When to Have 'The Talk'
Have it “as soon as intimacy is contemplated,” says Keith Lloyd, MD, professor of urology at the University of Alabama at Birmingham School of Medicine. If you don’t perform well in bed, Lloyd says, let your date know up front and tell them the medical reason why.
Certified sex therapist Jane Brown, LPC, in private practice in Birmingham, AL, suggests that patients buy a copy of the book The New Male Sexuality, by Bernie Zilbergeld, PhD. Leave it on the coffee table as a conversation kick-starter for when your potential partner comes over, she says. When he or she looks at it, that’s your cue to say, “You know, I’m having this problem, and I’ve been reading this book to see if it could help me.”
The best-case scenario: The person offers to help with the problem. The worst-case scenario? They don’t. And you move on.
“If your date is not going to be sensitive to these issues, do you really want to continue with that person?” Brown asks.
Conquer Performance Anxiety
When you have ED, sometimes you can obsess about having an erection and lose sight of the big picture. Plus, ED problems can come and go, which can make you even more anxious.
“Once you’ve got a psychological overlay of wondering if you’re going to have a problem performing,” Brown says, “you’re almost guaranteed that you’re not going to get an erection. Even if your medical condition is under control, the psychological can override it.”
Brown says that among her patients whose ED is caused by psychological factors, 90% improve when they take the focus off their erection and put it on pleasuring their partner.
“Getting them to believe that this works, however, is monumental,” she says. “But once they do, they forget about their penis and suddenly find themselves with an erection.”
Brown suggests that in addition to giving oral sex, couples simply explore each other’s erogenous zones, including the ears, neck, under the arms, and the nipples.
“I ask them to find out what they and their partner like. You and your partner are not mind-readers, nor should you have to be,” she says.
Meds and Timing
Lloyd says if you’re taking oral ED meds, Cialis (which is taken daily) may allow for more spontaneity. “Also, its long duration of action makes it a good choice for men who are dating,” he says. “However, Viagra and Levitra can be used discreetly, taken an hour or two before planned activity.”
Using products and injections to cause erections might be more of a challenge. The medicated urethral system for erections (MUSE), a small pellet inserted in the penis, can cause mild vaginal itching and burning in female partners. Be sure to let yours know if you're planning to use it, Lloyd says.
If oral treatments don't work, Lloyd says penile injections may be the next easiest solution. For patients with significant ED, who are dating, a penile implant is probably best, he says.
It Isn't Personal
If you have trouble getting or keeping an erection with a date, assure her that you're attracted.
“Let her know it’s not her and you want this to happen,” Brown says.