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Sex and Intimacy Without Erections

If you have erectile dysfunction (ED), your sex life will probably be different than it was before. That can be frustrating or disappointing for you and your partner. But if you keep an open mind, you can find exciting new ways to have intimacy together.

“Oftentimes people have the notion of what’s socialized in media: that sex means you have an erection, there’s penetration with intercourse, and it ends with an orgasm. Sex is much broader than that,” says Tameca Harris-Jackson, PhD, a certified sexuality educator in Winter Park, FL.

Erectile dysfunction means you can’t get an erection some or all of the time, or long enough to have penetrative sex. But it’s still possible for you to orgasm and ejaculate without an erection.

First, talk to your doctor. They need to figure out what’s causing your ED. Health problems like heart disease and type 2 diabetes could be the reason. So could certain mental health conditions, like anxiety and depression. Some medications, including blood pressure drugs and antidepressants, can also lead to ED.

Once you rule out a health condition, you and your partner can start exploring what your new sex life will be like.

Knowing the cause of your ED can ease any fear your partner may feel, says Madelyn Esposito-Smith, a certified sex therapist and a mental health clinician with University of Wisconsin Health in Madison. “One of the first things I recommend for the men I work with is to simply communicate with their partner that this is not a personal thing. This is not anything that they’re doing wrong.”

Eric Garrison agrees. He’s the chair of the certification arm of American Association of Sexuality Educators and a certified sexuality counselor in Tidewater, VA. “When you become the expert in your own sexual health and sexual pleasure, and you can share that with others, it really helps with the conversation,” he says.

An open conversation with your partner can be great for your relationship. But it might also make you feel uncomfortable and vulnerable, says Kristen Lilla, a certified sex therapist and licensed clinical social worker in Omaha, NE. It’s important for your partner to try not to judge you, she says. If they only want sex with an erection, the two of you might benefit from working with a sex therapist who can help you both expand your horizons.

Talk to each other about what turns you on and gives you pleasure, even if you’ve been together for years.

“Really take time to figure out: What do you like? What do I do that feels good to you beyond penis-and-vagina or penis-and-anus?” Harris-Jackson says.

If you still get an erection sometimes, let your partner know what feels good when you have one — and what feels good when you don’t, Garrison says. “You can easily say: ‘When I have an erection, I love this, this, and this. In the times that I don’t have an erection, I love to have my ear licked, my elbow rubbed, my left toe massaged…’”

An intimacy-building exercise called sensate focus can help you and your partner get a better idea of where and how you like to be touched. In therapy sessions, Lilla has a couple try the exercise fully clothed, touching each other from the neck up. “It’s a really intimate experience, but it’s not necessarily sexually focused, and for some people it’s relaxing and connecting.”

You and your partner can practice sensate focus with a therapist guiding you, or you can try it at home, Harris-Jackson says. “The goal is to learn to explore one another’s bodies. Take time to just caress and kiss and verbalize to one another what it feels like without penetration, without oral sex, so there’s no pressure that anyone has to have an erection.”

Start simply if you prefer: You can rekindle intimacy by holding hands, making out, or cuddling nude.

Or maybe you and your partner are ready for more adventurous options, like oral sex, mutual masturbation, or sex toys.

If you’re up for exploring sex toys (like a vibrator or dildo) but you’re uneasy about going into a store that sells them, browse online with your partner, Lilla says. It’s important to shop together, she says, “instead of feeling like it’s one person’s job or that one person is putting this expectation on the other.”

If your partner wants to try a sex toy and you don’t, suggest an alternative, she says. You could say something like, “‘Well I don’t feel comfortable using a sex toy, but maybe we could try naked cuddling or maybe we could take a bath together.’”

It’s possible. “Sometimes people refer to it as ‘the stuffing method,’ where it’s putting a flaccid penis inside,” Lilla says. “It’s probably going to be easier with a vaginal canal than with an anus.”

Try not to think about how the sex used to feel, and make sure it’s comfortable for both partners, Harris-Jackson says.

Explore pleasuring each other in new ways. It helps to “remove that goal-directed or goal-driven idea that ‘we have to have penetrative sex that leads to orgasm,’” Harris-Jackson says.

Instead, focus on how to make pleasure the measure, rather than performance, Esposito-Smith says.

Or as Garrison puts it: “How do we optimize sex rather versus how do we maximize it? … I think if more people could get a grasp on that in their minds, sex would be so much more pleasurable for everybody, whether you have an erection or not.”

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