Question for the men....

[Behappyandbehave]

So it's very personal but obviously this forum is anonymous. Would really appreciate advice on this.
I've been with my dh for 30 years. We've been through so much together and have teens. We both work really hard and have had dry spells for years. But we came through the other side (mostly) and have resumed our sex life.
Only issue is he struggles with ED sometimes. It's not a problem, he takes a tablet. These work but the problem is having to pre plan sex. Would he be best taking 1 every day or so?
The other problem he has is how he feels about himself. He is so down and has no need to be. He's even started taking antidepressants as he just felt numb and miserable. He really struggles to instigate sex (cant say i blame him) and with teens there's not loads of chances.
He says he doesn't ever get an aroused feeling until I actually start foreplay. He has no urge at all and this makes me sad. I just want him to feel what I feel. I only have to think about having sex with him and really want to. He just isn't getting that. This has been going on now for a few months (way before the sertraline so that hasn't changed anything)
He is going to go to the GP again but they only prescribed him 4 viagra tablets last time so same price as buying privately.
He has tried that other one that's supposed to be stronger (can't remember it's name)
Do any men have any ideas on how to help him get his spark back? I cuddle him etc frequently, offer lots of things if you know what I mean! Just want him to want me as much as I want him.
Tia and sorry that's so long!

weekends without the kids helped us - trying new things , spicing it up - role play , bdsm , even a threesome . communication of turn ons , kinks .

mid fifties - not thinking about ED has helped loads plus a more adventurous sex life for both

Not persuaded by @SeventiesTom , but just in case spice is the way to go, others here have recommended mojoupgrade.com to talk about what you and dh like.

I'm sure the combination of antidepressants and viagra does all sorts of things to the mind. On top of depression (of sorts) and ED.

It's not you. If he has to take antidepressants something is happening to him. I know the state of nhs mental health services but does he get psychological help? This sounds to me like intimacy between you is only a part of something bigger.

It would seem like the depression is getting in the way if that is the true diagnosis.
The meds won't help but I understand that they are a requirement at the moment.
Has he had a full blood count? And of course a prostate examination.
If there is a mindful meditation class or yoga class locally then I would discuss the possibility of joining in that and would suggest you go together.
Introduce tantric massages into your bedroom routine without the need for happy endings. Just for intimacy.
The other pill to take is Cialis which remains in the system for 36 hours and is more conducive to spontaneity in the bedroom.

The first thing he needs to do is get his testosterone levels checked. The amount of free testosterone available in the blood is the important factor and not the total testosterone levels. The NHS doesn't usually get this right, so look for an online test. This should cost about £40. Once you know the basic facts, you can move from there.

The sertraline cannot be helping this particular aspect of his life, even though the issues arose prior to taking it.

Cialis is the alternative to Viagra and it doesn't seem to me to be the answer.

Thanks all. Forgot to say he has been checked and had blood tests from GP. All came back normal. Think this made him worse tbh as he was hoping it would be just as simple as needing more testosterone.
He could try Cialis again. But they only treat the physical symptom of the erection don't they?
He also needs help with getting an urge to want to have sex (without me doing anything!)

I think you have a few things to think about, loss of libido is a common side effect of ADs, so if his sex drive is a bit on the low side, they won’t help with that, depression and stress will also dampen his desire for sex - so bit of catch 22.

Viagra will help with the mechanics of getting an erection but not get him “in the mood” , try moving to one of the daily treatments rather than the take as needed pill

the other thing would be an overall heath MOT, blood pressure, prostate check, hormone checks & personally ( as an older man ), exercise and weight loss & diet changes have made me fell better about myself ( which is probably what he needs more than anything else)

The other thing I forgot to mention - as an older men, sex is about confidence as much as anything else.

confidence that your erections will still work and be usable and also confidence that your partner also wants sex and is not just doing it to shut you up << this is quite a big deal as well.

@Behappyandbehave Maca root is supposed to be good for increasing libido. You can buy Maca tablets from places like Holland & Barrett.

As PP have said, AD meds are definitely not going to help and both Cialis & Viagra only help with blood flow to assist with getting & maintaining an erection.

