What To Do When He Can’t: Erectile Dysfunction in Marriage

In the interest of full-disclosure (read: don’t hate me if I’m wrong) I have to say that I’ve not personally experienced this problem chronic erectile dysfunction. I’ve had one instance. So, admittedly I’m coming at this from a position of relative ignorance. However, being a man, and drawing from my limited experience I can try to imagine what goes through a guy’s head when this is happening. This is going to have info and suggestions for both husband and wife, so it might be worth sharing with your spouse.

I offer my thoughts humbly and with an open mind for your input. As I always say, this is a community and we highly value your input.


First off, we have to recognize that there are SO many factors that can lead to erectile dysfunction. One of the recurring themes in the list of factors I’ve linked to is blood pressure. This makes sense because erections are caused by blood flow to the penis. Low blood pressure can be caused by medications like antidepressants, blood pressure medication (obviously), and even antihistamines. It can also be complicated by heart conditions, obesity, alcohol and tobacco use, age, and even bicycling!

There are other physiological causes like surgery, trauma to the pelvic region, fatigue, radiation therapy, Parkinson’s disease, and multiple sclerosis. These can result in short-term or chronic erectile dysfunction.

ED can also be caused by psychological issues. Depression, pornography, sleep disorders, anxiety, stress, conflict and insecurity can combine with physical factors, or even cause ED on their own.

Wives, I list all these many reasons to get to one basic point: it’s not necessarily you. I know that as a wife it’s hard not to assume that he’s lost interest. “Maybe he doesn’t find me attractive anymore because I am older/had a baby/am pregnant/cut my hair/had surgery/a million other concerns.” Husbands, remember that this is affecting her, too. Give her time, and assure her of your love and desire for her.

If your husband tells you that he still loves you, finds you attractive, and wants to have sex with you, give him the benefit of the doubt. Don’t let self-doubt become a wedge between you and your husband. Accept his assurances. Move forward in trying to understand what he’s going through.


Let me begin here by saying that ED does NOT mean you aren’t a man. It doesn’t mean you aren’t a real man. It means you have a symptom of some underlying issue, whether bodily or mentally. That being said, it doesn’t feel like it.

Ladies, I want you to remember how important a man’s sexuality, sexual performance, and penis are to his identity and sense of self-worth. There’s a reason the penis is sometimes referred to as our “manhood.” It is so closely tied to exactly that, our manhood, our masculinity.

When a man’s penis is not functioning properly, it feels like a failure. It means he cannot sexually perform, which also feels like a failure. He can feel like he’s letting you down, like he’s not really a man.

The Erectile Dysfunction Spiral

Erectile Dysfunction Spiral

As mentioned above; stress, anxiety, and depression can cause ED. Combine that with the feelings of failure, and you can imagine the spiral that can happen here. An onset of depression that causes ED, which causes performance issues, which causes anxiety and depression, which worsens the ED, which causes more anxiety…

If your erectile dysfunction is primarily caused by psychological factors, it’s important to try to halt this spiral. Guys, remind yourself, and ladies remind your man that it doesn’t make him less of a man. Wives, remind him of your love, admiration, and respect for him. Call attention to those other aspects of his masculinity that make him the man you want to be with.

Get Creative

If you’re having ongoing problems with ED, you should definitely see your doctor. If it’s determined that the issues are likely psychological, it may be time to get creative. As always, decide at the outset to tackle this situation as a team.

If there are possible relationship issues in the marriage, address those. Try to reduce stress and anxiety in appropriate ways. If porn is a problem, address it. Consider seeing a counselor.

You may also want to get creative in the bedroom. Take things slowly. Change up the routine. Explore more foreplay. Celebrate small victories along the way, and don’t place expectations too high right away. If things don’t change immediately, don’t get discouraged.

The important thing in the case of ED, like any other situation you face in marriage, is to face it head on as a team. Give each other grace, patience, and compassion. Assure each other of your love, desire, and commitment to one another. You will get through this.

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