Episode 178 of the Sexology Podcast

In this episode Dr. Holly speaks with Dr. Moali about shame after sexual trauma, how survivors can regain their desire, learning to re-engage with positive sexual experiences and the importance of seeking out sex positive therapists.

In this episode, you will hear:

• Why do survivors experience shame around sex?
• Misconceptions around the causes of rape
• How people feel sexual shame after trauma in their bodies?
• Learning to show up for your body
• Navigating having positive sexual experiences
• Unhealthy habits survivors can pick up
• How desire disappears as survivors restrict their sexuality
• Looking at sexual dysfunctions
• Why it’s important to seek out a sex positive therapist

By R. Morgan Griffin

If you have erectile dysfunction (ED), it’s important to get past your awkward feelings and talk things over with your partner. ED is a problem with many solutions — and it starts with the two of you. Look for a way to move beyond the stress and work together.

“If you’re in a relationship, erectile dysfunction isn’t just happening to the man — it’s happening to the couple,” says Barry McCarthy PhD, author of Coping with Erectile Dysfunction and professor of psychology at American University. If both partners face it together, they can prevent ED from pushing them apart.

When you and your partner talk about the situation, you’ll both want to keep in mind some key things about ED:

Don’t blame yourself. “Men with ED need to know that this isn’t their fault, and their partners need to know the same thing,” says Holly Richmond, PhD, a somatic psychologist and certified sex therapist in Portland, OR, and Los Angeles. It’s not because of something that either of you did or didn’t do. There’s no one to blame and no need to apologize.

ED doesn’t happen because he’s not turned on enough. Partners need to know that they won’t be able to “cure” ED if they just try harder in the bedroom. In general, adding some sparkle to your sex life is fine, but sex toys and a spending spree at Victoria’s Secret will not solve ED.

It’s common. One major study estimates that about half of all men have some degree of erectile dysfunction. And it gets more common as you get older.

It’s treatable. “ED is not a crisis, it’s a speed bump,” says Roger Libby, PhD, a psychologist and sex therapist in Seattle. “You can solve it.”

Talk to each other. Think about what you want to say and then choose a good moment — over a glass of wine or on a walk. Talk about how you feel and be ready to listen. Focus on how you want to approach the problem together.

One pro tip from McCarthy: “The worst time to talk about ED is nude in bed,” especially after an attempt at sex that didn’t work out. Get some clothes on first.

See a doctor. ED is often related to health issues or medications you take. So any man with ED needs to make an appointment with a doctor. He may suggest a medication change or treatment with ED pills.

Your doctor may also recommend that you drink less alcohol, drop pounds if you’re overweight, and get regular exercise.

Many experts recommend that partners go to the appointment, too. It will get the doctor’s attention, and it will help make sure the man will actually bring up the subject.

See a sex therapist. The name “sex therapist” may sound intimidating. But Richmond reassures her wary clients. “We won’t touch you!” she says. “We’re just normal mental health practitioners with some extra training in human sexuality.”
She usually works with couples for 4 to 5 months, meeting once a week, where she guides them through a program.

“Once a couple is over the hump, they’re off,” she says. “One success leads to the next.”

Lower the stakes. Both Richmond and McCarthy recommend that couples not even try to have intercourse for a while. Once it’s off the menu, there’s much less pressure to perform — and that makes it easier to have fun and enjoy each other.

For now, focus on other stuff in bed, like massage, Richmond says. Ramp it up gradually. After a few weeks or a month, start to use your hands or mouth. Once you’ve broken the cycle, you’ll be ready to try intercourse again.

Try to relax. ED can feel like such a big deal sometimes, like it’s the beginning of the end of your sex life. It’s not. “Don’t go to the worst-case scenario,” Richmond says. “I reassure clients that there’s usually another erection just around the corner.”

And while sex really is important to the health of your relationship, it doesn’t need to be so heavy or intense. Sex is fun, remember?

Use this as a time to reconnect, to recall why you fell for each other. Remember that you’re a couple, not just roommates or parents. You could come out of this with a more satisfying, flexible, and enjoyable sex life than you had before.