Knowing how to deal with erectile dysfunction in a relationship is a challenge, both physically and mentally. In this generously donated article, one man (in a relationship with a woman) shares how he’s re-built his sexual confidence and erection resilience over time post Prostate Surgery.

If you enjoyed PIV (‘penis-in-vagina’) sex pre-Prostatectomy, then I imagine you will be asking yourself post-surgery:

‘How hard do I need to be if I want to make love again? ‘

‘And, what’s it going to take; pills, a vacuum device, or [heaven forbid] injections?’

Some men might not know when to try, how to try, or how best to succeed.

And failure, particularly in the face of hopeful expectations, can be quite devastating to confidence. It can make things even, dare I say, ‘harder’ going forward.

A softening penis in the midst of sexual intercourse can potentially initiate a catastrophic cascade of emotions and physical consequences:

1.     It’s going soft, you get distracted from erotic thoughts.

2.     That makes it a little softer, causing less friction and a loss of sensation.

3.     As your penis softens it starts to scrunch up, rather than glide all the way in.

4.     Because it won’t go all the way in, you lose sensation around the base of your penis and lose the bump effect of your pubic bones hitting together.

5. There’s less stimulation, and more worry.

6.   You fall out. You get a rush of adrenaline. It’s all over. 

Here’s my antidote to this cascade above:

Build ‘Erotic Confidence’ through small steps.

Given the slow rate of nerve recovery post-Prostatectomy, a successful strategy I’ve found is taking small, achievable steps.

This approach creates a positive feedback loop over time, and has built erotic confidence for myself, and my partner.

A bit like how compound interest eventually makes you more money.

STEP ONE: Focus on what you can feel, not what you can achieve.

It’s important not to panic when you start trying out sex again post-PC. Just be patient, and remember that you are there to enjoy and have fun, not perform a circus trick.  

I’ve found using oil or lubricant on our bodies and genitals can be a great way to feel more sensation, and encourage more slow touch.

Touch is essential. As well as generating Vitamin C (Confidence), you need Vitamin O (Oxytocin).

Oxytocin is free and is generated through touch. The more you touch each other, the more Oxytocin both of you produce giving you both more pleasure, and a better chance of building that confidence and the resilient erection you desire.

Here’s how I do it:

First, we spend time cuddling face to face in the missionary position. Then, when we’re both ready, we slowly press our genitals together. I hold the base of my penis to help retain blood.

My partner tells me the opening of the vagina and inner labia can be incredibly responsive to this type of gentle touch and building arousal, so we take our time.

Early on, I would find it quite frustrating when my erections stubbornly refused to rise from this delicious anticipation. The visual delight of seeing my partner warm to the occasion used to produce an instant response. Instead, there was tingling in all the right places, but no standing to attention!

Therefore, it was always necessary to masturbate to create any kind of erection in the early stages of rehab. To start the process, what works for me is base-to-tip stroking to help draw blood into the penis.

Like a lot of men doing penile rehabilitation, I’ve been prescribed a daily dose of PDE5 inhibitors. This is to maximise blood flow to the penis when aroused.

Early on, these pills alone were insufficient to do the job. So initially I augmented my erections using a Vacurect VED (vacuum erection device). Over time I’ve been able to use larger and larger restriction rings. Now, I can do without them entirely.

But, back to the sex!

If we can successfully make a start at penetration, I ask my partner to lift one or both legs. This makes the vagina feel straighter, so my penis can be pushed downwards with less interference from pubic bones bumping at a less-than-ideal angle.

Our aim here is just to concentrate on how the whole process feels, and make that long awaited connection.

STEP TWO: Deliberately hold back on traditional thrusting.

I’ve been surprised by how little rigidity is required to penetrate the opening of a vagina.

I haven’t had much luck with a totally flaccid penis, but as tumescence increases, it might bend in the middle and yet still have enough ‘lateral rigidity’ to make a start.

I call that a 5/10 erection.

Once inside, every now and then I try to take the next step. Perhaps some short thrusting, or just worming my way further in.

Over time I’ve gained the erection resilience to begin thrusting in and out, but much slower and more deliberate than pre-surgery.

To start, I practiced pulling almost all the way out before the next inward thrust. 

Not only does that feel nice, it builds a huge amount of confidence. It’s a bit like tempting fate and then giving anxiety the finger; very inspiring!

STEP THREE: Develop a repertoire of erotic re-stimulation strategies.

I’ve battled long and hard on the mind game of sexual confidence.

Before Prostate Cancer (after I got a little older) my erection would sometimes wane during sex. I would need to fantasise, talk dirty with my partner, change position, marvel at her sexy body, do something to get my erection back up and working.

Post surgery, I find it’s a much finer line. It’s much easier to lose that mental connection to the erotic moment.

When my erection wanes, sometimes my partner might come to the rescue doing or saying something that re-stokes the fire. But she’s only human, and might be tired, distracted or concentrating on her own experience.

So I’ve needed to build a repertoire of ‘erotic re-stimulation strategies’ to manage on my own.

The second I feel my erection faltering I think:

“That’s okay, don’t worry, it’s just part and parcel of making love, I’ve been here before and this does not mean the end”.

I then pull out one of my erotic strategies.

It might be to lift up and watch our pelvises bang together, or simply marvel at her gorgeous breasts. I might fantasise about ‘that time in the bath house in Turkey’ and modify the story line to my own nefarious purposes. Being ready to boost your arousal is the key.

Let’s face it, faltering tumescence in older guys and post PC men is just normal.  Peaks and troughs in arousal are normal and during love making, can be somewhat cyclical.  

The troughs can be overcome without anxiety ruining the picnic. As long as we don’t panic and let thoughts of disappointment overwhelm us. 

Practice patience. And remember, you’re there to enjoy and have fun, not perform a circus trick!

Conclusion

I reckon one of the most brutal disappointments for men with ED is the sudden lack of confidence in their erection. The constant worry that it won’t stay hard enough to “do the job”.  

That’s why I think these smaller, achievable steps towards something that feels ‘normal’ works.

Once you have achieved a step, you can return to this place of certainty over and over again. 

That’s how my journey started almost 12 months ago.

And now, this build up of confidence has led to the latest “step” for me:

Being able to make love without the clunky prelude of creating an erection manually first.

One night, with all those previous small steps under my belt, I felt like ‘the little red engine who could’.

My wife was so turned on by all the slow touch-based build-up we’d created, that I simply dove in with what was available. Then, as if by magic, I felt my erection grow inside her. An incredible feeling.

This process has brought my wife and I close to that spontaneous, less contrived sex we had enjoyed until PC reared its ugly head.

And for my soul, it has done a giant dose of good.