Blood pressure medications, erectile function, and alternatives to intercourse

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Dear Sex Counselor,

About six years ago, I developed high blood pressure. My physician put me on beta blockers. You know what they do to a man’s virility. Anyhow, over the first three years, I saw a steadily decreasing ability to have sex with my wife. At the end of three years, I was so frustrated and embarrassed at my attempts that I quit trying. For three years, we had absolutely no sex. She did not complain. Then, last year, I turned 60, and my physician suggested I include a urological exam as part of my physical. He is a male. When he found I was on beta blockers, he was quite shocked. He asked me about sex and I told him about my situation. He immediately took me off the beta blockers.

Now, three questions: First, will my ability to have intercourse come back? He says "to a degree" it will. I get erections during the night, so I am encouraged. Second, I would like to try a dildo with my wife to take performance pressure off me. What size and shape is preferable? There are dozens to choose from. Third, should I just not worry about intercourse until I "think" I can function? I mean, if I get all this started after all this time and can’t perform, will I be worse off? I love my wife and miss our intimacy very much.

While I am not qualified to answer your first question (and it sounds as though your physicians have already answered the question to the best of their knowledge) I will address the other two questions.

First, this is the time when you need to have a frank conversation with your wife. Many women enjoy penetration during sex, and many women enjoy sex without any penetration. She may be happy to have other contact with you, including oral sex, manual stimulation with your fingers, and more extended full-body contact. If she says she misses penetration, then you have several options. One, you can use your fingers and/or a dildo during oral or manual stimulation, moving your fingers or dildo as she indicates she likes it. Some women like the feeling of thrusting; others like the feeling of just being filled up. Having something in the vagina during orgasm can increase the orgasm’s intensity, but many women will say it’s not necessary.

If you wife says she misses actual intercourse, then you can purchase a harness and dildo and penetrate her as you used to. We generally suggest the "two-strap" style for men (the Orion Harness might be a good choice for you). In choosing a dildo, you need to consider how many fingers she enjoys having inside of her when she is aroused (when I say aroused I mean swollen vaginal lips and clitoris). You then choose a dildo that is about as wide as the fingers are. We give finger-width equivalents in the descriptions of our dildos, as well as actual widths. Length is less important, as you can control how deeply you penetrate your wife.

You also may want to talk with her about whether she enjoys G-Spot stimulation. If you and she don’t know where her G-Spot is, then you can start by exploring together with your fingers in her vagina (after she has become aroused). As she becomes more aroused you will feel a ridge of tissue at the top of her vagina (if she is on her back) about 1-1/2 to 2 inches inside the opening. Stroke that tissue, and ask if she likes that feeling. If she does, then you may want to choose a dildo with a slight curve that will stroke her g-spot as it moves in and out.
 

Another thing you two can do is explore what kinds of touch and contact you enjoy. While you may not be able to obtain an erection that is hard enough for deep penetration, you still can enjoy oral and manual stimulation, and can still have orgasms. Invest in a good personal lubricant (try a sample pack or read how to choose)and begin by exploring by yourself what feels good. Then invite her to learn with you about what kinds of touch feel best to you. Sex can be much more than just intercourse, and the connection many couples create when they begin exploring beyond intercourse can be very rewarding.

So I don’t think you need to wait; instead, I suggest you start exploring and finding the wide range of ways to pleasure each other. If you are able to have intercourse later, that’s great. If not, you won’t have lost anything, and in fact you may have gained a much wider repertoire of pleasurable activities that you both can enjoy. If you are looking for suggestions on what you can do, you might look for The New Good Vibrations Guide to Sex or Red Hot Touch as wonderful resources for the world of sexual possibilities.

The Sex Counselor