ED Treatment

How To Deal With Erectile Dysfunction in a Marriage

April 4, 2022

Erectile dysfunction is a fairly common occurrence for men, with an estimated 50% of guys over the age of 40 having experienced ED of some severity. 

How it affects married men and single or dating men, however, can vary significantly.

For married men, erectile dysfunction may lead to a loss of intimacy as well as feelings of low self-esteem, anxiety, or depression. All of these emotions can affect the mental well-being of both partners and potentially damage the relationship. In many cases, ED can also be a symptom of relationship or marital trouble rather than the cause.

But ED doesn't have to be the beginning of the end. Here’s some advice on what you can do about ED in a marriage. 

What is Erectile Dysfunction? 

Erectile dysfunction is the medical term for difficulties related to achieving or maintaining an erection that's firm enough for sexual activity. Achieving an erection involves the brain, hormones, emotions, nerves, muscles, and blood vessels. 

An issue with any of these many important physiological systems can make it harder to get or keep an erection. 

While not being able to achieve an erection occasionally isn't generally cause for concern, if ED becomes a frequent occurrence you may want to consider speaking with a doctor, especially since erectile dysfunction can be a symptom of another underlying medical condition. 

What Causes Erectile Dysfunction? 

The process of getting an erection is delicate and complex. While there is no single "reason" for erectile dysfunction, there are many contributing possibilities, mostly related to your cardiovascular system. Because an erection requires great blood flow, anything that impedes your body's ability to properly deliver blood where it needs to be can lead to ED.

Some of the most common causes of erectile dysfunction include:

  • Alcohol or substance abuse 
  • Atherosclerosis 
  • Cardiovascular disease
  • Chronic kidney or liver disease
  • Diabetes
  • High blood pressure or hypertension
  • Low testosterone levels
  • Medication side effects, such as antidepressants and high blood pressure treatments
  • Mental health conditions, such as stress, anxiety, and depression 
  • Obesity
  • Parkinson’s disease
  • Peyronie’s disease
  • Sleep disorders
  • Surgeries or injuries to the pelvis or spine
  • Using tobacco products

What is the Emotional Impact of Erectile Dysfunction? 

Sex or intimacy is a critical part of most marriages. It’s one of the many ways that people express their love for each other. Research has shown repeatedly that sharing intimacy deepens bonds and feelings of connectedness.

In most marriages, that's something we don’t experience with anyone else, and it can be key to a lasting bond.

Erectile dysfunction can severely disrupt the sex life of married couples and lead to additional issues as a result. 

One 2014 study confirmed that erectile dysfunction made men depressed, frustrated, and had a negative impact on their self-esteem. They also had an increased tendency to avoid their spouse. 

It’s not just men that are impacted emotionally due to erectile dysfunction, either. A review in 2016 found that the partners of someone experiencing erectile dysfunction felt more confused, anxious, undesirable, and suspicious that their partner was cheating. 

With both partners impacted by the effects of ongoing ED, it may not take long before cracks can start to develop in even the strongest relationships.

Tips For Dealing With Erectile Dysfunction Together 

The most important thing to keep in mind is that erectile dysfunction is common (especially for men in their later years) and treatable. Several highly effective prescription medications are available affordably, with minimal side effects.

As you consider prescription treatment, it’s important to also remain open, understanding, and supportive in your relationship.

In one study, when asked if having the support of their partner was highly important as they were dealing with erectile dysfunction, 94% of men said yes

Talk About It 

Considering its frequency (an estimated 10% of guys for every decade of life, so 30% of men in their 30s have dealt with ED), erectile dysfunction is nothing to be ashamed.

Ideally, say doctors, it should be addressed head-on with both partners.

Very often in cases of erectile dysfunction, men feel guilt or embarrassment about the event and will begin to avoid intimacy with their partner.

In turn, this behavior is often interpreted by the partner as a rejection of them, causing the partner to start feeling unattractive or unwanted. The symptoms of ED can lead both partners to believe that an affair is happening. 

These compounding problems can be avoided if a couple is open and honest about how they feel and what they're experiencing. Science has proven time and again that erectile difficulties don't mean that a man is any less masculine, or that his partner is necessarily undesirable.

