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Sex counsellor
Q&A with Saga's sex counsellor
Saga's sex counsellor, Mary Clegg, offers advice to a woman who feels her husband's use of Internet porn is eroding the intimacy of their own relationship and counsels a man who fears his medication may be interfering with his ability to ejaculate
Effect of medication on ejaculation
Q: I am a healthy 58-year-old, married and with a strong desire to continue my sex life. I am having problems ejaculating. My erections vary in strength, but I find it impossible to achieve ejaculation even though the desire is very strong. As I had also been experiencing some problems with needing to pass water frequently my doctor prescribed tamsulosin hydrochloride. Since taking this I have on one isolated occasion achieved ejaculation, with a greatly increased volume of semen. Any suggestions?
A: Retarded ejaculation is difficult to treat and poorly understood and there can be varying reasons for it. How long you have had the problem as well as the circumstances when you are unable to ejaculate will have a bearing on the cause. There could be a combination of physical and psychological reasons too.
Unfortunately this condition is also a symptom of the ageing process where your sensitivity can deteriorate. Many men think they are sufficiently aroused for sexual intercourse even when they are not. You will need considerably more direct stimulation than before for satisfactory lovemaking and ejaculation. All the fun of foreplay!
As any erectile difficulty can be a silent marker for much more serious undiagnosed illness I would recommend that you see your GP and have a thorough medical examination, which will include tests for cardiovascular disease and diabetes together with testosterone and thyroid blood tests. Anecdotally testosterone supplementation can help as it increases your libido and sense of wellbeing. Ejaculatory duct obstruction is rare but needs also to be ruled out.
Tamsulosin is a drug from a group of chemicals called alpha-blockers which relax the smooth muscle of the bladder and prostate. It has a number of side effects, one of which is difficulty ejaculating. There are other drug options for treating benign prostatic enlargement (including surgery) so I would discuss this with your GP, explaining that the side effects you are experiencing are not tolerable and you would like to discuss other options.
Internet porn is destroying our relationship
Q: We have been married for 31 years and have always had an active sex life with lots of variety and no difficulty turning each other on. However recently my husband has been looking at porn sites on the internet. He won’t talk about it but continues to do it. I looked and felt disgusted, and now find myself not wanting him near me. Any confidence I had is gone and I don’t want him looking at me after seeing all those young bodies. I have told him I hate it and why. I don’t know what is happening to us
A: In a recent survey it was estimated that about nine million men used a pornographic website in the last year and the numbers are increasing.
The internet is a stimulating environment and it is all too easy to get sucked in. If a person who is in a relationship spends too much time in front of the monitor then there is little time for relationship building. Quickly barriers go up and the other partner feels a sense of rejection and a lack of closeness. Worse still a loss of confidence in the relationship fuels resentment, anger and frustration.
There may be many things that trigger this kind of activity; stress, work issues, financial worries or sexual difficulties. If the situation is left too long the problem becomes increasingly difficult to deal with.
As with any problem in a relationship, the sooner you are able to talk about the issues the better – but in your case you appear to have gone beyond this stage and have become confrontational. Both of you have withdrawn to your separate corners and both of you, I suspect, are having difficulty in understanding what has driven you both to this impasse. Your self-esteem has plummeted and your husband retreats further into his fantasy world.
At some stage he will have to realise that his relationship is in serious jeopardy and he will have to do something about it eventually. Facing our problems is never easy and I recommend you get professional face-to-face help. I suggest the first step would be to seek guidance from a properly qualified psychotherapist Relate or British Association for Sexual and Relationship Therapy (BASRT). You will probably be seen on your own and then later asked to engage in couple therapy.
There are many different kinds of therapy and you will have the opportunity of assessing which pathway will be most suitable. There are some very useful websites, such as Beating Addictions.
Cognitive therapy could be used to treat the depression and anxiety that may be causing or a consequence of the addiction. In cognitive therapy the person’s thoughts can be reorganised to gain new understanding. New ways of looking at all the relationship issues, emotions thoughts and feelings and ways of behaving differently to avoid relapse will be explored.
In behavioural therapy, you explore ways of reducing fears and anxieties directly challenging the problem. You will both be shown new ways of managing the situation that will benefit both of you.
In psychodynamic therapy, you look at past experiences and how these have shaped the way you relate to your partner and he to you. Time will be given to explore all the feelings and emotions brought up, so that you can move on to develop a better understanding of each other.
Whichever method you choose it will be helpful for both of you to identify the need to change the way things are now, recognise each other’s limitations and fragility and find strategies that will work for you.
More on relationships
- Is this 'The One'?
- Linda Franklin's frank and funny internet dating blog
- Discuss relationships at Saga Zone
