17 Ways to Improve Your Sex Life
Impotence. The word somehow sounds like failure, weakness. If you feel that you are impotent, you may also feel that you have somehow lost part of your dignity, your masculinity, your wholeness.
There are many degrees of erectile difficulties. Some men may be able to achieve an erection, but are not able to maintain it. Others become erect, but not extremely rigid. Still others only have problems when they are with a new partner or with a long-time partner. And of course, there are those who cannot achieve an erection at all.
Do not despair. You may be suffering from a physical or emotional problem (or both) for which there are definite solutions. If your problem is of an emotional nature, the following tips may help. If your erectile problems arise from a medical condition (see "Could It Be a Medical Problem?"), there are now many new surgeries and therapies that can help restore your sexual health.

Whatever the nature of your problem, remember that almost every man has difficulties with erection at some point in his life. You are not abnormal, nor are you alone. There is no need to suffer in silence. Don't let embarrassment keep you from sexual health and happiness.

Remove the performance demand.
It's not unusual for a man to have an occasional episode of impotence, after drinking alcohol or after a particularly stressful day, for example. However, if he places too much emphasis on the incident and harbors fear that it may happen again, the anxiety itself may become a cause of erectile difficulties, says Michael B. Geisser, Ph.D., an assistant professor in the Department of Clinical and Health Psychology at the University of Florida in Gainesville. "Some men engage in thinking that distracts them or takes away from their sexual performance," he says. "Generally, we teach them behavioral exercises that take the performance demand out of the situation and relieve the anxiety about having to get an erection." One strategy that sex therapists often use is to have couples abstain from intercourse altogether, telling them instead to engage in cuddling and nonsexual touch. Gradually, over a period of weeks or months, depending on the couple, the partners work toward more sexual touching, then intercourse. The idea is to make sex a less-threatening experience, Geisser says.

Break out of a rut.
"One problem in people's sex lives is that they get into certain ruts and routines and they don't have much novelty," says William O'Donohue, Ph.D., an assistant professor of psychology at Northern Illinois University in De Kalb. "For example, they always have sex at 11:00 at night with the lights off, with the same foreplay, and so on. Their sex lives are relatively invariant. Soon, their partner becomes about as exciting to them as a flounder." His recommendations? Incorporate some variety-go to a hotel or a different setting. Vary the routine. Buy your wife some new lingerie. In short, spice up your sex life.

Learn to relax.
Stress, arising either from performance anxiety or from other life situations, can also be a culprit in erectile problems, according to Geisser. Regardless of the cause, it's difficult to enjoy yourself when you've got too much on your mind. "Relaxation exercises are helpful," Geisser says. He recommends deep breathing or progressive muscle relaxation, where the person consciously tenses and relaxes each part of the body in sequence. "In and of itself, as a treatment for impotence, relaxation is not effective," Geisser says, "but it may be a good first step for someone trying to improve their own functioning."

Express your feelings.
Marital or relationship difficulties are notorious contributors to sexual problems, according to Raul C. Schiavi, M.D., professor of psychiatry and director of the Human Sexuality Program at Mount Sinai School of Medicine in New York. Anger, resentment, and hurt feelings often spill into the couple's sex life, turning the bedroom into a battlefield. This situation is especially likely to develop if partners are noncommunicative, therapists agree. "You need, to verbalize your feelings," Schiavi says. "Not in terms of accusations, such as 'you did this,' or, 'you did that,' but more like 'I felt upset or hurt when you said that."' In other words, use "I" statements, and keep the focus on your feelings, instead of on your partner's actions. Doing a thorough housecleaning of the relationship, instead of storing up emotional debris, may very well clear the way for a healthier sexual union.

Talk about sex.
Sometimes, erectile problems can come right down to not feeling aroused. In these cases, sex therapists often work to help patients communicate more openly about their sexual relationship, according to Geisser. "This can be an embarrassing area, one that people don't talk about," he says. "Not talking contributes to the problem. We encourage people to communicate about what they like in sexual situations, so they can get more pleasure and stimulation out of it." Again, to avoid defensiveness and hurt feelings, "I" statements are key, Geisser says. Choose to make assertive, rather than aggressive, statements.

Don't drink before sex.
Drinking alcohol or being drunk can significantly impair your sexual functioning, says Schiavi. His advice is simple sex and booze don't mix.

Remember your successful experiences.
If performance anxiety has undermined your confidence, thinking about positive sexual relationships or experiences you have had in the past may help boost your self-esteem, says Geisser. It may also convince you that you can have a fulfilling sex life in the future. "We have patients think about past successful sexual experiences, to try to shift the focus from worrying about the current situation and to help them experience it in a more pleasurable fashion," Geisser says. Involve your partner. Although erectile difficulties originate with the man, they are a couples' problem and have couples solutions, according to Kenneth R. Fineman, Ph.D., a clinical psychologist and associate clinical professor of medical psychology at the University of California at Irvine School of Medicine. If the problem is not a medical one, there are many strategies that can help. However, your chances for improvement are much better if your sexual partner is involved in the solution, Fineman says. "If you are in a committed relationship, you need to develop a strategy to get your partner in there. Convince her that she is the most logical solution to the problem."

