How to manage impotence and relationships

Most health conditions are something which are a purely private matter, not unduly affecting another person, and an issue for the individual alone to resolve.

However, impotence is something very different, a condition which if not handled sensitively can blight an entire relationship.

Often mistakenly taken as a sign as being sexually undesirable, being the partner of an individual suffering with impotence can be a difficult position too. Impotence has nothing to do with how attractive your partner might be, but because of the embarrassment factor, it can very easily create a barrier between two people.

According to statistics, more than half of men will suffer from impotence at some time in their life, and it’s an issue which affects over 140 million men worldwide. But the fact that it’s a common complaint can be little comfort when you’re trying to deal with the problem yourself.

It may not be a subject you particularly want to discuss, but avoiding the issue or even worse, avoiding sex can make the problem loom larger than it needs to. With practical help and honest conversation, impotence doesn’t need to wreck a relationship.

We take a look at some of the most important factors to consider when dealing with impotence and relationships.

It’s good to talk

As a man, if your penis fails to work as expected during foreplay or sex, it can be a huge blow to the ego, and can lead to anxieties about whether it will happen again.

Foreplay can be important to combat impotence

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It’s important not to try and lay blame anywhere, and also not to make a big deal out of it when it first happens.

Many men who suffer a bout of impotence may be able to sustain an erection perfectly well next time they have sex. A one-off episode relating to alcohol, fatigue or stress is a fairly common event and no cause for concern.

If you are regularly struggling to get an erection, or you can’t sustain one long enough for sex, it might be worth considering getting some medical advice.

But before you do this, it’s a good idea to talk things through with your partner.

Both parties may be secretly feeling angry and hurt, with the man harbouring feelings of guilt and embarrassment while the partner feels undesirable and rejected. All of these feelings are completely understandable but it can help to appreciate that impotence is the failure of a series of biochemical events within the body. It’s no-one’s fault and it’s not a reflection on either the manliness of the individual, or the attractiveness of the partner.

Talking about the issue can diminish its power; by leaving it unspoken, the scale of the problem can grow and grow and end up creating an almost insurmountable barrier of silence.

Understanding that you don’t have to deal with impotence without support from your partner can be a huge relief, whilst for the partner, getting reassurance that they are still wanted and desirable can help to allay insecurities.

The partner may be able to offer some insights into the underlying cause; they may have noticed that you’ve been tired more than usual, are particularly stressed or even haven’t been looking as well as you could. This can be useful when you go to your doctor to try and identify the underlying cause.

Your doctor may ultimately decide to prescribe you treatment for impotence but they will want to try and ascertain the underlying cause first. This is because impotence can be a warning sign of problems such as cardiovascular disease, so it’s essential to rule those out first.

Maximising the potential

If there’s no underlying disease you might find that taking a different approach, or getting creative in the bedroom can help to take the focus away from the penis, and in doing so, relieving some of the stress and pressure.

Maintaining an erection is all about ensuring there’s a good blood flow to the penis so thinking more carefully about what you drink and how much can be a good start.

A small amount of alcohol can help to relax you if you’re feeling anxious but too much could prevent you from being able to maintain an erection.

But this doesn’t necessarily just mean alcohol. Caffeine has the effect of narrowing blood vessels, and this constriction can reduce the blood flow to the penis, exacerbating erectile problems. Nicotine can have the same effect. For this reason it’s a good idea to avoid both nicotine and caffeine for a while before you plan to have sex.

Coffee should be taken in moderation as it can adversely impact impotence

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A room which feels comfy will also help you to relax and enjoy the moment. If it’s too hot, too cold, you’re worried about being interrupted or you’re not physically comfortable it could stop you being able to focus on love-making and could interfere with your ability to maintain an erection.

A warm shower before you have sex is great foreplay; not only is it intimate and fun, it also increases blood flow to the penis, the perfect preparation.

Once you’re in bed together, don’t feel the need to rush or perform to certain expectations. Don’t set any standards, and allow yourself to just enjoy whatever transpires. Agree this with your partner in advance; it can really help to take the pressure off the situation.

If you can’t get an erection but still want to pleasure your partner, there’s lots of other ways to do this. Use your fingers, your mouth or even sex toys; not being able to have an erection doesn’t mean you can’t have a sex life. For some men mutual masturbation provides a better chance of being able to both maintain an erection and orgasm too, so this might be worth trying with your partner.

Some sex therapists in the past have suggested that different positions may make a difference to sexual function, and whether an erection can be maintained during sex.

