And if he always needs to take the pill, that's okay, too.
Isn't it great he lives now rather than100 years ago?

I'm relieved when we see LW's in long-term relationships with kids being on the same side of an issue and not blaming each other for some type of insufficiency. Thanks for listening, Dan!

We should really start to destigmatize the failure of loosing an erection.

It's not the end of the world; there's always tomorrow or later. No need to melt down just because it's not as hard as it was when you were 18.
As you get older; just a naked woman doesn't always do it for you. Just like a woman you require some warm-up.
You don't need pills. If you have a problem getting it up and your wife is naked on the bed wanting some... you still can give her some. Use your fingers; use your tongue ... maybe after a little foreplay you'll be willing
Relax; take a deep breath the more you worry about it the more you will fail. So say to yourself if a doesn't work; use your backup plan.

If your wife has an issue with you going down on her or using toys instead of piv... then you may want to find a new wife.

Intimacy should be the goal; piv feels good but it doesn't bring a woman to orgasm by itself (for most). So try something new.

Dump the pills; these side effects are kind of serious...

I would hate for my partner to think that because of the Viagra that I needed to please her... that my ass had a heart attack

Maybe i'm too nice.

Sudden vision changes, blurred vision, or vision loss.
An erection that's painful or lasts longer than four hours.
Symptoms of a heart attack, such as chest pain; chest pain that spreads to your jaw or shoulder; sweating; or nausea.
Irregular heartbeat.
Shortness of breath.

I often say...Viagra to men = Lube to women. No shame at all! I'd never shame my wife for needing lube.

@4: Yeah, I'm all for better living through chemistry. I have never understood why so many women take it as some sort of referendum on their attractiveness if their male partner needs the help that Viagra et. al provides.

I do understand that using it can be a bit fraught, as it is a reminder that one's growing older, in the same way that needing to use lube can remind a woman of what she didn't use to need, but overall, I think people invest both with too much negative significance.

Suicide is painless, it brings on many changes; and I can take or leave it if I please.

Just get your wife to dress up like Nurse Dish.

L-Dub... you have problems. Not dick problems. Mental problems. This is a serious obsessive compulsive anxiety induced freakout. Sure, this could be a one off, but the words you use sound like the words used by people have a freakout problem generally, not specifically. Use Viagra to solve the immediate issue, but my man... you need to deal with the over the top shit losing. You are writing to Dan because of the sexual aspects and consequences of this particular freakout, but this shit has got to be popping up (ha!) all over the place in the rest of your life. Take a hard look for patterns. It seems unlikely to me that this is a completely isolated incident.

Good luck!!

Stress has got you. Kids have got you. Life has got you. But mostly, YOU have got you. Look for self-help or a counselor (no shame) to help you learn how to chill out a little. The bad news is that there will ALWAYS be shit to stress out about. The good news is there are ways to deal with it. You’re not the first guy to lose a boner. As others have said, fess up to the wife and deal with it together (that’s what marriage is ABOUT). The bad news is, wait until you get old and the hard-ons REALLY get elusive. Then thank your lucky stars for modern medicine. Wasn’t too long ago you would have been permanently screwed (which is an ironic statement considering “not screwed” is what it really means).

LW needs to get a complete physical, because erectile difficulties can be a symptom of other serious health issues, including diabetes, depression, and cardiovascular disease. Self-dosing with medications purchased online without a doctor's care is never a good idea.

Having an erection is a symbol of his manhood, virility and ability to please his wife. Losing it has to be mentally and emotionally devastating. It's easy to say he should just deal with it, but it's very understandable why he's having problems coping.

We live in a culture that has unrealistic expectations of toxic masculinity and never-ending youth. What he described sounds so normal for middle age with kids....hard to find the time for sex with his wife and now to make matters worse his dick isn't working the way it used to. I'm sure his doctor can help, if he can get past being embarrassed long enough to make an appointment.

And also just try not to worry about it.

80% of the time I can do a multi-hour erection.
15% of the time I'm a (few)-minute man.
And 5% of the time it just doesn't want to cooperate.

I stopped trying to figure out why and just roll with it on the off occasions.

I'm lucky not to have significant virility issues, but I like having the meds around anyway. They're a nice buffer against performance anxiety with someone new. And my partner has trouble with actual penetration. What he likes to do the most falls just short of it, and that can be painful (or even dangerous) if I'm anything less than 100% turgid.

For me, Cialis (or, actually, its generic equivalent) is ideal. It doesn't bring on the dealbreaking flushing side effect I experienced with Viagra and Levitra, and having one dose last for a day and a half means I don't have to worry about when to take it in order not to waste it.