You can get a daily Cialis tablet from your doctor, but probably only on a private prescription. I believe Lloyds pharmacy offer this online - fill in a couple of questions, pay @£45 per month and they deliver them to your door. The benefit of these is it's supposed to be active all the time, so no need to pre-plan things.

The other thing to consider is counselling. If he is depressed, he may need help to find his way out.

^^ this is great advice, maybe some counselling or therapy to help with the depression along side the daily Cialis to give some comfort and help with getting and keeping a decent usable erection

Behappyandbehave please ask him to return to the GP and ask for the specific numbers on his free testosterone levels. I was told that everything was normal for years, but still felt that it wasn't. I have just had the results of a private test and been told that my free testosterone level is 0.219 n/mols per litre. Normal for my age would be somewhere between 8 & 15, so I am to return to the GP on the 19th. Please do some research and don't be surprised when you know more about a subject than your GP does. The GP isn't an endocrinologist and doesn't know what to ask for in a blood test.

Best wishes.

A few things to consider. The NHS criteria for testosterone replacement therapy is extremely strict. What they deem as 'fine' would be considered extremely low in other countries. Its worth asking for a print out of the results. Its also maybe worth consudering going to a private clinic.

Before I'd do that, I would ensure his diet and sleep schedule are decent.

Speaking only for myself, lifting weights and taking a zinc supplement sent my libido into overdrive.

Its a bit of a common myth that all people at all ages and stages of life and relationships should be regularly experiencing 'spontaneous desire' (that is the sudden urge to have sex/be sexual out side of any external factors)

Most people after the limerence part of a relationship more often experience 'responsive desire' (the desire/urge to be sexual after being triggered to do so).

If he is never in the mood or having urges to have sex, but when you touch him sexually or do whatever starts to light up his circuit board he is experiencing responsive desire and that's a perfectly normal way to be. Not everyone walks about randomly getting horny or sex urges. Some people need a series of triggers to set them into the mood and spark of sexual desire.

Karen Gurney (i think that's the spelling) a sex and relationships therapist has spoken a lot about this. I highly recommend a read of her insta page and published books.

I would say the urge to have sex relates to depression (of some form).
When I went through depressive periods that didn't happen to me but... Each to our own... It is often mentioned - as much in men than in women.

The impression for me is:

• don't rely on my impression, this is bigger.
• That said. viagra, cialis, etc. will patch the ED and help you both continue to have a sex life, which could help you both maintain confidence and live better through what is clearly a difficult time. But it is treating the most superficial symptom.
• Lack of libido is a less superficial symptom. Something like depression (and this takes more than mumsnet to understand well) is more serious, and could be related.
• Address any underlying problems, especially related to mental health, seriously. Not treated, it gets worse, or at best you would both have a very hard time and it could last years.

Holistically you could try

Horny goat weed and/or Stinging nettle root to see if it sparks libido. The underlying thing here though is the depression. It needs to be treated properly.
These remedies won't have any effect if there is no desire.

Hi @Behappyandbehave I was on ADs for a while after a stressful work episode and a significant bereavement. It killed my libido and Viagra/Cialis helped get an erection but it didn’t make me full of rampant desire. During that time I would go through the motions to make DW happy, but even orgasms felt … uninspiring (hard to find the right words). Counselling helped me get off the ADs and my libido returned. Now roles are reversed entirely though

My own experience might be useful. Three years ago I became depressed and was put on fluoxetine for about three months. I lost physical sensation generally and my sexual function was ruined: I had no libido and could not perform. While I got it back again the notion that my erections might not work has been kind of stuck in my head ever since and that has, occasionally, worked as a libido killer even during sex itself.

But I think the issue with your DH is really the depression. I keep that off by keeping myself as physically fit as I can, and making sure I have a good sense of purpose. That's helped me deal with the inevitable crises of life. If I'm happy, my libido functions better. I probably push myself a little hard with things generally. I'm not specifically recommending that, but it does work for me.

I've had the odd bit of ED since and I've learned to avoid sex unless I am good and horny because getting started and it all failing is dispiriting. Words matter too, I've realised how fragile that part of me can be.

Antidepressants can cause ED problems.
we have found being more adventurous and daring now again can trigger my libido again but a loving understanding wife keeping my confidence up is the best help of all.