Dr. Naidich,
I desperately need your help! I have been happily married to my wife for 31 years. We have 3 children and 4 grandchildren. My wife is threatening to divorce since I can no longer meet her "needs". I am 60 years old and have tried viagra a couple times. But I wont use it anymore! The last time I used it, I had to go to the emergency room due an erection that lasted almost two days and a rash on my legs. I am too old for this "sh-t." I spoke to my doctor and he said I should try to satisfy my wife in some other ways. I spoke to her about my doctor's advice, but she told me that she was still in her "prime" and that the other ways were not the same thing. I dont understand my wife's priorities. Please help me.
Dear Desperate,
Let me start by saying I agree with you--no more Viagra!!! With serious side effects like the ones you have experienced, this is not the solution to your problems.
Being happily married for 31 years is quite an accomplishment! I am sure you have weathered many storms together and I don't see why this one should be any different. It sounds like both of you are extremely frustrated with your sex life (and each other) right now. While there are other ways to satisfy your wife's sexual needs it is important to get to the underlying problem here.
While I do not have all the information I would like to have, it sounds like you are suffering from erectile dysfunction (ED). This is an inability to achieve or sustain an erection suitable for sexual intercourse. This is not considered normal at any age. It can be caused by physical or psychological problems. All physical problems must be ruled out first by a medical specialist who will conduct a comprehensive medical/psychosocial interview and battery of tests.
The doctor will want to know if you can ever get an erection, if you get erections in the morning or at night, if you can masturbate, if you can get (and/or maintain) an erection in the presence of your wife, what medications you take, what chronic illnesses you have, how your relationship with your wife is going (are you still attracted to her/have you had an affair), what major life stressors/changes you have recently experienced, what your alcohol consumption is like, how much exercise you get, etc. A thorough medical examination and tests such as a complete blood count, liver and kidney function, sexual hormone function, thyroid function, cardiac function, blood flow function, etc. should be conducted. If the cause is physical there are other options, aside from Viagra, to treat the problem. If medical factors are ruled out--stress, depression, fatigue, too much alcohol, performance anxiety, or relationship problems may be the primary culprit. If this is the case cognitive-behavioral therapy is indicated.
Since your wife is threatening divorce, I strongly recommend that you start couple's counseling with a cognitive-behavioral psychologist who specializes in sex therapy and relationship issues (while you simultaneously rule out physical factors). Your wife may be unhappy about other problems that she is not telling you about and blaming it on your inability to meet her sexual "needs". Perhaps she has other needs that she feels are not being met or is dissatisfied with other aspects of your relationship. The same goes for you. Your sexual difficulties might be based on underlying psychological or relationship factors that need to be addressed with a therapist. Sometimes having a third party in the room who is specialized in getting to the root of the problem and facilitating communication can make a huge difference! Even if you find out that your problem is medical this certainly can't hurt at this point. At least your wife can get some useful information about ED.
Go find out what is really going on--avoid divorce and heal your marriage.
Let me know how it works out! Best of luck!
Dr. Naidich
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