Erectile dysfunction is the inability of a man to develop an erection that’s sufficient for intercourse. It can be a big issue for the sex lives of women at midlife or beyond because it’s so widespread among their typical male partners: in a large nationwide survey about sexual behavior among older US adults, 37% of men ages 57 to 85 reported having difficulty achieving an erection.5 The problem worsens with age, as almost half of men age 75 or older are unable to achieve an erection adequate for intercourse.9 Even if a peri- or postmenopausal woman is fortunate not to have troubling sexual problems of her own, she can end up dissatisfied and distressed if her male partner consistently cannot achieve an erection.
Ironically, the many effective treatments for erectile dysfunction can ultimately cause an entirely different problem for some women. The sudden restoration of erections in a man can result in newly robust sex that may be painful for his peri- or postmenopausal partner, whose vagina may have become less elastic after months or years of little or no sexual activity. In this situation, the couple may need advice on how to become sexually active again in a way that will be pleasurable for both partners.