How to satisfy your wife in bed

My wife and I can spend up to three weeks without sex and when we do, I don't satisfy her. Please help me.

Frustrated Man

Dear Frustrated Man,

Thank you for writing to me sir. Due to the fact that certain crucial details are missing from your questions e.g. your age, any medical issues, etc, allow me to answer you in generalities.

What you may be going through is sexual dysfunction. There are varied reasons for sexual dysfunction in men. Some of them are a medical condition, stress and psychological challenges.

Medical conditions that can impact a man's sexual health include but are not limited to: diabetes (which can affect the nerves including those in the penis, often leading to weakened erections, decreased libido and premature or delayed ejaculation), being over weight or obese (which can interfere with a man's sexual stamina due to fatigue, not to mention the effect of fatty deposits on blood flowing through the veins, including the penis), hypertension/HBP (which hardens arteries, limiting blood flow including the blood flow to the penis.)

This can lead to challenges like weakened erections, decreased libido and premature or delayed ejaculation. Other medical conditions that your doctor may look at would be hormonal imbalances, any sexual or physical trauma or injury that could affect your genital region and even STIs.

I know that these possibilities can be scary but it's important to note that medical interventions are available and accessible so there is no need to worry. More likely than not, a medical issue can be treated and sexual function is likely to improve. A good first step is to visit a doctor (GP or urologist) to establish whether or not there could be a medical reason for your dysfunction.

What are some other causes of male sexual dysfunction?

Assuming that you are in good health, please consider the following:

1. Psychological challenges: These include depression, anxiety and other mood disorders. Treatment can include medication, talk therapy or a combination of the two. The benefits of talk therapy cannot be stated enough. It's not enough to take medication; it's important to speak to a mental health professional who can offer you ethical, compassionate mental health support.

2. Stress

Life being what it is, the stresses that form part of the seasons of our lives can have a negative impact on a man's sex life. Ask yourself: have there been any major life changes e.g. birth, death, child moving out of home, elderly parent moving in, new job or even graduation? Has anything happened to increase your worries? Are your parents unwell?

 Are you getting married? Do you have a big project at work? Is there a significant anniversary coming up? Please note that major life events need not be negative for them to have a negative impact on a man's sexuality so don't overlook them.

Ways to get help

Once you identify a source or cause of stress in your life, take direct and immediate measures to reduce your stress levels. I have a new 10 minute rule: do something that connects you to your soul/essence/goodness for at least 10 minutes per day.

Do you love music? How about listening to music at least 10 minutes every day? Do you love (or need) to work out? How about exercising to an exercise video or jogging/walking? You can call a friend who makes you laugh or feel good about yourself and have a chat for at least 10 minutes. Get the idea?

Commit to doing something for yourself daily for at least 10 minutes. Write it down and post it someplace visible in your home as a reminder or get someone to support you but whatever you do, begin today.

Talk therapy has many benefits which include support in learning how to cope, set boundaries, self care and strengthening your self esteem.

In terms of finding a therapist who is a good fit for you, my general rule of thumb is this: if you see someone and cannot feel a connection after three sessions, something is off. Start by bringing it up to your therapist and if things don't improve, do not be afraid to seek the help of another therapist.

Speaking of therapists, be wary of those who give you advice (it's unethical for a professional to offer advice to a client), who make you feel judged, who don't listen e.g. taking phone calls during sessions, etc.

On behalf of therapists, I'd like to say two things:

1) Please be open with us because our deepest hope is for you to experience improvement but we can't do that if you withhold relevant information, and

2) We are not magicians. Therapy is a process and processes take time. Expect to feel supported and hopeful from day one but don't expect magical solutions. Give the process time. Therapy also requires your commitment as much as that of your therapist.

Maggie Gitu is a Marriage, Family & Sex Therapist. She can be reached at [email protected] and via her Facebook page: Maggie Gitu