How Do I Get an Erection Without Viagra? And Please Teach Men How to Help a Woman Orgasm!

Experts answer the questions you are too embarrassed to ask

Ellen Uzelac,

AARP

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Published July 11, 2024

cactus plant on a countertop with medication

Susanna Gentili

A lot of reader questions involve the penis: getting hard, staying hard, staying hard longer. I’ve been working hard here at Erection Advice Central to get you expert guidance on how to keep that shaft firm. Pay attention because there may be options you haven’t heard of before.

Our other question this week is from a 50+ reader who wonders why so many men don’t know how to help a woman orgasm. I can answer this one: Follow directions — hers. And no shortcuts. Our experts give you more details.

If Viagra and Cialis don’t work for you, what else can you try? I’m willing to do anything to please my partner.

It’s disappointing that those meds didn’t result in a reliable erection for you. Typically, according to urologist Michael Lutz, they work well for about 70 percent of men who have no underlying health conditions such as a metabolic disorder, diabetes or cardiovascular disease.

The good news? You have other options — several of them.

For starters, Lutz, associated with the Michigan Institute of Urology, suggests having your testosterone level checked. If it’s low, you can be treated with testosterone replacement therapy and/or penile shock wave therapy, which uses ultrasound to improve blood flow in the penis. These treatments can boost the efficacy of drugs such as Viagra and Cialis.

Other alternatives Lutz recommends:

A vacuum pump erection device enhances blood flow to the penis. These can be purchased through retail medical supply companies for $300 to $500.
Give yourself a penile injection of a “vasoactive” medication before sex to help get you hard. These are not typically covered by insurance.
Penile implant surgery can give you reliable erections. The surgery typically takes one to two hours, performed on an outpatient basis, and recovery takes about six weeks. The procedure is usually covered by insurance.

Lutz is a fan of psychological counseling for patients who can’t stay hard. “It helps couples get on the same page and potentially identifies any underlying anxiety the man might have,” he says.

Mike Johnson, a tantric sexologist certified by the American Board of Sexology, suggests practicing deep breath work and meditation to calm the mind/body as another nonmedical option to address performance anxiety.

Johnson recommends not focusing solely on the penis during intimate moments. Expand your sex play.

“Only using your penis during sex is such a lazy way to make love,” says Johnson, the author of Making the Love You Want. “We get into such a routine with partnered sex. We know what’s going on before it happens.”

What tips can you offer men to help them learn how to help a woman orgasm?

Men are notoriously bad at asking for directions — and that can include guidance on how to arouse a woman to climax.

More 50+ Sex Advice

“Why don’t men know? Because they don’t ask,” says certified sex therapist Sari Cooper, founder of the Center for Love and Sex. “It’s a don’t ask for directions policy.”

Slow it down. Many men go straight for the genitals when they initiate partnered sex, a move that most women find sudden and intrusive, Cooper says. “They don’t feel turned on when their breasts and genitals are touched immediately,” she says. “Women have a longer simmering time.”

Sonya Maya, a certified sex therapist, recommends 15 to 20 minutes of foreplay “to warm up the oven.”

Some men don’t understand female anatomy, which puts them at a deficit, Maya says, citing a “lack of sex education.” As an example, she says, many men don’t realize that the majority of women require direct clitoral stimulation to climax.

Talk to each other. Cooper advises men to be vulnerable — and ask for directions: “I don’t actually know what arouses you. Help me get there.”

Some men become upset that it takes external or additional stimulation (a vibrator, a hand) during intercourse, certified sex therapist Nan Wise says. And some women don’t feel entitled or empowered to explain to a partner what works for them.

Wise suggests that couples get into a mindset of being playful, experimental, caring and curious. “A man might say, ‘I notice you’re not having an orgasm while having sex. Is that OK for you? Are you satisfied?’ ” Wise says. The woman might consider showing her partner the way to her happy place by masturbating in front of him to demonstrate exactly how she wants to be touched.

Do you have questions about sex or relationships as a 50-plus adult? Send them to sexafter50@aarp.org.

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