Iā€™m 45 and terrified I might be impotent

7 March 2025

My wife and I are currently in a bit of a tough spot. We havenā€™t had sex in around eight months as I have been struggling with maintaining an erection.

I never had issues with this up until the last year or so. At first, we chalked it up to stress with work, and anxiety post-Covid. And now I feel like itā€™s also performance anxiety ā€“ a vicious cycle of thinking that the longer it goes on, the more this might be a permanent thing.

I know it frustrates my wife as we are not able to be intimate and itā€™s really impacting me mentally and emotionally as I worry she thinks itā€™s because Iā€™m no longer attracted to her. I also donā€™t want to hold her back or make her live a sexless life at 42.

Iā€™ve gone to the GP about it and theyā€™ve told me to monitor my stress but I feel like thatā€™s not really helpful. Is this my life now? I feel depressed and scared. What should I do?

ā€˜Have you been using porn? If so, Iā€™d encourage you to avoid itā€™ says Kenny (Photo: monkeybusinessimages/Getty)

So many men in their mid-forties start struggling with erectile dysfunction (ED) and I want to reassure you that neither you nor your wifeā€™s lives are going to be sexless from here on in.

The first thing Iā€™d recommend you do is communicate with your wife about your worries that she might think youā€™re no longer attracted to her. Has she expressed this to you, or is it your concern? Make it clear that the attraction is still there and it isnā€™t anything lacking in her. Reassure her that you donā€™t want either of you to have a sexless life.

Communication here is key because youā€™ll find that the more open you are with her, the more she will understand the situation, and the less your worries are likely to swirl.

Then, take yourself back in your mindā€™s eye to what was going on in your life a year ago when you first noticed this issue. Itā€™s very likely that something was going on. If you can work out what might have triggered this very common response, youā€™ll be much closer to moving past it.

Did anything change at that time in your inner or outer environment? Your outer environment might be a work-related change such as an influx of younger people whoā€™ve reminded you that youā€™re a different generation or a downturn in business; or it might be related to stressful interactions in your community or sports. What were the work stresses you were experiencing at that time? How did they make you feel?

Do you have any health concerns of your own? If there are health issues in your life, or medication that you take, these can play into ED and Iā€™d recommend returning to the doctor and asking whether there could be a link. Did your lifestyle change? As you probably are aware, bodies tend to become less forgiving as we age and a healthy diet and regular exercise are important for erectile function.

Examine your inner thoughts: have they become more fear-based? What exactly are you anxious about post-Covid? Has health been brought into the fore of your mind? Did you lose loved ones during the pandemic?

Iā€™ve noticed in menā€™s groups how frequently issues from the past rise up when people are in their forties ā€“ often because their lives now feel safe and secure enough to come to terms with them, rather than keeping them buried.

Trauma from childhood and young adulthood can have a huge impact on ED and this might be the time to deal with past issues so you can have a deeper relationship with yourself and become more open-hearted with your wife.

Often in our twenties and thirties, weā€™re in survival mode and on full throttle building careers and our own lives. In our forties, we might be more settled and this is when anything weā€™ve suppressed is likely to surface. If this might be the case, Iā€™d encourage you to acknowledge those subjects and the feelings they created in you, perhaps with a therapist or friends.

Have you been using porn? If so, even if in the past this had no effect on your sex life, Iā€™d encourage you to avoid it, or instead seek out ethical porn such as Erika Lust. A review into pornography this month found that free and easily accessible content has become increasingly violent, degrading and misogynistic.

Viewing porn frequently desensitises people from intimacy and connection with their partners. Itā€™s almost as if when faced with the love of a real person, where thereā€™s no skipping to the most stimulating bit, or possibility to jump from one place to another, or overstimulation, the body starts to struggle.

Itā€™s also important to consider how youā€™ve felt towards your penis over the past year. You might feel angry or frustrated that itā€™s causing you these problems. If thatā€™s the case then itā€™s worth changing your mindset ā€“ this is most probably about every other part of you, rather than your penis. If you feel like youā€™re on the same side then everything is more likely to flow.

Once youā€™ve identified external and internal factors that might be contributing to this temporary ED, I would recommend spending more intimate time with your wife while not having sex. Completely take it off the table for a month, but dedicate more time to giving each other pleasure in bed; make this time about rebuilding intimacy with no pressure at all.

You might previously have felt that sex was all about you performing to make her happy ā€“ a surprising number of men see sex this way ā€“ but now is the time for you to receive and find out what she wishes to receive. Make time and space, be present and enjoy so your body can relax and focus on living rather than survival, love rather than fear, intimacy rather than performance.

While itā€™s not uncommon these days for men to take Viagra ā€œjust in caseā€, Iā€™d encourage you to not go down that route because it again focuses on performance over playfulness and relaxation. Talk to your wife about what she enjoys: you might find that she sees sex as much more than penetration, and that intimacy and orgasms are important for her.

If you find talking about sex difficult, then you might want to use the Wheel of Consent framework, developed by Dr Betty Martin. This helps you understand when youā€™re giving (or serving), receiving, taking or accepting and might give you the language and a structure with which to talk about intimacy.

I hope very much that after addressing internal and external worries and stresses in your life and taking time to explore each otherā€™s bodies as if anew, learning about each otherā€™s pleasure and your own, you might find that your ED issues are a thing of the past.

My strong suspicion is that while the symptom youā€™re experiencing is ED, the cause of your current problems does not lie with your penis.