Not that I sweat that too much anyway, since i got my doctor to write a prescription that dispenses almost 90 at a time so I could fill it through a Canadian pharmacy that offers steep discounts for large orders. It ends up being around 50¢ a pill, as opposed to the OoP price of between $5 and $10 that I'd pay to get it filled locally with the branded product.

It is so nice hearing from sane people in a really good relationship for a change, who just have a roadblock to get past.

LW, sounds like you don't have a lot of free time on your hands, so I don't know if this is feasible, but are you taking any time for exercise? As us guys age, we have to start taking better care of ourselves in order to get the kind of performance we want. I've personally found exercise to help a lot in the erection department. Plus it's good for you too.

I haven't taken any boner pills, but if they're working, they're working. I might add some other suggestion. First, I know the kids kill sex but carve out some time for something more elaborate: dress up, different kinds of kinkier sex, get pegged to stimulate that prostate, fuck in the car after you drop the kids off, handjob in the movie theater, mutual head in the dressing room at Walmart, whatever. LW is just worrying too much in advance. I think some spontaneity can help. That's not to guarantee a cure. I just know from my own experience that I might have a hard time getting it up if I've had too much sex recently (damn 40s) but when anal sex is an option, my cock is ready to go.

Dumno @3 and Biggie @10 have it, in more and in fewer words. It's a cliché but this DOES happen to every guy occasionally. Roll with it, do other stuff, try again tomorrow, no problem. Freak out about it, and it becomes a self-fulfilling recurring issue. LIMP has even identified the psychological cause of his problem: high expectations because they haven't had sex in a while so this time has to be porno perfect. Stop with that. Have sex more often. Build the time for quickies into your schedule; define "quickies" as any kind of sexual contact, whether it involves your dick or not; and I'm pretty certain this problem will go away without meds. Good luck, LIMP!

The human nervous system is divided into the parasympathetic nervous system (PNS) and sympathetic nervous system (SNS), which operate independently in some functions and interact cooperatively in others. In certain cases, the two systems can operate in opposition so that one activates a physiological response and the other inhibits it. In the case of male sexual response, sexual arousal triggers PNS action that causes an increased blood flow to erectile tissue, but stress triggers the SNS to disrupt this action. It's like stepping on the accelerator and brake at the same time.

LIMP’s heightened anxiety about whether he is going to have and maintain an erection is overwhelming his natural sexual responses. At least in part, his anxiety is about disappointing his wife and himself by failing to provide the sex he know she wants. So being honest with her about his fears should reduce his psychological stress and make getting erect easier. But if he treat this situation like a catastrophe, that will lead him to have more performance anxiety.

In the near term, he may want to significantly shorten the time between becoming sexually aroused and having vaginal sex. If he starts having sex once he is erect, he may reduce the likelihood that his psychological concerns cause him to lose his erection.

LIMP should also see his urologist and obtain and ED medication. Taken in low doses everyday, the drug saturates the erectile tissue, and helps overcome the SNS's breaking function. Once he has overcome his performance anxiety, and have reestablished his sexual confidence, he can discontinue using the medication.

I came here to say what Girlie in 9 said. Full medical check-up with a doctor. Full honesty about erectile dysfunction with that doctor. Let's hope the ED problem is psychological. Let's hope a bit of viagra is all it takes to get over it.

For the letter writer-- (I refuse to use the LIMP name as it would seen to perpetuate the shame, stigma and label we're trying to avoid.) I'm female. I got up the nerve to see a doctor about lack of lubrication and painful intercourse. The 2nd doctor I saw had a prescription for me that's made all the difference. If I can make that awkward appointment and have that awkward conversation with a strange doctor, you can.

I've never taken time before to think about Dan's predictions that LW's like LIMP will in time not need the pills. But isn't it equally possible that someone prone to it will develop psychological dependence?

The side effects cited by dumnogenus@3 sound worth avoiding if at /all/ possible.

Glad to see Comments with helpful advice like a complete physical, therapy, and exercise for LIMP. (Hell, who /shouldn't/ do that stuff.)

Hopefully his wife will be very supportive. But if she's the opposite of supportive, perhaps therapy for his wife too, or perhaps divorce.

@11 Fred Casely
"Cialis...having one dose last for a day and a half"

Please forgive my ignorance, but how does that work? (I presume that you're not fully erect for the whole 36 hours.)

@15 SublimeAfterglow
" significantly shorten the time between becoming sexually aroused and having vaginal sex"

Yet another good reason his wife will hopefully be his partner in overcoming this.

