The Fundamentals of Sex

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Couples who go through treatment together report better sexual and relationship outcomes.

Open communication of desires and boundaries can dispel the assumptions that happen in silence.

Even a single joint session can help couples understand how to better support one another.

Most men who seek treatment for erectile difficulty often do it alone. They research solutions online, order prescriptions through an app, or visit a health provider all on their own. Sometimes they do so without ever telling a partner what they are worried about or how they are trying to resolve it.

That’s understandable. Erectile issues can challenge a man’s sense of himself—his masculinity, his age, his health, his worth. Embarrassment and shame try to protect us from those vulnerabilities by saying, “Keep it to yourself. No one will understand. You have to solve this on your own.”

The reality is that erectile problems frequently occur in the context of relationships, whether that’s short-term encounters or long-term partnerships. There is certainly benefit in starting with individual work, learning how to navigate anxiety or a changing body. It is also invaluable to include a partner when one is present.

While I focus on the relational context in this post, please note there are many cases when erectile troubles occur on one’s own or when single. You don’t have to be partnered to feel distressed or to seek help.

What Gets Missed in Individual Treatment

A partner’s experience is important for many reasons. They might be suffering in their own way, they may be unintentionally contributing to the problem, and/or the man may be making assumptions about the partner’s experience. Most importantly, including a partner can improve treatment outcomes.

The following case is a composite with client details anonymized to protect privacy.

Devon........

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