For couples, emotional connection and sexual intimacy are dynamically related, so difficulties in one area often destabilize the other area. And the "chicken-or-the-egg" relationship between sex and emotional connection may be different for each partner. For some people, the desire to be sexual comes as a result of feeling emotionally connected.
But for others, perhaps because of their histories, physiology, and attachment styles (their particular love map), being sexual is how they find their way to emotional vulnerability.
Often in a relationship, one person seems to be designated as the sexual initiator, whether because of tradition, culture, gender, or perhaps because that partner's preferred way of seeking attention is through touch, affection, and sex.
When a partner takes the lead in the couple’s lovemaking, they bear the brunt of intimate rejection more often. Initiating sex requires such risking and revealing of oneself in primitive need,
that having a sexual bid disregarded or rejected can be especially painful. Research shows that a positive response strongly contributes to a happy marriage and that a critical or absent response can cause serious damage to the relationship.
Every partner who initiates sex hopes for a receptive, excited reaction from their lover. But sometimes the bid doesn’t come at the right time or isn’t welcome given a person’s state of mind or the state of the relationship. Fortunately, as long as we are honest, vulnerable, and direct, we can reject the bid without damaging our emotional attachment.
Here are three scenarios illustrating a partner rejecting or ignoring a sexual bid, along with some suggestions for handling the situation in a more attachment-preserving way:
After lunch on a Sunday afternoon, Adam wiggles his eyebrows at his wife Sharon suggesting a "nap" for themselves while their children are napping. Feeling stressed after corralling young children to church and lunch, Sharon sighs and heads for the bedroom.
Sharon could have honestly leveled with Adam about her true needs while still honoring the spirit of the advance: “Sweetheart, I’m afraid I’m frazzled and need my own quiet time to recover from the morning before I can mix it up with you. Can we take a real nap and then I’ll be refreshed before this evening together?”
Lavonne comes up behind Trevor after his evening shower while he’s brushing his teeth and puts her arms around his waist, saying, “My man is one hot man!” While he feels desire for her,
Trevor has become increasingly anxious about his occasional erectile dysfunction. His anxiety comes out as an angry retort “Lavonne, you expect too much!” and breaks out of her embrace.
Trevor could have contained his anxiety, stayed vulnerable, and turned towards his wife’s overture with, “Well, why don’t you run the bath, baby, while this hot man turns on some music.”
Sitting in a sensuous, slippery tub together for fifteen minutes would have given his erectile medication time to begin working and allowed him to feel calm, connected, and confident.
Daniel cuddles up close to his husband Jean-Paul early in the morning and kisses his neck. Without a word, Jean-Paul leaves the bed to use the bathroom and then starts the shower for his morning routine.
Jean-Paul, still angry over their late night fight, wasn’t ready to make up even though he recognized Daniel’s overture as a bid to reconnect. Instead of ignoring Daniel’s bid altogether (and leaving him feeling completely rejected),
Jean-Paul might have directly said, “I’m still upset about last night; I don’t want sex until we’re through with that conversation.”
Sexual Problems in Men
A sexual problem, or sexual dysfunction, refers to a problem during any phase of the sexual response cycle that prevents the man or couple from experiencing satisfaction from the activity. The sexual response cycle has four phases: excitement, plateau, orgasm, and resolution.
While research suggests that sexual dysfunction is common (43% of women and 31% of men report some degree of difficulty), it is a topic that many people are hesitant to discuss. Fortunately, most cases of sexual dysfunction are treatable, so it is important to share your concerns with your partner and doctor
Sexual dysfunction in men can be a result of a physical or psychological problem.
Physical causes: Many physical and medical conditions can cause problems with sexual function. These conditions include diabetes, heart and vascular (blood vessel) disease, neurological disorders, hormonal imbalances, chronic diseases such as kidney or liver failure, and alcoholism and drug abuse. In addition, the side effects of certain medications, including some antidepressant drugs, can affect sexual desire and function.
Psychological causes: These include work-related stress and anxiety, concern about sexual performance, marital or relationship problems, depression, feelings of guilt, and the effects of a past sexual trauma
Both men and women are affected by sexual problems. Sexual problems occur in adults of all ages. Among those commonly affected are those in the geriatric population, which may be related to a decline in health associated with aging.
What Are Ejaculation Disorders?
