This post is a marital public service announcement of the sort you don’t see very often. To make my point, I need to be comparatively explicit. Consider this a warning of a PG-13 rating.
In my practice, I frequently see middle aged couples who have encountered difficulties with their sex life. Often this takes the form of the man experiencing erectile dysfunction when he is with his wife. The first time this happens to a man, it tends to freak him out. Additionally, the wife often interprets this as an indication that he is no longer aroused by her because she has aged or her body no longer is reflective of cultural ideal for the female form.
For the purpose of this discussion, let us assume that there is no medical cause for his ED. That is to say, he is having regular physicals and his testosterone level is in the normal range.
That first incident can occur from something as simple as him being worried about something completely unrelated to his wife or their relationship. The problem is that if he then begins to worry about his ability to get and sustain an erection, that anxiety starts to work against him (and his erection). The more he tries to will it to turgidity, the more the opposite happens. He could be with a woman who represents his idea of feminine perfection, and if he is worried that his erection is going to be a problem, it is going to be a problem.
This can become a vicious cycle of putting pressure on himself to perform only to find his ability to do so gets further out of reach. This cycle is further exacerbated if his wife takes his lack of an erection as a reflection of her desirability or lack thereof. Now the pressure is really on. He may decide the solution is to get a prescription for Viagra or Cialis. She may object that she wants to be desired and not have him need to use meds to overcome a lack of desire for her. You see the problem.
This particularly hits middle aged and older couples as a byproduct of normal male aging. As men age, it takes longer to obtain an erection, and it might not be as turgid as it was when he was younger. This is normal. In his teens and 20’s, he might have been “blue steel” as soon as he thought about sex. In his 50’s, it might take a little longer to get going. If it takes him five or ten minutes of foreplay to get an erection, it is only a problem if it causes him to worry about it, thereby preventing the erection he otherwise would have gotten.
Ladies, I need to assure you that this is not about you. It may really seem like it at the time, but it isn’t. Even if he should (heaven forbid) tell you that it is about you, don’t believe him. You can chalk that up to his fragile ego looking for an explanation (or something or someone to blame).
There is something you can both do to help this situation. First, be okay with it. Don’t freak out. Don’t take it personally. Second, don’t try turning to porn as an attempted cure. This will ultimately have the reverse effect from what you want[1]. Porn makes sex about performance, physical perfection, and achieving a higher high. This is missing the best part. Healthy sex is about intimacy, connection, and mutual pleasure. If you are all about the former, your sex life can only go one direction across a lifetime together, and that is downhill. If is about the latter, it can continue to get better as you and your relationship mature and grow closer. Additionally, if it is about the latter, intercourse is a wonderful part of the package and not the whole point of the exercise. When the focus is on enjoying the closeness and mutual pleasure, intercourse tends to work out just fine.
Still having difficulty? Assuming your physician says you ought to be good to go, find a therapist who can help. Sometimes by the time the couple decides to get therapy, it has been years or even decades since they have had sex together. That’s a long time to do without when you didn’t need to.
[1] Porn use has been linked to erectile dysfunction in men when with their partners.
scottwoodtherapy 
Posted on June 4, 2016
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