No studies have been able to prove that any position is better than another for erectile dysfunction, and blood flow, when measured, appears to be the same regardless. However, there are some experts who still believe that the woman being on top can help the man to achieve and maintain an erection during sex. This is because the man does not have to exert any energy into large muscle group movements which could then divert blood away from the penis.

This theory is not proven, but some sex therapists believe it is an effective tool. As every individual is different it’s impossible to be certain about whether this could be of any practical use, but it certainly wouldn’t hurt to try.

Work on your relationship

If your relationship is floundering in other ways, the impotence may be symbolic of what’s going on elsewhere. This might particularly be the case if the man is going through a difficult time, such as being made redundant, or if there’s money worries.

Therefore, setting some time aside to nurture your relationship in a non-sexual environment can help to create feelings of intimacy and rebuild every fracture which may have occurred. This may be enough to help you regain confidence in the bedroom, and may improve erectile performance without any further treatment.

Therapists suggest making sure you make eye contact regularly, and also kiss. Couples in longer term relationships often start to skip on these fundamental basics, which can result in a loss of intimacy.

Keep working at your relationship

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Think about what you used to enjoy doing together: maybe you went to concerts, or enjoyed going to a restaurant for dinner. Perhaps even a stroll in the park to feed the ducks. Whatever you used to enjoy doing together when you were dating, try to recapture the moment. Remember how you felt just spending time hanging out as a couple, and work on feeling that way again.

The self-test

If you want to get a better idea of whether your body is capable of creating an erection, or whether there is a physical underlying cause preventing the phenomenon from occurring there is a simple self-test you can do.

For this you will need a strip of perforated stamps, long enough to stretch around your penis.

Before you take the test avoid all chemicals and drugs (where possible without contravening medical advice) for at least two nights in advance. You should also wear at least boxer shorts or pyjama bottoms for the nights you do the test.

Before going to sleep, wrap the strip of stamps around your penis, making sure they are stuck in place and overlap at the end. You should now have a circle of stamps secured in a circle, which shouldn’t be too tight, but shouldn’t be so loose it can slip or move.

The simply go to sleep as normal

Every night it is normal for a man to have between 4-5 erections, regardless of what they dream about. An erection will break the perforations in the circle of stamps. This can help make it clear in the morning whether you have had an erection during the night.

It’s suggested that you repeat this on at least three occasions to make sure it wasn’t a fluke occurrence or an accident with the paper.

This is one of the universally accepted self-tests for impotency, and whilst it won’t provide any magic cures, it can help to identify whether the problem is physical or psychological.


There are a number of different therapies which can be used to help treat men suffering from impotence; some are best attended with a partner whilst others can be just as effective if attended alone.

Psychosexual counselling examines the relationship and what factors may have contributed to the impotence. It provides the chance for both partners to explore the issues they may have found difficult to raise by themselves, and can be a safe place to express views and work through problems.

This kind of counselling won’t make an immediate improvement but if both parties are committed to an honest and open dialogue, it can really help to resolve any niggling problems. Even if psychological factors aren’t the primary cause of the impotence, making sure the relationship is as healthy as possible can only help.

Counselling can be invaluable in treating impotence

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Cognitive behavioural therapy can be tackled solo if desired, and can be helpful for both the partner and the man suffering from impotence.

Having a strong sense of self-esteem can help to make it easier to deal with impotence without it being complicated by feelings of worthlessness, guilt or shame.

The role of Viagra

Impotence can have such a devastating effect on a relationship; it may be helpful to have some time where you can enjoy regaining sexual intimacy.

Depending on the cause and the effects of impotency on the individual, Viagra may be available on the NHS, costing only the usual prescription charge. For those that have to pay, the cost will vary depending on the pharmacy but expect to pay between £17-30 for four tablets.

Sex and intimacy is such an important part in a relationship, Viagra can offer the chance to get back into good habits. Maintaining a healthy sex life, setting time aside to enjoy each other both in and out of the bedroom and getting enough sleep can all help towards creating a warm and loving relationship.

Intimacy is important in any relationship

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You may only need Viagra for a short period of time, particularly if the cause of the erectile problems is psychological. A sex therapist could work with you to help you reduce the use of Viagra in your sex life if you want some support when you’re ready to stop taking the pills.

Impotence can create a destructive cycle of blame, withdrawal and avoidance and this unholy trio can spell disaster for a relationship.

Non-judgmental communication is key to working through the problem together, whether the cause is physical or psychological, and Viagra can help to provide some breathing room while you work out what you both need.

Image Credits: GreggMP, Camera Karrie, Andrew Rennie, A&M-Commerce and Stephan