I am surprised you did not say to have the doctor check for any medical conditions that can cause ED. He does not say his health condition. Diabetes is known to cause ED.

Yes medical checkup, yes exercise, yes foreplay for the man. This sounds like a lost boner each time rather than a no-boner... we’re seeing this too as we get older, that my partner may lose his erection while going down on me. Try 69, or her using your dick to play with her clit, so your penis stays stimulated. Also dirty talk and fantasy to take your mind off your penis. Good luck—we’ve all been there, or will get there.

Curious@17~ “...Please forgive my ignorance, but how does that work? (I presume that you're not fully erect for the whole 36 hours.)...”
Viagra and Cialis And the like work by relaxing your blood vessels so when it is time for sex your penis will engorge. You are not walking around all day long poking small children’s eyes out, but when you are ready the blood is there for you to get hard.

@20 DonnyKlicious
Oh thank goodness it doesn't really work like Hollywood comedies suggest!

Curious @17: "@15 SublimeAfterglow
"significantly shorten the time between becoming sexually aroused and having vaginal sex"
Yet another good reason his wife will hopefully be his partner in overcoming this."

Yeah, that jumped out at me too -- that may solve the problem for LIMP at the cost of his wife getting off. So she has to choose between no foreplay or potentially no fucking? Many of us wouldn't be too keen to make that sacrifice. LIMP, if you do employ this strategy, please make a point of getting your wife off non-penally afterwards. On behalf of the women of the world, thank you.

@22/BiDanFan: “Yeah, that jumped out at me too -- that may solve the problem for LIMP at the cost of his wife getting off. So she has to choose between no foreplay or potentially no fucking? Many of us wouldn't be too keen to make that sacrifice.”

Does it need to said that LIMP can perform lots of oral on his wife as foreplay to get her aroused? Indeed, that he can give her multiple orgasms before any attention is directed at his dick? I wouldn’t think so.

There is zero sacrifice of foreplay or orgasms for his wife. In fact, LIMP can get zero stimulation until they want to have vaginal sex, but at that point, when attention is directed at his arousal, either through manual or oral stimulation, and LIMP becomes hard enough for vaginal sex, they should have sex right then. His wife can’t say, “Just let me suck your cock for a few more minutes.”

LIMP, you should also try 69 if that works for your and your wife. You may find it ramps down your conscious thoughts that produce your anxiety, allowing you to get erect enough for vaginal sex.

Curious@21~ “...it doesn't really work like Hollywood comedies suggest...”
No, a permanent hard-on would actually be super bad for you, that’s why they say, “In the event of an erection that lasts more than four hours...tell all your friends!”

@20: Close - Viagra inhibits the action of phosphodiesterase 5, a chemical that degrades guanosine monophosphate, which relaxes the smooth muscle that controls arterial bloodflow, dilating the arteries. Increased guanosine monophosphate levels (that directly relax the smooth muscle) are caused by activation of guanylate cyclase by nitric oxide release, which occurs locally in response to parasympathetic nervous action (as SublimeAfterglow notes) - in the case of erections, often as a result of sexual arousal, though reflex and spontaneous erections can occur in the absence of sexual arousal.

Basically, Viagra inhibits a chemical that degrades another chemical that's directly responsible for smooth muscle relaxation, increasing the effectiveness of the relaxant chemical and increasing arterial blood flow into the erectile tissue in the corpora cavernosa, though the relaxant still has to be triggered by release of nitric oxide in response to nervous system activity (i.e. sexual arousal, mechanical stimulation triggering reflex activity).

Side note: while the arteries feeding into the corpora cavernosa dilate to increase blood flow, the veins feeding out constrict to block outflow. Lack or loss of erection can be caused by a failure of the venous muscle to constrict the veins as well as a failure of the arterial muscle to dilate the arteries; either of these can be caused by chemical inhibition of the direct action on muscles or nervous inhibition that prevents the release of signaling chemicals (e.g. anxiety, stress).

The guy needs to talk to his doctor and have a thorough physical. Suddenly losing your erections and problems getting an erection can be a warning symptom of an underlying medical problem. He needs to first rule that out (or address it if a problem is found). Then his doctor can provide a legit prescription for Viagra or one of the other boner pills. BTW, is the guy able to get erections when he's not with his wife (that is, can he get an erection and masturbate to orgasm? If there's an underlying physical problem, he would very likely experience the same problems with masturbation).

