Penis: Out of Order

Written by Sexual Wellness Institute Therapist, Eric Anfinson, MS LMFT

Difficulty with erection is probably one of the most common concerns I work with as a sex therapist. Erectile challenges affect a majority of men under 40 at some point in their lives and that number only grows after 40. For such a widespread problem, lack of or loss of erection is something we just do not talk about. Today we are going to talk about erections and what happens when a penis won't cooperate. I am writing both for people with penises that are not cooperating, as well as for those of you who might have a partner whose penis is having some difficulty. As a partner your response to lack of erection is hugely important and can do wonders to get things back on track. For either person, we need to begin by understanding why penises sometimes don't work when we want them to, and why we don't talk about it.

Manhood: What does that mean for sexual health?

Being raised as a man in our culture you learn early on that your penis is a primary factor of your manliness. As you hit puberty you learn that it's size and ability to become erect are also very important to your manliness. We learn that when you're turned on by something your penis will get hard. Many young women get these messages as well. We are then made to sit through a parade of jokes in movies and television where a man not being able to get an erection either means he's lost his manhood, or he's not attracted to the women he's trying to be intimate with. With these kinds of messages it's no wonder men don't want to talk about their difficulties with erection, even though most of them have dealt with the issue at some point. You're either losing your masculinity or risking directly insulting your partner by showing them that you don't find them attractive enough to get an erection. This leads many men to hide their difficulties from their partners and make excuses as to why things aren't working. Many often end up avoiding sex for fear they might have difficulty again. The problem with this is that none of is an accurate depiction of masculinity or how penises work. So starting the process of working through erectile dysfunction by throwing out these concepts is a good way to start. The next step is educating yourself on how this process really works, we'll do that now.

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Sexual Calculus: A Complicated Erection Equation

Sexual arousal is a complicated equation. Many times we only look at the outcome of that equation instead of the complete picture. Step one here is to think of the equation as "Turn Ons - Turn Offs = Arousal"
Many people only think about the Turn Ons side of this equation and this can lead to a great deal of hurt. I hear this come up in sessions like this, "If my wife really found me attractive she'd initiate sex with me" or in this case "If my partner really thought I was sexy he would get an erection." In both of these cases we're missing half of the equation.
​If we look back at the last section we can identify a huge Turn Off that many men experience, especially if they've had difficulty with erection before. This turn off sounds like "If I can't get an erection my partner will think I'm not man, or I'm not attracted to her and she'll be very hurt." This is an incredibly powerful thought and a huge Turn Off. Let's take a look at how this thought takes over. This is the story I see with 99% of men who I help with erectile difficulties. The man is tired, drunk, or uncomfortable in some way, these Turn Offs add up to be bigger than his Turn Ons. This means no erection. This typically does not go well. Partners feel hurt or angry, the man feels great shame, and the sexual session ends on a bad note. Because we don't talk about these things the couple avoids the topic and just hopes things work next time. But when next time comes that thought is there waiting for him. "What if it happens again?" And all of the bad things that happened last time come flooding back, creating a massive Turn Off that is very hard to overcome. This fear leads to difficulty with erection happening again, and creating a brutal cycle of fear and failure. Taking the breaks into account lets us have a very different conversation with our partner that sounds something like, "I'm very attracted to you and would love to have sex, but I'm very afraid you'll be hurt or won't like me if this fear takes over." But we'll come back to solutions later. First I want to acknowledge one other piece of this complicated arousal equation.

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Non-Concordance: Arousal is Complicated

Non-concordance is a term coined by researcher Dr. Emily Nagoski. She discusses it at length in her book "Come As You Are" which I highly recommend to anyone. Simply put, non-concordance describes the disconnect between what we want, and our bodies response. This happens to both men and women and in both directions of wanting and not wanting. A very simple a common example is the use of lubrication during sex. Sometimes a vagina simply does not have enough lubrication for comfortable penetration, despite what the owner of said vagina wants. Here it would be normal for most couples to use some lube without a second thought. Simple non-concordance. On theme with our post, sometimes a man very much wants to have sex but he body just doesn't respond and he struggles with erection. Now this also works in the opposite direction as I said. Sometimes we don't want to experience physiological arousal and we do. A common joke here is a man getting an erection when he has to stand up for a presentation, even though he's not aroused. A more difficult but power example is to look at people who have experienced sexual assault. Many people who are assaulted experience erection, lubrication, and orgasm. To suggest that they felt these things because they wanted to be assaulted would be horrific. Sometimes our bodies don't do what we want them to, and having acceptance for yourself and your partner on this topic can bring a great deal of trust, comfortability, and closeness to your sex life.

Now What? How to Address Erection Concerns

I want to take a moment here to mention that physiological concerns can absolutely impact erection and it is always worth consulting a doctor to be sure you're ok physically. While there are many ways to start using all of this information to improve your challenges with erectile difficulty, I want to talk through the most simple and effective way to make changes. You're going to have to talk about it. Whether you're the one struggling or you're reading this for your partner, the best way to start moving forward is by talking about it. Let's break this conversation down. There are two key things we want to communicate. Why are we struggling with erection? And, what do we do when it happens? 

Breaking Down the Tough Conversation

Hopefully after reading through this you have a good idea of what Turn Off is getting in you or your partner's way. Step one is communicating this while being understanding of how difficulty with erection might be misinterpreted. If you're the one struggling this might sound like what I wrote previously, "I'm so turned on by you and excited to be with you, and every time we try I get so scared that it will go wrong that it throws a big break on getting an erection." If you're the partner in this situation you can acknowledge the pressure that your partner is feeling to "perform." Once both partners understand the why, we move to what to do. I tell all my clients who are struggling with this to just expect it to happen again. When it does the plan is to acknowledge it, process the feelings that are coming up, and then continue having a good time. This means you acknowledge "hey these thoughts are getting in my head again." 
Next, it is vital that the lack of erection in the moment be OK. It isn't good, it isn't bad, it's just ok. Spend some time in this space where there's no erection and it's ok, no one is hurt, intimacy isn't done. Hold each other, kiss, touch, but see that it is ok that there is no erection. Once you or your partner catches onto that feeling that "hey, this is fine" the fear starts to melt away. With the huge Turn Off of the fear gone, the Turn Ons that are still present can move the penis towards erection. It may take a couple of interactions where you see that it's OK before the fear fully passes. Be patient with yourself or your partner and make sex a safe and accepting space for them. If you're looking for more help my fellow therapists and I would love to work with you!

Ready to Start Sex Therapy in Plymouth, MN?

Our sex therapists want to help you address sexual concerns here in Plymouth, or anywhere in the state with online therapy in Minnesota. Get started by following these simple steps:

1. Contact the Sexual Wellness Institute to set up your first appointment.
2. Meet with one of our skilled sex therapists for an intake appointment.
3. Begin building better communication with your partner, overcome sexual concerns and experience new fun and intimacy in your relationship!​

Other Mental Health Services in Minnesota

In addition to sex therapy, our LGBT & polyamory friendly sex therapists provide a wide range of mental health services at our Plymouth, MN counseling office. Other services include couples therapy & marriage counseling, EFT, evidence-based couples therapy, EMDR & sexual trauma therapy, as well as, teen therapy. In order to help serve the mental health needs of all those living in Minnesota, we also offer online counseling & sex therapy. We also provide a variety of helpful tips on our mental health blog. Please feel free to reach out with questions, or if you would like to schedule an appointment to begin working with a skilled sex therapist! Your sex life can be amazing. Sex therapy can be a part of that process for you.