My husband has a problem, but won’t get help

This column is all about you and we want to hear more. Send me your sex, relationship and work dilemmas and get sound advice from our experts.

Email your questions to tellmeaboutit@irishtimes.com or contact Kate on Twitter @kateholmquist.

Q My husband has had problems in the bedroom for a couple of years now, but so far has been unable to bring himself to seek help, or even to acknowledge the reality of what's going on with him. My heart really goes out to him as I sense he's suffering terribly inside. However, I'm at a total loss about how to bring it up without destroying what's left of his fragile ego.

I wish I could just pack him off to the GP to get “fixed”, but she’s a close family friend and I just know he’d be far too embarrassed to broach this subject with her.

A Your husband needs a GP he can talk to about anything so seeing a female GP who is also a close family friend seems self-defeating. That said, erectile dysfunction can’t be permanently “fixed” with a bottle of pills, because it is an emotional issue caused by a stressful lifestyle, relationship worries or both.

"Many sexual difficulties have their origins in unrealistic performance expectations men and women bring to their sexual relationships. It is important therefore to approach erectile dysfunction as a couple's issue right from the start and create a sense of the two of you working together to deal with the problem," advises Brendan Madden of Relationships Ireland.

To prepare for the initial conversation you are dreading, find out as much as you can about erectile dysfunction and plan your approach carefully.

“Do things beforehand that bring you closer as a couple. Don’t start the conversation at an intimate moment. Arrange a neutral time and place which is private and when you won’t be interrupted,” Madden advises.

A “soft” start-up is key to introducing any difficult conversation, so be positive and supportive in the days leading up to it so that background resentments are reduced. Start with praise – tell him what you love about being physically close to him. Avoid any sense of blame or complaining.

“Use words like ‘we’ and ‘us’ to emphasise that it is an issue for both of you as a couple and that the resolution of the difficulty will be achieved by both of you working together. Don’t overly personalise the problem by using words like ‘you’ and ‘yours’,” Madden advises.

Your husband might get irritated or even walk out of the room when you bring the issue up first. “Accept that he feels ‘flooded’ by stress hormones and plan to come back to the conversation again. You will have achieved an important first step in signalling that this issue is on the agenda for you as a couple and he will have time to prepare himself for when it comes up again,” says Madden.

When the time is right, seeking the help of a couples therapist specialising in sex issues could be invaluable to keeping your marriage healthy.

Q I am a married man in my forties. The pressures of work and family life mean my once-large social circle has shrunk to a very small number. Even these I hardly see.

Making new friends is hard, and platonic friendships with women – which I generally find more satisfying – are tricky when you're married. My wife isn't the jealous type, but everyone – including the woman and her partner – tends to be slightly unsure of the situation: so it's hard for a friendship to flourish.

The little social time I have I tend to spend with my wife. This is enjoyable in itself and enriches our marriage, but leaves little time for other meaningful relationships, which impoverishes life in general.

A Friendship is part of the richness of life and while you enjoy your wife's company, you need to maintain connections with other people. "It could be said that it's even more important for men to maintain friendships as they generally open up and share less than women tend to. If they lose the potential support network of their mates they can be at risk of becoming isolated," says psychotherapist Teresa Bergin.

You know your relationship with your wife has to be your priority. The sticky issue is that in friendship you prefer the company of women, and this seems to have caused anxiety for all concerned, even if your wife is not “the jealous type”.

“You would like this friendship to flourish but what does that mean exactly?” Bergin asks. “How meaningful do you wish this friendship to become? It would be natural for your wife to be concerned that this platonic friendship might develop into something more and actually be the beginnings of an affair.

“In addition she may be concerned about the boundary of your own marriage and the possibility of the private details of your relationship with her being aired with someone else. With the ‘shoe on the other foot’ you might well experience the same anxieties.”

You need to explore your own thoughts and feelings about this friendship so that you’re clear there is nothing more to it. It might also be useful for you to reflect on why you feel drawn towards friendships with women more than men.

“It is essential to have an open and frank conversation with your wife so that you can hear any concerns she may have – she may need reassurance around the nature of this friendship. It may be helpful for your wife to meet your friend, or indeed for both couples to meet socially so that everyone gets to know each other a little more and this friendship, if it develops, can become inclusive, rather than exclusive,” Bergin suggests.