I forgot to add to my comment (#26). In the meantime, try doing things in bed that are not PIV oriented. He appears to be talented oral and his wife responds with orgasms, so keep on doing that. Consider buying a discreet vibrator and introduce it in the love making. Maybe let her select a dildo or another toy(s) that might titillate her interest (take a step or two beyond vanilla. Finally, since she's often exhausted from caring for the children, maybe try some physical activities in the bedroom that aren't preludes to sex. Buy some scented bubble bath, bath salts or bath oils and prepare her a relaxing bath. Maybe some massage oils and give her a message. When I came out of the closet, a friend of mine gave me a large canister filled with exotic oils, candles, and other items to spice up an evening in bed. My favorite item was a small feather duster and a container of honeysuckle powder. The scent, the sight touch of the duster moving across the body, it was very sensual and erotic.Again, I bring this up as activities you can share with your wife both to help her when she wants to get off but also to give her a chance to relax without having to do a thing in return.

Good advice, and interesting lesson John Horstman@25.
I wasn’t blessed with a phallus this time round, and I do see for most men it takes pride of place, so when it falters, it must be very hard to accept.
As others have said, LW, go to the Dr.
First, talk with your wife. Yeah. You love each other so many years in.
And look to have your sex when you are both not exhausted and so horny it goes a little haywire. Plan it, as we tell women who find themselves with small children and sexual issues.

@23 I'm even willing to go so far as to suggest that perhaps his wife could make a sacrifice in this instance (gasp!) to help her husband get his dick working again. Perish the thought though in this arena.

How do you know she wouldn’t, @29, and watch it with the snide asides.
The LW needs to talk with his wife about the pills and how long this has gone on for etc. They love each other, their intimacy is intact, and once she knows the full story I’m sure she’ll find ways to help sort the problem.

Work stress, home and life stress, smoking, alcohol, marijuana, many medications, obesity / poor physical conditions, bad diet, depression and other mental health challenges can all lead to an uncooperative dick. The pills can paper over things for a bit, but the reset life button may be what is really required. It would seem he is way too young for the issue to be simply aging. A deeper dive that just medication may be in order.

@30 Did you just tell me to watch it? Threats? Wtf? Or what? Just what are you going to do to me if I don't 'watch it'?

@32 philosophy school dropout
Aw man, I thought LG was trying to make peace. I was thinking alike, since your response did appear directed at BDF's reply, particularly since I was so happy when BDF returned after a little time off (just after she said some stuff about trying to live here more peacefully).

Or maybe LG was just thinking of taking up a collection to send you back to 'philosophy school'?

Personally I'd love to join President's Rump's new initiative to regularly rake (yes, RAKE) the vast forest wildernesses of the American West (the lack of which he blamed Saturday for the hundred burned to death [and 10x that still missing]) in California. What a brilliant understanding of natural ecosystems; of COURSE they need raking!

Why are people embarrassed to talk with their doctors? Doctors are there to help you. If you're worried that your doctor will judge you for getting a Viagra prescription it is time to find a new doctor.

Make peace curious, @33? I was responding to the question, not sure who I have to make peace with.
No @32; it’s not a threat. Like how could it be? If you want to address someone directly, go for it. Addressing them indirectly, thru snide comments, is why I told you to watch it.

@35 I'll respond how I like. Thanks. And I won't watch anything. Make a note so you don't forget it.

Please bicker elsewhere LavaGirl and PS dropout.

Sublime @23: Yes, that does need to be said. Most non-gay men become aroused by going down on a woman -- if not by just -thinking- about going down on a woman -- so your "he should penetrate her as soon as he becomes aroused" did appear to preclude that, or any other foreplay. Thanks for clarifying.

Jon @26: Great suggestion on how to tell whether LIMP's issue is psychological or physiological.

Philosophy @29: Sure, that would be an okay short-term strategy. I'm sure most wives wouldn't mind forgoing an orgasm or two to help restore their husbands' confidence. It would get kinda boring kinda quickly though, so if the only way the guy can keep it hard enough to come is by fast-forwarding to PIV straightaway, they should both be willing to compromise so that each gets off some of the time. Or, as I stated in my initial comment @22, he should be willing to get her off afterwards. It's amazing how many straight men think that nothing can ever happen after his orgasm. (Not jumping to the conclusion that LIMP is one of them.)

@35 LavaGirl
I meant "create peace" (between PSD and BDF). I inadvertently used the idiom "make peace" which I now see sounded to you like I intended to say you were a party to the "peace" I was crediting you with seeking. But that was not my intent, I didn't think of that idiom.

Curious @40: Unless I'm missing something, I have no involvement in today's tiff! Please don't bring me into flame wars, I'm quite good enough at doing that myself. :)

@42 BiDanFan
If it were me, I'd rather not know this, but since you bring it up...
The "snide aside" (quoting LavaGirl@30) by PSD@29 appeared (as I mentioned @33) directed at your @22.

