I have a beautiful girlfriend who is a wonderful and understanding partner. Unfortunately, for over half a year I have been struggling with "partial impotence". I am writing this because when I feel excited I get an erection. Maybe not as strong as I recall it from earlier years, but it is strong enough that intercourse should be successful. Unfortunately, it turns out that most of our attempts are unsuccessful. The penis loses its stiffness and may not even shrink completely, but is very "pliable". After a few months, I went to a sexologist in Poznań. It was the worst decision I ever made. The man who accepted me, and then us (we invited my partner to meetings on my initiative), always wasted about 15 minutes on reading his notes, and then kept telling me to say: "what am I coming with today?" I tried to be fully open to him and not have any emotional inhibitions. The sexologist commissioned us to exercise together, sometimes he tried to show that everything was fine with me and after a few meetings he did it very insistently, and at the last meeting he told me directly that he did not want to take care of me. We were very shocked with my partner. I have not written any complaint or grievance anywhere, because I do not want to have anything to do with this man anymore or anywhere else to talk about my condition. Right now I am very frustrated, I don't know what to do. My financial situation does not allow me to receive private treatment. I'm finishing my studies, working part-time on weekends, living with my sister and barely making ends meet. When my ailment appears in our bedroom, we try not to react that it is some kind of problem, but we try other caresses. It often happens that even after unsuccessful intercourse, when stimulating the penis by hand or orally, I am unable to ejaculate, and often my penis does not get a full erection. The rest of the cases are when I have an incomplete erection but still ejaculate. Please believe me that nowadays I often think: "will it be ok this time" etc. Where should I look for help? What should I do? I am almost convinced that my impotence problem is not psychological. How should I act in the bedroom? More and more I also want to avoid sex, slowly I don't associate ithe with pleasure, and with the profession that awaits me. I will just add that alcohol is a rare guest in my house, and as for cigarettes, I "smoke" a pack of cigarettes for a week. I try to give them up definitively, but somehow I can't do it. I do not take any other stimulants. I've also started going to the gym on a regular basis and go jogging every now and then. Maybe I should give up these physical activities? Can this help?
I'm sorry about the unsuccessful treatment with the sexologist. Your frustration and discouragement are understandable.
The background of the lack of erection
The symptoms you described show that the causes of erectile dysfunction are largely psychogenic, but it cannot be ruled out that there is also an organic component. If you are able to maintain an erection during masturbation, and it disappears or the penis flabby only during intercourse or attempted intercourse, then erectile dysfunction is of psychogenic origin. If you are unable to maintain an erection while you masturbate, and you do not experience spontaneous morning, day or night erections, then biological factors may be at play.
Taking into account your doubts and your financial situation, it is worth visiting a urologist. You need a referral from a family doctor, then the visit will be at the National He alth Fund. He may order, among other things, testosterone level testing, which is responsible for the level of libido, but also for a proper erection, or he may prescribe you one of the Viagra type drugs. Taking these drugs for a short time should stop a deepening of negative attitudes towards sex.
As for physical activity, it is highly recommended and please do not give up on it. One of the most recommended forms of it is the swimming pool.
Couple exercises
Below is a list of exercises and recommendations for couples. The key training for couples often described in the literature is the method of focusing on sensory experiences developed in 1970 by Masters and Johnson, or the psychosexual interpersonal training of Kratochvil based on it. The following sexological exercises can be used within the training:
- body map - the partners mark with colored felt-tip pens on the figure of a human place, which they enjoy touching (green) and not providing such pleasure (red). On the second sheet of paper, they try to guess their partner's preferred places in the same way; p
- stimulating sensory foci - an exercise consisting in searching for areas (erogenous zones) that enable orgasm and testing various forms of stimulation (e.g. with fingers, lips, penis),direction (e.g. in a straight line / rotation / sideways movements) and forces (strong / gentle / fast / slow frictional movements of the penis in the vagina);
- extra-genital sexual activity - as part of this exercise, partners provide each other with tenderness and caresses through oral activity and / or manual stimulation. The patient should be aware that an erection is not a necessary condition for a woman to achieve orgasm. The partner can obtain sexual satisfaction through oral or manual stimulation;
- gradual sexual activity - in which partners are advised to focus on those forms of sexual activity that make them happy on both sides (prolonged foreplay, caresses, kisses). In the event of the appearance of pathogenic factors (negative emotional states, observer's attitude, negative automatic thoughts), you should temporarily stop caressing and undertake relaxing alternative activity (e.g. pleasant conversation, shared shower), and then, in a relaxed state, restart sexual activity;
- a method of extending the vaginal line - consisting in telling your partner to extend the vaginal line with her hand during sexual intercourse, embracing the penis while removing it from the vagina;
- gynecological positioning method - involves having sexual intercourse in the so-called gynecological position that allows the penis to be inserted into the vagina: the woman lies in the position she takes during the gynecological examination, and the man stands between the woman's thighs. This position provides good access to the vagina (the genitals of both partners should be approximately at the same height), without erection or with partial erection. After penetration, the patient maintains an expectant attitude (with a penis in the vagina), so that emotional tensions and preoccupation associated with the activities performed will pass over time. As the direct contact of the penis with the surrounding vagina prolongs, many men experience a gradual increase in erection of the penis, which often becomes stiff enough to allow for frictional movements;
- the honeymoon method - in which the patient is forbidden to have intercourse for a certain period of time (e.g. a month), instructing him to spend time in bed with his partner, communing with her body (touch, caressing each other). The purpose of this method is to reduce the anxiety associated with the "obligation to have intercourse";
- femoral intercourse method - performing movements imitating sexual intercourse in the side position in which the partner's thighs embrace the penis. Stimulation without the risk of vaginal contact will improve the conditionerection.
Remember that our expert's answer is informative and will not replace a visit to the doctor.
Agnieszka ChochołSexologist, psychologist, Solution Focused Therapy therapist, certified ICC coach. He deals with promoting broadly understood sexual he alth as well as providing help and support in the field of sexual and psychological difficulties. She conducts individual therapy and couples therapy. More at: http://sulec-radom.pl/
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