Our expert says:
I must apologise as I will have to reply in English; I can understand your question but I would struggle to respond in Afrikaans.
Firstly, if you are already aware that he has a heart problem, I hope you are in regular contact with doctors and making sure that you are keeping as healthy as possible.
I am assuming that his heart condition does not prevent him from the physical effort that sex requires?
There are a number of approaches to this problem:
(1) you could consider the use of the old treatment for erectile dysfunction which involves a small injection (caverject) into the penis which result in immediate hardness which lasts for about an hour. This would need to be prescribed by a urologist who would also train your husband to use it himself. I am not sure of the cost of this in SA.
(2) there are vacuum pumps which are not ideal, but work. Essentially the penis is made erect in a vacuum device and then a constriction ring is placed at the base of the penis to keep the blood in the penis. It does not stand upright, but it may be firm enough for penetration.
(3) Option 1 & 2 are not as romantic as it once was when everything worked as it should. You could try to maximise his natural erection - even if it is less hard than it used to be, if he focuses on sensations and not on worrying about whether it is hard enough (this is called spectatoring). This performance anxiety will add to the difficulties he is having with his erection. Sex therapists can assist you both with performance anxiety - so possibly this is one way that you could make do with less but enjoy what does happen more naturally.
(4) It may be that you have to consider this as a challenge to your beliefs about what sex involves, and you can find ways around the soft penis so that you both can still experience closeness and sexual pleasure. So many people sex as just being about penetration - it can be so much more than that and it may be that this is what you will have to do.
A session or two with a sex therapist, may help you to find your way around this. If you don't know where to find one, speak to your GP or call the SASHA helpline 0860 100 262 and leave a message saying where you are based.
Claire - SASHA
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