Q My boyfriend and I are in our thirties. He was a college athlete and had several injuries and surgeries that prevent him from being able to do cardio exercises like running or even a lot of walking because they cause too much pain. He also has a history of back problems; it can sometimes take him two or three minutes just to tie his shoes. I noticed early in our relationship that he was very “quick” about sex in that there wasn’t a lot of foreplay and it would only last a few minutes. A lot of times he would rather sleep than be intimate after coming home from work—even after I had been gone for two weeks on business! He would usually claim he was too tired or didn’t feel well and was therefore not interested, even though, when I push a little, his body responds very naturally and healthily. As a result of his disinterest, I’ve been feeling hurt, rejected, frustrated and insecure. He assured me that it is absolutely not me. He says he has just generally not been feeling well, he’s tired from work, he hasn’t been sleeping well, and he’s frustrated that his body isn’t what it used to be. He has promised that he will try harder. I am a very healthy female who enjoys sex and considers it very important in a relationship, but I am not willing to leave him over it because I care for him a great deal. He is wonderfully affectionate, attentive and good otherwise. I just find it hard to believe that a formerly athletic man in his 30s has a low sex drive. Do you have any suggestions as to what may be causing him to behave this way?
A People tend to evaluate their sex lives as good or bad based on whether or not they meet their expectations—and yet they often have very unrealistic expectations about sex. In your case, I can’t help but wonder if you would feel better if you adjusted your perspective. For example, you seem to have a sense that men should want or be ready to have sex much of the time—and at least as often as their female partner wants it. You also seem to believe that his being an athlete makes him particularly likely to have a high sex drive. But many athletes, just like nonathletes, have moderate or lower sex drives, particularly if they are overworked, tired or in pain. The reality is that, although your boyfriend is young, he also suffers from physical health problems that are severe enough to impair his ability to perform daily activities like walking and tying his shoes. If he finds these activities challenging or frustrating, it’s not surprising that sex could be a challenge, too. Just because he can get an erection when “pushed” to (by you) doesn’t mean that he always wants to be having sex or that he finds it pleasurable if you’re pressuring him into it. In fact, the pressure may be driving him further away. Stop relying on gender stereotypes and communicate with your boyfriend. It seems as if he’s telling you how he feels, but good communication depends on you being able to listen to what he’s saying (that he feels overworked, tired, frustrated and in pain) and then figuring out together how you’re going to make your sex life and relationship work in spite of those circumstances. Two books I highly recommend are The New Male Sexuality (Bantam, $17) in order to learn more about men’s sexual issues, including desire, and The Ultimate Guide to Sex and Disability (Cleis Press, $18.95), which provides concrete tips related to creating a satisfying sex life in the midst of chronic pain or other physical health conditions. I wonder, too, if your boyfriend may be experiencing mild depression (which can also affect desire), given his frustration over his injuries. If so, he and you might consider meeting with a counselor or therapist to address those issues as well (aamft.org or aasect.org to locate a therapist near you).

Q I’m a gay man in my early 40s with a somewhat older—but not a lot older—partner. I am healthier and more active than him, though. Lately he has been having trouble getting erections. It’s caused a problem in our sex life because my erections are fine and his aren’t that good anymore, and he gets frustrated and short with me, and gets all “never mind” if I say anything about it. Is there anything I can do to make this less of an issue or to help him get a stronger erection going, or should he just go to his doctor to see if he can get on medication?
A Men who are experiencing ongoing erection problems should always (let me repeat, always!) check in with their health-care provider—not so that they can fulfill the dreams of pharmaceutical companies everywhere by asking their doctor for a prescription, but so that they can be checked out for any other health issues. While many people think of erectile problems as only a sex issue, they are sometimes an early sign of diabetes or a heart condition. As such, the first thing I’d recommend is to try to talk to him about his erections at a time when you two aren’t about to have sex and haven’t just had sex. Try talking to him when you both have the time and energy to have a caring, uninterrupted conversation. Sandwich the tough stuff with encouraging words. For example, start by saying how much you love or care for him and how important your relationship and his health are, and that because of that you have a concern you’d like to discuss, which can lead to a conversation about his erections as a possible health issue. As for the sex part, try to reassure him that you enjoy being sexual with him regardless of what either of your erections are like, and try to be affectionate with him during times when you aren’t focused on sexual activities that require an erection from him. If his erection softens during sex, you might switch your focus to another body part or another activity, like kissing, anal play or sensual massage. Finally, Coping with Erectile Dysfunction (New Harbinger, $17.95) offers information related to medical, psychological and relationship aspects of erectile function.

Q During the past few years I can’t help but feel like my vagina feels too big. It’s like I can’t feel my husband anymore when we have sex. Have I lost elasticity? Or is he just getting smaller? Is there anything surgical or medical to be done about it?
A Depending on your ages and other physical changes, your husband’s erections may be less firm and your vagina may indeed feel as though it has lost some of its strength or elasticity. Each of these can affect how sex feels to you. If you’re concerned about your vaginal tone, check in with your gynecologist. Sometimes the front or back vaginal wall can become more relaxed and weak, and the bladder or rectum can push through on the wall. This can often be spotted by a doctor during a gyn exam and, depending on the severity and other issues, is sometimes treated with surgery. Other times women find they can strengthen their vaginal tone through Kegel exercises (squeezing and contracting their pelvic floor muscles; the same ones that are used to stop the flow of urine). Sex toys like ticklers or enhancers (that fit around a man’s penis, adding girth and sensation for female pleasure) may be an option, too. The first step, however, is checking in with your gynecologist.

Send letters to Debby Herbenick, Ph.D., c/o Time Out Chicago, 247 South State Street, 17th floor, Chicago, IL 60604, or send e-mail to inandout@timeoutchicago.com.