'I'm worried I no longer excite my husband sexually' – our columnist Anna Richardson advises a reader

In a long-term relationship, it's incredibly common for sexual intimacy to go up and down at different points in our lives, as you evolve as individuals and as a couple, as you face stresses and strains as well as joys and pleasure.

In this Ask Anna column, a reader sought my advice about her husband's difficulties in getting an erection, which was making her feel undesirable.

It's such a common problem (hence the popularity of those little blue pills), but taboos often stop us from talking about problems in the bedroom and how to boost libido. Luckily, I was happy to advise.

Changes in the bedroom

The reader said: "My husband is in his early 50s and seems fit and healthy, but in the last year he has been having difficulty getting an erection. Previously, we had a fairly regular sex life.

“I’ve reassured him that it doesn’t matter and I’ve tried to make more effort in the bedroom – sexy lingerie and even booking a romantic weekend away, but it hasn’t helped.

“We’ve never been very good at talking about sex and I know he’d never see the doctor about it.

His work is stressful – there have been redundancies so he’s feeling the pressure, but I’m worried that I no longer excite him.”

Don't let this common problem knock your self-esteem

One of the biggest myths we have to deal with in relationships is that men have insatiable sexual appetites – and whereas women struggle to keep up with it, men have no difficulty with ‘keeping it up’ at all. This is, of course, nonsense. I want to reassure you that what you’re both experiencing is a very common relationship issue.

Navigating changes in sexual dynamics within a relationship can be tricky, especially when you say you’ve both ‘never been very good at talking about sex’.

But what worries me here is that you seem to be making all of the effort – buying the sexy lingerie to excite him, booking a romantic weekend away to ignite the flame of desire – all while your husband is quietly keeping his head very firmly in the sand.

When a couple has a problem and one of them won’t discuss it, then really, you have two problems; and your confusion and unhappiness is starting to erode your self-esteem.

I think it’s important to recognise that this issue now needs a more comprehensive approach.

Common reasons for ED

When it comes to erectile dysfunction (ED), there are two things to consider: the physical reasons for why the blood flow to the penis is insufficient, and the psychological reasons for why it may not be getting there in the first place.

And remember, the two are not mutually exclusive – in other words, it’s perfectly possible that your husband may be hot with desire all day long, it’s just that his penis isn’t getting the message.

That’s why I’m keen for you to gently encourage him to pay a visit to the GP – simply to rule out any underlying physical illness. As a man in his 50s, there could be several issues lurking beneath the surface that might be affecting his ability to get an erection, including high blood pressure, high cholesterol and diabetes. If this is the case, he can take active steps to lower them – including medication.

If everything checks out physically, then you both need to consider what’s going on psychologically for your husband. Stress, tiredness and anxiety can cause ED, and given that you’ve mentioned he has a stressful job and is feeling the pressure of redundancies at work, it’s perhaps no surprise that he’s lost his mojo.

I wonder if you could help him to find healthy ways to manage his stress? Exercise, mindfulness, hypnosis or other interests that distract him from work could be all he needs.

Work on your relationship together

And then, finally, there’s the two of you. Plus, the elephant in the room that’s your sex life. Consider seeking some couples counselling from a psychosexual or relationship therapist to improve your communication around sex and intimacy in a safe way.

You could also explore alternative forms of intimacy that don’t rely solely on penetrative sex, to remove the pressure from both of you. That could be as simple as deep kissing, cuddling or enjoying some ethical porn.

Have you lost touch with your sensual selves? Maybe it’s time to reconnect with what you both find erotic. Remember, true intimacy is about connection and closeness – when you start to prioritise each other’s wellbeing, you can rediscover pleasure again.

If you would like help with a problem, email askanna@futurenet.com or leave a voice note at hello@itcantjustbeme.co.uk and mention you’re a woman&home reader. Note that Anna may choose your dilemma to discuss on her podcast, It Can't Just Be Me.