Regrettably (as I've now heard from both you and LG) I let PSD@32 provoke me into getting involved @33.

Today's LW wrote the letter I could have written 20 years ago. I talked to my Dr. who pooh-poohed my idea for me to try the blue pill, (and this embarrassed me) . I went to a generic source,.... it worked, and have used it ever since. I cannot pay hundreds for the name - brand stuff, (I am self-employed) the generic from El Norte works fine. I "fired" my Dr. (he was a prick anyway) and got a new one.
AS for his performance in the cunnilingus arena Congrats! My Miss N. forbids this practice but as #38 says (Thanks BDF) I love it when i find a partner who also enjoys it;...VERY arousing for me to hear and feel a partner who is also aroused by my efforts. BTW I do not consider the drug to be a crutch,..it is an enhancement, just like my nice long warm-oil massage seduction routine.

I'm a straight woman and find this issue very perplexing. I get that losing an erection is a scary experience that brings up all kinds of fears about aging and mortality. But it's so common, and we women don't really care so long as you handle the situation properly. I've had a few partners who struggled to get hard during initial sexual encounters, and they made it way more awkward than it needed to be. One guy locked himself in the bathroom for 15 minutes, presumably masturbating furiously, before coming back out to the bed, curling up into a ball, and begging me to give him another chance on a different day. Way to magnify the issue unnecessarily! A less mortifying way to handle that situation would simply have been to stay in bed with me, say "I'm sorry if this is disappointing, but sometimes I get nervous when I'm with someone new and lose my erections. Can we take it slow?" and do non-PIV stuff until the issue resolves itself. We women might not have dicks, but we understand that erections are a biological response that lies out of your control. If I were LW's wife I'd probably be more likely to be offended that he kept this from me (the anxiety around sex, the Viagra) than that his dick went down when we were having sex. If you don't trust your partner enough to share your sexual anxieties and fears with her, it's going to be much more difficult for her to respond to your subtle cues and help you through whatever it is you're going through.

@46 You've probably never been called gay for not wanting or being able to have sex tho. Well, probably you have, but not by someone you are already naked with. My experience is, there's a 100% chance of being called gay if you are under 30 and can't get it up, and a 80% chance if you reject an explicit sexual advance. I think you're right in terms of the general climate - ED is relatively normal and plenty of women are chill enough with it. But most women - at least of my generation - aren't.

@47 Sportlandia
"My experience is, there's a 100% chance of being called gay if you are under 30 and can't get it up, and a 80% chance if you reject an explicit sexual advance"

For pete's sake, what women are you people sleeping with?

@48 I dunno, regular people? College educated women in NYC, mostly. If you're male and been with more than a few women, I don't know how you haven't come across this yourself. If it matters, I'm 38 presently, perhaps you're from a younger generation.

John Horstman, great lesson at 25. This anatomy geek got her fix for the week...

Curious @43: Didn't appear that way to me. And as Philosophy has previously stated he has a policy of not engaging directly with me, I choose not to read it in a huff-inducing way. I wasn't the first person to query how this strategy might be received by the wife. Of course the answer to that is, like pretty much everything, depends on the wife.

@51 BiDanFan
Oops my bad then. I'll take your word for it (and save myself looking at all that again!).

While it probably is just performance anxiety, I would HIGHLY recommend getting a checkup from your doctor. You'll need to see one to get a legit Viagra script anyway. Tell him what's going on, that you aren't really worried (there's nothing to worry about yet, so don't freak out) but you'd like to make sure just in case.

Ohmyfuckinggod, Dudes! Your dick is seriously SO not important! I know that's probably not what you want to hear, but believe me when I say: for many many many women, your dick is like maybe 10% of what we like about having sex with you. 70% of women can't orgasm from penetration alone! If your dick gets hard? Cool! Some women like to get railed once in a while. If it doesn't? ALSO COOL!! Go down on her! Make her come 3, 4, 5, 10 times that way! Your dick is soft, but (to quote Dan) what about your fingers? Forearm? Big ass dildo? If she loves penetration, there are plenty of other ways to give her that sensation without using your dick. Dick not working? Put Dick in timeout for the next few months and give your wife the screaming orgasms she deserves in other ways! Seriously! She will NOT be disappointed!!! It is NOT a consolation prize!!! For fuck's sake, STOP thinking of your dick as the star of the sex show!! That guy gets performance anxiety and the other "players" don't get their due.

Say it again for the kids in the back: YOUR DICK DOES NOT MATTER!!! If he wants to play? cool. If not? ALSO TOTALLY COOL!!!

The end.