Andy and Sheila (1)

Andy M came to our first appointment on his own. But problems with sex don’t just happen to one person, they have consequences for partners too; so the patient is really the sexual relationship rather than any individual. For example, if you are ejaculating (‘coming’) too quickly it will have effects on your partner’s sex life too, they will be concerned for you and want to help. They may be contributing to the problem. So, if you’re a couple, it helps to discuss things with both partners. However, Andy came alone and this isn’t unusual for a first appointment; men and women like to check things out first, see what the place is like, see what the therapist is like, dip a big toe in just to test.

His problem was that he was losing his erection sometimes when he was having sex. It began 2 years ago when he and Sheila were having very vigorous intercourse and he felt a sudden, sharp pain at the base of his penis. When he looked there was a large and painful bruise and it took a couple of weeks to heal properly, but when they tried to have sex again Andy lost his erection during penetration. He didn’t think too much about it the first time, it happens to us all, but the second time he got a bit worried, the third time more worried...and then he started to take Viagra. All this sounds very medical, maybe to do with an injury to the penis, but Andy then said that he began to get spontaneous and solid erections back again. In fact the couple had sex ten days ago and everything was fine. If he can still get good erections it’s almost certainly a psychological problem, but I see a lot of men who are very disappointed by this news, who actually want there to be something physically ‘wrong’ because they seem to be able to cope with that better. Perhaps it’s the word ‘psychological’  and the stigma attached to it, but there’s no doubt in my mind which type of problem I’d rather have.