Sex Counseling: "I'm on medication, I've lost my erections, am I done for? I want to give my partner more than just caresses."

Here's a new installment of the sex clinic, one of the 20minutos clinics active to help readers. These are this week's answers from our expert, Santiago Frago, director of the AMALTEA Institute of Sexology in Zaragoza.

No erections with the lover

QUESTION: I've had sex outside of marriage. The truth is, I'm quite attracted to the other person, but I can't get a good erection like I do with my regular partner. What can I do? Pelayo.

EXPERT RESPONSE It is reasonable to experience some difficulty with erection at some point in your life, especially with new partners where expectations are high, complicity is low, and the context is more stressful.

If you have a good sexual response with your regular partner and erection difficulties with someone you're very attracted to, this indicates that the cause is psychosexual.

This new context of intimacy causes you to experience erotic encounters with a degree of fear and anxiety. Fear and desire wage a battle, in which fear always wins. This causes a "penile vascular emptying" in your sexual response, resulting in a loss of erection. In this case, the solution lies in pharmacological support prior to sexual intercourse with your casual partner to counteract the negative effect of anxiety on your sexual response.

Ejaculate without pleasure

QUESTION: Why don't I feel pleasure when I ejaculate? Diego.

EXPERT ANSWER Hi Diego. I'm trying to answer you, although I'm missing a lot of details to give you a definitive answer. I need to know if your ejaculatory discomfort is something you've always had or is something recent. I also need to know if you're taking any medication or have undergone any surgery.

The source of your discomfort can be varied, and therefore the treatment will depend on it. The causes may be psychological: depression, anxiety, stress...or organic: spinal cord injury, neurological disease, diabetes...or the result of a side effect of a medication: antidepressants, antihypertensives, or alpha blockers prescribed for prostate problems.

You can discuss treatment with a sexual medicine professional who can modify or reduce the dosage of the offending drugs and/or address the underlying condition.

Medication and (little) sex

QUESTION: Over the past 10-12 months, I've stopped having erections, neither with my partner nor with masturbation. Until then, I had erections every 7-10 days, sometimes with some help from my friend sildenafil. About 6-7 years ago, I also stopped ejaculating due to prostate medication.

My annual tests show I'm fine in all parameters, and I only take other medications for hypertension (moderate) and acid reflux. My question is: Is there anything I can do to get my erections back, or should I just give up on that? I'm not worried about it, I just want to give my partner more than just manual and oral caresses (and her too, of course). Jesus.

EXPERT ANSWER Hello Jesús. You didn't specify your age, although given the health circumstances you mention, you're likely in your midlife. The fact that you haven't had erections for a year, either in your individual or shared eroticism, indicates that the cause is organic and/or a consequence of the side effects of the medications you're taking, in your specific case, the antihypertensive.

Furthermore, you're taking a drug for your prostate problems, I imagine tamsulosin or its derivatives, which has a side effect on ejaculation, and this would explain your anejaculation. You indicate your blood tests are correct, which is a good indication that you're not "doomed" in terms of recovering your erections.

I also notice that your eroticism as a couple is quite versatile, and you enjoy non-penetrative foreplay. This makes things much easier. My suggestion is that you try Sildenafil 100 mg or similar if you want to include coital play in your sexual relationship. It's a very safe and highly effective drug. You shouldn't rule out an evaluation with a sexologist in your area.

Don't forget to ask your questions about sexology. Our expert will help you.