Expert's Reply

A.

Sexologist

Erectile problems may occur for a number of possible reasons, the most problematic of all could be serious health issues and so you need to have a physical check up. It would be useful to know whether you have healthy nocturnal erections, if these are healthy and if all is well on the physical front, it may be that that the difficulty is explained by a psychological block - e.g. fear of sexual failure/poor performance (e.g. losing erection, ejaculating too quickly, partner is not orgasmic or has pain during sex); anger at partner. Psychological factors like this essentially block the normal working of the sexual response and can be addressed through couple work with an experienced professional.

There are treatment options for ED - both pharmaceutical and psychosexual - why not consider some of these option together to see how this can be addressed. It is common that when one partner experiences sexual difficulty the overall intimacy in the relationship declines - this only makes matters worse (e.g. she gets angry with you when you try to 'use' your nocturnal erection when she is sleeping, or feelings of rejection/personalising your avoidance of intimacy)

As a first recommendation - have a physical check up by GP and tell him/her about your erection difficulties at the beginning of the consultation (not as a last comment as many men do!) so that his/her assessment is geared towards this issue. If you gets the all clear, then both of you go to see a health professional with experience in this area.

For further information please consult SASHA’s website at www.sexualhealth.qw.co.za/dru. For referral to a professional in your vicinity, please send an email to helpline.sasha@gmail.com