There are different types of ejaculation disorders in men, including:
Premature ejaculation: This refers to ejaculation that occurs before or soon after penetration. Inhibited or retarded ejaculation: This is when ejaculation is slow to occur.
Retrograde ejaculation: This occurs when, at orgasm, the ejaculate is forced back into the bladder rather than through the urethra and out the end of the penis.
In some cases, premature and inhibited ejaculation are caused by psychological factors, including a strict religious background that causes the person to view sex as sinful, a lack of attraction for a partner, and past traumatic events.
Premature ejaculation, the most common form of sexual dysfunction in men, often is due to nervousness over how well he will perform during sex. Certain drugs, including some antidepressants, may affect ejaculation, as can nerve damage to the spinal cord or back.
Retrograde ejaculation is common in males with diabetes who suffer from diabetic neuropathy (nerve damage). This is due to problems with the nerves in the bladder and the bladder neck that allow the ejaculate to flow backward.
In other men, retrograde ejaculation occurs after operations on the bladder neck or prostate, or after certain abdominal operations. In addition, certain medications, particularly those used to treat mood disorders, may cause problems with ejaculation.
What Is Erectile Dysfunction?
Also known as impotence, erectile dysfunction is defined as the inability to attain and/or maintain an erection suitable for intercourse. Causes of erectile dysfunction include diseases affecting blood flow, such as atherosclerosis (hardening of the arteries); nerve disorders; psychological factors, such as stress, depression,
and performance anxiety (nervousness over his ability to sexually perform); and injury to the penis. Chronic illness, certain drugs, and a condition called Peyronie's disease (scar tissue in the penis) also can cause erectile dysfunction.
What Is Inhibited Sexual Desire?
Inhibited desire, or loss of libido, refers to a decrease in desire for, or interest in sexual activity. Reduced libido can result from physical or psychological factors. It has been associated with low levels of the hormone testosterone.
It also may be caused by psychological problems, such as anxiety and depression; medical illnesses, such as diabetes and high blood pressure; certain medications, including some antidepressants; and relationship difficulties.
How Are Male Sexual Problems Diagnosed?
To diagnose a man's sexual problem, the doctor likely will begin with a thorough history of symptoms and a physical exam. He or she may order other tests to rule out any medical problems that may be contributing to the dysfunction.
The doctor may refer you to other health professionals, including a urologist (a doctor specializing in the urinary tract and male reproductive system), sex therapist, and other counselors.
How Is Male Sexual Dysfunction Treated?
Many cases of sexual dysfunction can be corrected by treating the underlying physical or psychological problems. Treatment strategies may include the following:
Medical treatment: This involves treatment of any physical problem that may be contributing to a man's sexual dysfunction. Medications: Medications, such as Cialis, Levitra, Staxyn, Stendra, or Viagra may help improve erectile function in men by increasing blood flow to the penis.
Promescent is a drug used to treat premature ejaculation. The topical spray is applied to the penis and contains lidocaine, reducing sensitivity and allowing for more ejaculation control.
Hormones: Men with low levelsof testosterone may benefit from testosterone replacement therapy.Psychological therapy: Therapy with a trained counselor can help a person address feelings of anxiety, fear, or guilt that may have an impact on sexual function.
Mechanical aids: Aids such as vacuum devices and penile implants may help men with erectile dysfunction.
Education and communication: Education about sex and sexual behaviors
and responses may help a man overcome his anxieties about sexual performance. Open dialogue with your partner about your needs and concerns also helps to overcome many barriers to a healthy sex life
Can Sexual Problems Be Cured?
The success of treatment for sexual dysfunction depends on the underlying cause of the problem. The outlook is good for dysfunction that is related to a treatable or reversible physical condition.
Mild dysfunction that is related to stress, fear, or anxiety often can be successfully treated with counseling, education, and improved communication between partners.
While sexual problems cannot be prevented, dealing with the underlying causes of the dysfunction can help you better understand and cope with the problem when it occurs. There are some things you can do to help maintain good sexual function
When Should I Call My Doctor About Sexual Dysfunction?
Many men experience a problem with sexual function from time to time. However, when the problems are persistent, they can cause distress for the man and his partner and have a negative impact on their relationship.
If you consistently experience sexual function problems, see your doctor for evaluation and treatment.
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