Know that you are not abnormal.
It can never be stated enough: Having problems with erection does not mean that you are physiologically or psychologically abnormal in any way. It is not your fault. "People tend to feel guilty about their sexual problems," says Geisser. "Men often feel that, to a certain extent, they have lost their masculinity. It may bring on a significant decline in self-esteem. But the truth is, most men, for one reason or another, experience erectile failure. Even if periodic failure occurs, try not to get too upset about it. Oftentimes, people really come down hard on themselves or have a partner that gets very distressed and feels that it is because they're unattractive or unwanted. Getting too upset can lead to performance anxiety. Do your best to be open and understanding about the problem."

Read, then talk.
Many of the sex therapists interviewed for this section said that they were often surprised by their patients' lack of knowledge about the sex act itself. There is a plethora of helpful written resources out there--books that can help you and your mate solve your problems and work toward a more mutually satisfying sex life, says Fineman. "Read the various manuals, the ones that are appropriate, not X-rated material," he says. "Then dialogue about it. One person says 'I think that's silly,' and the other might say, 'Well, why not? I'd like to try that.' Read books about sex, even if you don't choose to go on to try the exercises."

Develop coping strategies.
Just as penis size isn't the measure of sexual prowess, neither is the rigidity of the penis, says Schiavi. "In a study of 100 healthy, aging couples, there was a decrease in sexual drive as age progressed," he says. "There was also a decrease in the rigidity of the penis and in the frequency of intercourse. However, couples who developed coping strategies to bypass these difficulties, by assisting insertion manually or by developing alternative ways of reaching orgasm, still rated themselves as sexually and maritally satisfied." The moral of the story is: Creativity pays off.

Skip the aphrodisiacs.
Spanish fly and other so-called aphrodisiacs are usually little more than placebos sugar pills that do nothing but boost your confidence, says Geisser. In fact, he adds, no drug has ever been shown to boost sexual performance with any degree of reliability. What's more, Spanish fly can be very dangerous to use and can even be fatal.

Employ fantasy.
Many men with erectile problems engage in "spectatoring," or constantly observing their own sexual performance, says Schiavi. This takes the individual out of the moment and leads to being overly critical, he says. "We try to set up a situation where the attention is focused someplace else on experiencing pleasure as one is being caressed or on experiencing the pleasure of caressing someone else. We also may advise the use of fantasy focusing on a sexual fantasy that may involve the partner. This helps to minimize spectatoring and enhance sexual arousal."

Try masturbation.
Performance anxiety is just that-anxiety over performing. But sex between loving partners was never meant to be an off-Broadway production. Don't forget that while it's important to please your partner, you're also there to please yourself. Masturbation bringing yourself to orgasm while you are alone-may be helpful by reteaching you how to achieve your own pleasure (as long as it's not overdone). The next step is to bring that ability into a sexual situation with your partner changing the focus from performance to mutually pleasurable interaction, says Fineman.

Don't be afraid to seek help.
When you've tried everything, to no avail, it's time to seek medical attention, says Geisser. Studies have shown that therapy can significantly improve a couple's sex life. Where you go is up to you, but do your homework and shop around. Many states have certifications in sex therapy. Licensed psychologists will also be able to help you (and may be better regulated, according to Geisser). Get referrals if you can. The most important thing is to find a certified or licensed professional who has helped others with problems similar to your own.

Prevention Tips
Several types of medical conditions and injuries can make you impotent-permanently, according to Irwin Goldstein, M.D., a professor of urology at Boston University School of Medicine and codirector of the New England Male Reproductive Center at University Hospital in Boston. Here is his advice on preventing the most common physical
causes of impotence:
Quit smoking. Studies conducted at Boston University School of Medicine have shown that smoking is associated with blockages in the penile arteries, obstructing the blood flow that is necessary for an erection. The findings aren't really a surprise, since previous studies have linked smoking to blockages in the arteries of the heart, according to Goldstein. "Impotence is similar to vascular diseases, such as arteriosclerosis," he says. "It is the manifestation to the penis of those types of disorders. The smart person would say: Don't smoke, exercise, don't eat high-fat foods. In short, be smart about your cardiovascular health. That will impact on your potency and your sexual health." Quitting smoking won't reverse existing damage, but it can help prevent it from worsening

Protect your crotch from injury. One very common cause of impotence, especially in young men, is an injury to the crotch area. Often, these injuries (and the impotence they cause) do not heal of their own accord and must be treated with surgery "People who bicycle should be very protective of the crossbar," says Goldstein. "Other activities that require caution include karate, horseback riding, rodeo riding, and anything else that may cause injury to the crotch." If you believe that your erectile difficulties were caused by such an accident, you should see a doctor

Could It Be a Medical Problem?
The word "impotence" can be a little vague, since it refers simply to erectile failure and does not address the source of the problem. However, the causes of erectile difficulties can range from diseases (such as diabetes) to guilt about sex. So how do you tell the difference between a physical or a psychological cause?
"Both factors contribute a great deal," says Raul C. Schiavi, MD. "Even if the patient has a clear physical factor, there are always psychological factors contributing to the problem." The most common diseases that cause impotence are diabetes, cardiovascular
disease, Parkinson's, multiple sclerosis, and epilepsy In younger men, accidents, such as a gunshot to the spinal cord, car crashes, and skiing wipeouts, are often responsible. Other problems can include hormonal imbalances, says Schiavi. Lastly, there are several prescription drugs that can impair erectile function. Among the most common in this
category are blood pressure medications and antidepressants. Of course, alcohol, marijuana, and cocaine can also keep you from achieving an erection.
If you have a sexual problem and have one of the illnesses listed above or have just started taking a prescription medication, contact your physician, Schiavi recommends.
Likewise, if you have doubts about whether your problem is physical or emotional, see your doctor