Hello MKE SEX,

How do you bring up to a partner that he may have erectile dysfunction and you want him to do something about it because nobody is having fun? You know, taking into account a most fragile masculinity, a lot of insecurity, and that any sex talk is engaged in with a ton of difficulty often resulting in anger or hurt feelings? He’d rather just not talk about it. For what it’s worth, we’re a hetero couple, and we’ve been together for about 10 years.

Open to any suggestions!

Dear Open,

My heart goes out to the two of you. We all want trust, honesty, and compassion in our relationships, but a mutually fulfilling sex life is very important, too. When we discuss sexual dysfunction with our partners, there’s a very real risk that we’ll hurt their feelings, and the problem can spiral. Given the potential consequences of introducing the topic, it’s no wonder many people choose to just stay quiet. Often that does seem to solve the problem, at least temporarily.

But did you know that the World Health Organization calls sexual health a basic human right? In 2006, they defined sexual health as “…a state of physical, emotional, mental, and social well-being in relation to sexuality; it is not merely the absence of disease, dysfunction or infirmity. Sexual health requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination, and violence.”

His desire to “just not talk about it” does not supersede your right to a sexually fulfilling relationship. You both have a responsibility to communicate your needs, and come up with solutions that respect those needs. We often approach these discussions feeling like we need to defend our own position, preventing us from really hearing our partner’s perspective.

One of the best tools for these tough conversations comes from the world of improv theatre. In improv, a scene grows because the actors evaluate each action and ask themselves, “Yes, and?” Instead of driving a scene in the direction the actor thinks is best, the “Yes, and?” brings true collaboration to the stage. If you both agree to approach this conversation saying “Yes, and?”, there is a much higher likelihood that you’ll find a solution that works for you.

From a medical perspective, it’s important to rule out potential underlying causes of ED if it lasts more than a few weeks or months. A doctor can also prescribe medication that will help achieve a hard-on. There are also some herbs that can be helpful, but I recommend staying away from the ones sold at truck stops and head shops. Purchase your herbs from a reputable vendor that has vetted their inventory, or work with an herbalist who knows about potential drug interactions and safe dosages.

If your partner is dealing with a more transient form of ED, or if it definitely seems related to stress or depression, there are other things that might help. Cock rings (which are worn all the way behind the testicles) are really effective at trapping the blood inside the shaft the penis and delaying ejaculation. There are stimulating creams and gels that draw blood rapidly into the penis, giving a boost to the body’s natural function.

Of course, there’s always the option of changing the working definition of “sex” in your relationship. Instead of following the cultural standard (vaginal intercourse equals sex), you and your partner could shift your focus to pleasure-based experiences that are mutually satisfying. Oral sex can be practiced on a flaccid or semi-hard penis. Prostate stimulation needs no erection at all. For your pleasure, vaginas can be penetrated with fingers, vibrators, and dildos. There’s really no limit to your sexual expression if you remain committed to open communication.

Curious about cunnilingus? Anxious about anal? Do you have questions about queefs or problems with your prostate? Lucky Tomaszek is the education coordinator at The Tool Shed: An Erotic Boutique, Milwaukee’s only mission-driven, education-focused sex toy store. Send her an email at mkesex@gmail.com and she’ll get back to you with an answer.