When it comes to awkward sex scenarios, dealing with bodily malfunctions is up there with condom breakage and being walked in on unexpectedly. But it has the potential to be even worse, actually, because there are often some pretty complicated emotions that come along with physical SNAFUs in bed. To be clear: I’m talking about being with a guy who struggles with erectile dysfunction or premature ejaculation. (There are plenty of other ways our bodies can malfunction in bed—and we women face our own challenges—but here, we’re focusing on the men.)
Erectile dysfunction, or the inability to get or keep an erection, affects millions of men in the U.S., with the number increasing with age. But that doesn’t mean millennial men don’t experience it: According to the University of Wisconsin Madison’s School of Medicine and Public Health, mild or moderate ED affects 10 percent of men per decade of life—meaning 20 percent of men in their 20s, 30 percent of men in the 30s, and so on, though we’ll assume with a drop-off at some point.
Premature ejaculation, on the other hand, is when a guy can’t stop himself from ejaculating shortly after penetration. Some sources estimate that 20 to 30 percent of men might struggle with PE at some point or another (the condition can come and go).
That’s all to say that the number of women who’ve slept with a guy dealing with one of these disorders is also likely very high. (If we’re going just by my group of friends, that’s certainly true.) And no matter how empathetic you are to the problem, how patient, or non shame-y and blame-y, it’s still just that: A problem. You know it and he knows it, but the question of how to fix it remains.
Below, five smart suggestions from top sex therapists about where to start.
Don’t Make it About You
Though it might be tempting to cave to insecurities the minute something goes wrong—especially when it’s ED—try hard not to turn the focus onto yourself, says sexologist Emily Morse, Ph.D., host of Sex with Emily. “This doesn’t mean he’s not sexually attracted to you,” she says. “Men put so much stock in their penises working properly because of our culture’s idea of masculinity. But the same way that how wet you are doesn’t always reflect how turned-on you are, what’s happening below the belt for him isn’t always an accurate reflection of how badly he wants to be boning you.” Take a deep breath, quiet those inner voices, and resist the urge to ask him why you’re not hot enough to get him hard. Trust: Whatever negative things you’re hearing inside your head, he’s telling himself stuff that’s ten times worse.
Keep the Convo Casual
Along with avoiding talking about yourself, don’t bring an air of gloom, doom, or super-seriousness to the conversation when you do talk to the guy about it. It’ll just freak him out more than he is already. “Don’t have the conversation in the bedroom,” says Morse. “Try doing it over breakfast the next day. Another tip is to do it when you’re in the car or walking the dog—it’s a sensitive topic, so giving them the option not to make eye contact can be a big relief and make the conversation go smoother.” Your tone and vibe matters more than what you actually say, but your message should be something along the lines of, “What happened last night was no big deal! I’ve heard a lot of guys struggle with this, so maybe it’s worth having a doctor check it out.”
Rule Out Physical Factors
In young men, odds are the problem has psychological roots, says sex therapist Laurie Watson, LMFT, host of the podcast FOREPLAY: Radio Sex Therapy. “Here’s how to rule out that it’s physiological: If he has morning erections; if he can get an erection but can’t keep it; and he can get an erection by himself and ejaculate without any problem when he’s masturbating, the problem is not physical.” Instead, there’s probably something going on emotionally or intellectually that he may need to look at. Depending on how serious and invested you are in him and the relationship, that’s something you may be able to help him with.
Address the Ways He’s Psyching Himself out
There are some lifestyle or psychological factors that you can help him address. For instance, is he regularly drinking before you have sex? That can kill a boner. Has he been overdoing it on porn? “Porn keeps raising the bar of stimulation, meaning that men need a higher stimulus to get off because it’s what they’re getting used to,” says Morse. “Tell him—nicely—that if he backs off or takes a break, it could help your sex life.” Also, if you’re fighting in other areas of life, it could be spilling over into bed, says Watson. “If he’s angry at you, he can lose the ability to function properly,” she says. “Some men who cheat have trouble getting hard because they feel guilty and their penises are literally conflicted about sleeping with two women at once.” If it’s nerves, reassure him that you’re having fun no matter what happens with his D—and that he can always pleasure you in other ways. Once he takes his mind off it, he might find that he’s able to get it up or control how soon he comes.
Take Your Cues from Him
If you’re not able to home in on what’s causing the PE or ED, and his doctor says it’s not physical, you could consider seeing a sex therapist, says Watson. Hey, that’s what experts are for! But ultimately, he’s the only one who can get help. “Men are afraid to see sex therapists because they’re afraid they’ll be told they’re inadequate,” she says. “But if he delays getting help for very long, it might indicate that he is not a sex partner who will be willing to grow and change over time.” And that’s a whole other issue in and of itself.
If he’s being a dick about the situation and his ego’s too bruised to work together and find a solution, pay attention to what that’s telling you about him. Is he someone you want to keep sleeping with, let alone dating? “If there’s a pattern of delays, excuses, or anger when it comes to this subject, think twice about staying in the relationship,” says Watson. “It’s not a question of sexual incompatibility, but incompatibility with a person who isn’t a learner, won’t be open, and isn’t willing to change.”
Originally published October 2016. Updated October 2017.