Gay Men and Sexuality

Sexual Difficulties in Gay Men

Sexual Health and Relationships WA and Impotence Australia works with all sexualities and believes that all people have the rights to: their sexuality without discrimination, fear or harassment access sexual information and other resources express their sexuality regardless of their HIV status express their sexuality regardless of their occupation, color, race or creed.

Gay Men and some of their concerns

Some gay men might find it difficult to admit they have a sexual problem. Men have a high degree of self esteem and sexual identity attached to sexual performance. The common myth that men should be ready for sex at any given time gives a false measuring stick.

GayMenMany men find it difficult to ask for help with sexual concerns, and may ‘put up’ with it for many years. Impotence Australia offers a confidential help line to assist with addressing the common difficulties men have in accessing help for their sexual concerns.

Difficulties with erections

Erections can change over time, sometimes stronger or weaker then other times. When men are in their teens they often have little control over their erections and obtain erections when not in a sexual situation. For most men this stops in their late teens to early twenties. As men get older erections may not always be obtained when they want one. Almost every man has the occasional time when their erection is less strong than they would like but sometimes it becomes a problem.

If the erections are fine except with a partner, then it is likely that the problem is largely psychological. If the erection is never OK (with a partner, with masturbation by yourself and never there when you wake up), then it is likely that the underlying problem is physical. Often people have a mixture of psychological and physical things which together cause difficulties. Many physical things can cause erection difficulties. Drugs, both prescribed and recreational, are a common reason for difficulties. Other health problems, such as diabetes, multiple sclerosis, prostate and circulatory related diseases, may cause erection difficulties in some men. Occasionally there is a problem with the male hormone, testosterone.

Help is available for psychological and physical causes

Having psychological problems with sex does not mean that there is anything wrong with your mental health. Sex therapy can assist you, Raelene Stokes is a trained Clinical Sexual Health Counsellor who serves the straight, gay, lesbian, bi and transgender communities. If you have any questions around sex therapy or relationship counselling, or want to make an appointment with Raelene please click here.

Drugs, oral or injections, to help obtain and maintain an erection are available from your local doctor.

Vacuum devices, which draw blood into the penis where it can be trapped with a special ring placed at the base of the penis is also useful.

In a smaller amount of people who have extreme vein damage surgical implants, which strengthen the penis from the inside, are available. .

Difficulties with coming

Many men experience difficulty in controlling ejaculation, or coming. Coming too quickly is called premature or rapid ejaculation. When it takes longer to ejaculate then you would like it is called delayed ejaculation. Premature or rapid ejaculation can be treated by sexual counselling and homework exercises (if you have a regular partner it can be useful if they go to at least some of the clinic visits). Local anaesthetic creams can be placed onto the sensitive parts of the penis. Some doctors are also treating rapid ejaculation with viagra or injections, the man usually still comes quickly but may either keep or get his erection back in a short time to continue penetration (some men using this method report a reduction in the feeling of orgasm or the inability to obtain a second erection). Some anti-depressant drugs that have a specific action of lengthening the time it takes to get to ejaculation are being used (these have not been approved in Australia for this condition). A new drug for premature ejaculation is also on the market within Australia for more information please contact Raelene Stokes email:

Delayed ejaculation has been considered a rare condition, however there are reports of more men presenting for treatment. Drugs do not seem to help much. Sexual therapy, with exercises to do at home, seems to be the preferred mode of treatment.

Difficulty with sex drive

Occasionally ‘going off sex’ has a physical cause and can be treated by a doctor. More often the difficulty has started in the mind and is best treated by a sexual therapist.


VIAGRA and Poppers

VIAGRA must not be combined with nitrite inhalants (“poppers” or “amyl”) or any form of nitrates, because the combination may result in dangerously low blood pressure, which could be fatal.

Getting Help

Most people are recommended to seek help from their GP. This may not be that easy for a gay man, his doctor may not know about his sexuality. If you don’t want to go to your GP then Sexual Health Centres can offer assistance, either directly or an appropriate referral. Private Sex Therapist is also useful.

Finding good quality care that also is ‘gay friendly’ may not be easy, particularly in some country areas.

Impotence Australia may be able to help you with an appropriate referral. Email:

Fact Sheet : Impotence Australia
Raelene Stokes is WA Coordinator for Impotence Australia and she specialises in Men’s Sexual Health. Sexual Health & Relationships WA serves the straight, gay, lesbian, bi and transgender communities.

If you would like to make an appointment with Raelene click here.

Other useful Organisations

  • Gay and Lesbian Counselling Service
  • Anti-Violence Project
  • Gay and Married Men’s Association
  • AIDS Council

(Local phone numbers can be obtained by directory assistance or looking up your local phone book directory)

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