helpline (our contact details are at the bottom of this page).
You can also visit the NHS Choices website at www.nhs.uk for information and advice on many different health and lifestyle topics.
Download or request our factsheet ‘Explaining sexual problems to your GP’ and/or our booklet ‘Sex and growing older – Men’
By donating to the Sexual Advice Association, you will know that you are helping improve the lives of people living with sexual problems. If you are interested in donating, please click here or contact us for more information (details at the bottom of this page).
Thinking About Sex Day: February 14th
Launched by the Sexual Advice Association, Thinking About Sex Day (TASD) is designed to encourage everyone to think about the physical and psychological issues surrounding sexual activity.