anonymous on September 12, 2011

My boyfriend is on blood pressure medication and can’t get it up. How do I talk to him about it?

I am a 56-year-old post-menopausal woman with a healthy interest in sex. I have begun a serious relationship with a 66-year-old man, who is on medication for blood pressure and SSRI medication. He knows that the blood pressure med affects his sex life, but he acts as if there’s no problem. He hates the idea of Viagra and doesn’t want to talk about it. I love him and we talk about spending our lives together...but I want to be able to have sex. How can I get through to him?

answered by Mitchell Tepper, PhD, MPH on September 12, 2011

Thanks for asking this important question. Aging and medications can cause issues in the bedroom for both men and women, and I’m happy to offer you some insights into what could be happening with your partner’serectile dysfunction (ED) and low libido. But, of course, it’s ultimately up to him to take action on the situation you describe.

First, regarding your partner’s sexual dysfunction, it sounds like there could be a number of issues going on. As you noted, blood pressure medications can affect a man’s ability to get an erection. And SSRI medications (often prescribed for depression and other issues) can affect sex drive (libido). Not to mention, age can affect a man’s testosterone levels...another hindrance to having sex, or even wanting to have sex.

Some other issues you didn’t mention – like heart disease, diabetes or even alack of physical activity – can further diminish a man’s ability to get and keep an erection.

As you pointed out, medications like Viagra, Cialis or Levitra might help him get it up…but if he ends up being more open to these possible meds, he should first discuss possible side effects with his doctor. And, although a surgical implant to restore ED is a solution typically reserved for when less invasive treatment are ineffective, some men prefer the reliability of this method and the convenience of not having to take another pill.

Your partner may also benefit from testosterone therapy, if low testosterone is an issue.

Besides medical issues that can cause ED and a low sex drive, some psychological issues can influence sexual functioning, too. For example, depending on your partner’s past relationships and his other prior experiences related to sex, he may have some other issues to work through…perhaps with the help of a counselor or sex therapist.

Couples therapy or counseling may also help you and your partner sort out your different levels of interest in sex…and what to do about it.

So, how can you talk to your partner about his sexual dysfunction? With compassion and sensitivity to his medical and emotional history, I encourage you to share with him all the reasons why sex is important to you in a relationship (emotional intimacy, physical closeness, orgasm, you name it).

From there, once he realizes just how important sex is to you, he’ll hopefully be willing to take a next step (for example, speaking with his doctor and/or a therapist) so that he whatever issues are at the root of his ED can be addressed.

I wish you both the best of luck in achieving a mutually satisfying sex life.

Related info:

Mitchell Tepper, PhD, MPH

Dr. Tepper directs sexual health education at An AASECT-certified sexuality educator and counselor, his areas of expertise include sexual dysfunctions, sexuality following disability or illness, pleasure and orgasm, relationships, and military and veteran couples' counseling. Dr. Tepper was educated at the University of Pennsylvania and Yale University.

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