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Kinsey Confidential

POSTED AT 12:00 AM ON Oct. 5, 2005 

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Q: My boyfriend can't maintain his erection during vaginal sex, only during oral or anal. It often takes a long time to get one initially too. He claims he has always thought of vaginal sex as too conventional and that's why he loses it. I have asked him if he's gay and he denies it. He is afraid of Viagra and will only take one-third of a pill (he doesn't like the increased heart rate) -- it helps but he still loses it. He also doesn't think he needs to see a doctor about this (he got Viagra off the Internet). Thanks a lot!

A: Thanks for your questions. Most men will experience erection problems at some point in their lives. In young men, the cause more often has a basis in psychology than in medical conditions. For that reason, improvement might be more likely to come from sex therapy than from medications like Viagra (which is targeted more toward men with a physiological cause for erectile problems), though checking in with a health care provider might be a useful start to rule out any medical conditions.

Because erection problems can be affected by relationship issues (e.g. pressure to get or maintain an erection, performance anxiety, concerns about being a good lover, disappointment or frustration from a partner, anxiety about unintended pregnancy) -- and sexual problems can cause relationship problems -- it can be useful for couples to attend sex therapy together. You can locate a certified sex therapist through the American Association of Sex Educators, Counselors and Therapists (www.aasect.org) or by asking at your health center.

It's important to note that your boyfriend doesn't always have erection problems; it appears to be a situational issue (during vaginal but not oral or anal sex). This might truly be because he finds oral or anal sex to be more exciting (as he said, he feels vaginal sex is "too conventional"), a feeling that is shared by some other men and women too. People vary greatly in terms of their sexual interests and you might not be able to change his feelings. However, perhaps you two could work with a sex therapist to develop mutually satisfying ways of sexual expression.

While Viagra is not a "dangerous" drug in and of itself, buying it over the Internet certainly can be dangerous, as (a) there is no guarantee that what one purchases is truly Viagra, (b) even if it is Viagra, it might be a different dose than claimed and (c) he might have medical conditions or be taking other supplements or drugs that could interact negatively with Viagra, or whatever else is really in his Internet-purchased pills. That's why Viagra is a prescription -- so that trained health care providers can review a man's family health history, general health and other over-the-counter and prescriptions he might be taking, in considering whether Viagra is a good option.

Asking your boyfriend if he is gay might do more harm than good. While there's certainly nothing wrong with being gay, the idea of questioning something as big as your boyfriend's sexual orientation (and just because of his erections) might make him feel misunderstood or anxious. That, and your continued focus on his erection difficulties might only cause further problems with his erections and possibly within your relationship.

Erections are complex and might be affected by hormones, medication, mood, anxiety, medical conditions, fatigue, stress or even the temperature in a room. They are not necessarily a reflection of a man's love, lust or attraction for his partner.

Reading "For Each Other: Sharing Sexual Intimacy" might be useful in learning about other ways of sexual expression, and "The Sexual Male: Problems and Solutions" might provide additional insight into the complexity of erections. You can also learn more on the KISISS Web site. Good luck.

 

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