It’s important that both parties understand these truths. 

Go To Therapy 

It’s also possible that the relationship itself might be leading to erectile dysfunction.

Emotional distress is one of the leading causes of erectile dysfunction, and difficulty in the bedroom can quickly exacerbate issues in a troubled relationship. 

Seeking therapy individually, although preferably as a couple, can help both partners express their thoughts and feelings in an open and intentional setting. Experienced counselors won't be surprised at this conversation, and quality guidance from a pro can lead to a better understanding of both partners' needs and frustrations. 

In fact, studies have shown that between 50% and 70% of men with erectile dysfunction due to stress saw their symptoms improve when their partner started attending therapy sessions with them. 

Get Creative With Intimacy 

When someone is experiencing erectile dysfunction, penetrative sex might not be possible. However, there are plenty of other ways for a loving couple to be intimate with each other. 

Kissing, cuddling, and hand-holding are affectionate actions that will help people feel closer to each other. In addition, there are lots of sexual techniques and positions for both partners to experience sexual pleasure without relying on penetration. 

Having multiple paths to pleasure will help reduce sex-related performance anxiety, which is a key risk factor for developing erectile dysfunction. 

What Are the Treatments For Erectile Dysfunction? 

There are a variety of medical treatments and approaches available for erectile dysfunction. The most effective will depend on what's causing the erectile dysfunction in the first place. 

Some of the best ED treatments include:

Lifestyle Changes 

One of the most effective treatments and best options for an ED cure is to change certain lifestyle habits that might be the reason for your erectile dysfunction. 

For example, getting enough daily exercise will help to improve blood circulation, which will help during the erection process. It may also help you lose weight, especially when coupled with a healthy diet, which can improve cardiovascular and respiratory function, both key to great erections. 

Alcohol can cause trouble with sexual function, and smoking is another culprit as well. These are two of the biggest risk factors for developing ED. Cutting back on alcohol and quitting smoking can help improve sexual performance. 

You might even use these changes as a bonding exercise with your partner. Committing to exercise together every day or so could be another activity that you can enjoy together. Taking long walks and cooking healthy meals together can be a great way to boost intimacy and bonding in a nonsexual way.  

Prescription Medications 

The most common and popular treatments for erectile dysfunction are Viagra® (sildenafil), Cialis® (tadalafil), and Levitra® (vardenafil). These prescription drugs help to improve blood flow into the penis, allowing for firmer, longer-lasting erections. They're effective for the majority of guys who try them, and they're generally safe for ongoing use once prescribed. 

They're also inexpensive thanks to generic formulations available from providers like Rex MD.

While not a permanent cure, they can help you achieve and maintain an erection firm enough for sex.

These medications do interact with several other medications, particularly high blood pressure medications and nitrates, and are not suitable for everyone. 


For men who can’t take these commonly used oral medications for whatever reason, direct penile injections are available. These treatments involve small injections of a medication called alprostadil or a mix of medications into the penis just before sexual activity begins.

These injections are effective for most men who try them, and the erections typically last for around 30 minutes or until climax. 

The Takeaway

Erectile dysfunction is frustrating and challenging to experience alone, but it can be even harder to deal with when married. It’s important for both partners to recognize that ED is a common occurrence for men as they age, and working collaboratively and openly is the best path to resolving the issue and deepening their romantic bond. Understanding and treating root causes (whether physical or mental) with the help of a clinician can help, and effective prescription ED medications are one of the fastest ways to jumpstart intimacy in the marriage once again.

Marriage takes commitment even in the best of times, however, dealing with the effects of erectile dysfunction can create new stressors in a marriage. It’s important that both partners are open and honest about how they feel, specifically in regard to sexual intimacy issues that may have arrived with the erectile dysfunction.


(PDF) The role of the sexual partner in managing erectile dysfunction | Research Gate

Treatment for Erectile Dysfunction | NIDDK

Recent advances in the treatment of erectile dysfunction | BMJ Journals

Erectile Dysfunction (ED) | NIDDK

Transition Stages in Adjustment of Wives With Their Husbands' Erectile Dysfunction