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Anal Sex and Erectile Dysfunction

Oct. 7, 2010
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I am 60 years old and have been married for 37 years. My wife and I have incorporated anal sex into our lovemaking. We both give and receive. She will use large dildos on me, and she will also use a strap-on (pegging). Usually, once she finishes with me, I am able to maintain an erection and return the favor. This has been going on for 20 years. Over the last three years, I noticed that I cannot maintain an erection. If she doesn't use the dildos, I am able to maintain. I am in good health; I've been a Type 2 diabetic for 25 years, but it’s under control.Is it age or mental?

We get many questions about both anal play and erectile dysfunction. Since this particular question might involve a medical issue, I turned to Mark P. Behar, PA-C, a physician assistant at Milwaukee Health Services Inc. and a volunteer at Brady East STD (BESTD) Clinic. Here’s what Mark had to say:

“Several things might be contributing to the inability to maintain an erection during sex. Using dildos with adequate lubrication should be fine as long as they do not cause pain. I can't explain why dildo use now prevents you from getting and maintaining an erection, since you've been successfully using them for so long. I'm sure you already know that dildos come in many lengths and diameters, shapes, and materials, ranging from soft to very rigid. Perhaps a different type of anal stimulation will be better. Sometimes even gentle and careful anal stimulation can irritate hemorrhoids and may cause bleeding from an inadvertent crack or scrape.

“Libido and sexual ‘performance’ tend to diminish as men get older, and this may be due to several factors, including lower testosterone levels. Chronic conditions, such as diabetes, reduced kidney function, high blood pressure, obesity, high cholesterol, certain medications and drugs, alcohol and tobacco use, as well as other health conditions may also affect a guy's ability to develop and maintain erections, and have satisfying ejaculations with orgasm ("climaxing"). When you say that your diabetes is ‘under control,’ that doesn't mean that it may not beaffecting your ability to have sex. And you didn't mention if you've had a screening colonoscopy to check for diseases of the large intestine and rectum.

“Once a guy begins to experience problems with having sex—due to worry, anxiety, or other psychological reasons or for medical reasons, then sexual performance can be affected. You may benefit from using erectile dysfunction medications (Viagra, Levitra or Cialis), but your health care provider needs to make sure the rest of you is OK and there may be no other explanations for your complaints.”

So, in short, the change you’ve noticed could be age-related, it could be mental, or it could be both. I echo Mark’s recommendation to talk to a health care provider. Also, our bodies do change as we age, and we might not be able to do things that seemed easy for us in the past, sexually or otherwise. Rather than look at this as a failure, I encourage you to see it as an opportunity to explore other types of anal stimulation and play that are satisfying for both you and your wife.

Want Laura to answer your questions in SEXpress? Send them to
laura@shepex.com. Not all questions received will be answered in the column, and Laura cannot provide personal answers to questions that do not appear here. Questions sent to this address may be reproduced in this column, both in print and online, and may be edited for clarity and content.

Laura Anne Stuart has a master’s degree in public health and has worked as a sexuality educator for more than a decade. She owns the
Tool Shed, an erotic boutique on Milwaukee’s East Side.




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