Getting the groove back


Dear Dr. Jenni,

My husband is 54 and has recently begun to lose his erection in the middle of intercourse. This is driving me crazy! He is not overweight, but his doctor thinks that because he’s a smoker, this is causing the issue. He has been smoking for over 30 years, but why now?! His doctor gave him a Viagra, but he says it’s just not working for him. If you ask me, I don’t think he’s really taking it. How do I get my husband back?

—Struggling to Get Our Groove Back

Dear Struggling,

His doctor is correct. Long-term smoking can damage and reduce blood flow to all vessels, including the penis. He may not be overweight, but increasing his exercise and decreasing his smoking will amplify blood flow to the whole body, and genitals.

Almost all men have had experience losing an erection; and many struggle with erectile dysfunction in later years, especially when health is compromised. Anxiety and pressure from self or other may exacerbate erectile dysfunction. Therefore, I suggest stepping back and relaxing. Getting stressed about sexual issues only intensifies them.

Typically, the PDE5 inhibitors (Viagra, Levitra, Cialis) work wonders. However, he can’t pop a pill and hope for the erection to emerge. There still needs to be a sufficient amount of arousal.

If the issue is more psychological and/or relational, then doing personal development around issues of sexuality can help enormously. Also, create intimacy dates without an agenda of intercourse or orgasm, but rather reconnection without pressure to perform. This will help both appreciate that he is more than his penis, as well as access other ways of experiencing pleasure together.

Dear Dr. Jenni,

When I’m making love to my wife, I find myself fantasizing about her best friend. I feel really guilty about this. To stop this behavior, I have tried to focus more on my wife and being in the moment, but I tend to get bored and find my mind wandering. I have tried to fantasize about strangers or even movie stars instead, because this feels less wrong, but when I orgasm, my mind always switches over to her best friend. How do I stop this?

—Furiously Fantasizing

Dear Furiously,

Ask your wife to team up with you to tackle this issue. Disclosing details about her best friend may not be necessary; however, it may help to tell her you are struggling to stay focused. Ask for her support in being more present. She will most likely sympathize, as we have all struggled at some point to stay fully focused.

Another idea is to share fantasies about your wife while making love to her. See how elaborate you can paint these pictures. You can both take turns narrating fun fantasies where you paint a few places and activities you’d like to try together.

Keep in mind that the whole point of fantasy is to escape into the new and taboo, and explore pieces of your sexuality that you may not want to act out in real life. Having a full fantasy life doesn’t mean there is a lack of love in real life. Some people just need a little more imagination for stimulation.

On the other hand, if you do find there are relational issues, then exploring these with a counselor would be a good idea.

Send questions for Jenni Skyler, PhD, to Skyler is a sex therapist and board-certified sexologist who runs The Intimacy Institute in Boulder,