Dr. Kris Case: Being a Father and Being a Partner After a Baby

I hear this very often from new fathers: "Since the baby came, we're more like housemates than a couple." This case is a clear example that problems in bed often don't start with the body. They start with a life that leaves no space for each other.

Background

He was a man in his mid-30s who worked hard almost every day. In the early years of marriage their sex life was very good, but once they had a toddler, intimacy drifted away. Every time there was a chance, they had to listen out for whether the child would wake or cry, so sex became something to get over with quickly.

As a result he started to have premature ejaculation, and sometimes could not get an erection because he was too anxious. He tried to fix it himself first by ordering erection pills online, without knowing whether they were genuine or fake. After taking them he had palpitations, dizziness and nausea, which frightened him and left him more stressed than before.

What I found

• Generally healthy. His blood pressure, glucose and lipids were within normal ranges, and he had no medical condition that explained the symptoms.
• The pattern of symptoms. He still had morning erections, but lost them in pressured situations, which pointed to anxiety playing a big role.
• Acquired premature ejaculation. It began during this rushed period of life; it had not been there from the start.
• The pills had no known source. They had no verifiable drug registration number, the dose was uncertain, and he did not know the contraindications with other medicines.
• The relationship. They still loved each other but had never talked about this directly. His wife was also exhausted from looking after their child.

1. 1
   Hurry to finishListening for whether the baby wakes
2. 2
   AnxietyA tense nervous system
3. 3
   Early, no erectionDeveloped later; not lifelong
4. 4
   Self-dosingUnknown source; palpitations, dizziness
5. 5
   More stressFear of the next time grows

Care

1. Stopping the pills of unknown origin, and explaining the risks of fake medicines, which may contain an overdose, the wrong drug or contaminants.
2. Medication as assessed by the doctor. A PDE5 inhibitor at a suitable dose as a temporary aid at first, with an explanation of how to use it and which symptoms to watch for (read: tadalafil vs sildenafil). For premature ejaculation, we started with control techniques, considering specific medication only if needed.
3. No hormones without an indication. He asked about testosterone, but he had no symptoms and no blood results suggesting it was needed, so I did not recommend it.
4. Separating the "parent role" from the "partner role". I encouraged them to treat time for the two of them as an important appointment, for example leaving the child with someone they trust for one night, switching off their phones and not talking about work or the child, so it becomes time to truly relax.
5. Changing the goal from "having to finish" to "being close". I suggested sensate focus to bring intimacy back without pressure.
6. Involving his wife, because she also has needs and tiredness that deserve care.

Several weeks later, he told me they had started to have time for each other again. His anxiety had eased and he needed medication less. What he said that has stayed with me was, "I forgot that we have to look after each other too, not just the baby."

1. 1Stop illicit pillsExplain the risks of counterfeits and unsafe combinations
2. 2Medicine as assessedA short-term aid; no hormones without an indication
3. 3Separate rolesCouple time apart from parent roles
4. 4Sensate FocusShift from "must finish" to "being close"
5. 5OutcomeTime for each other, less anxiety, less medicine

What I learned

• Rushing is the enemy of erections and ejaculatory control. A stressed nervous system works against sexual arousal.
• Erection pills are not sweets. Buying them online risks both fakes and unknown contraindications, especially if used with nitrates or poppers.
• Hormones are not the answer to every problem. There must be symptoms and confirmatory blood tests first.
• A relationship needs protected time, just as we protect a child's sleep time.

If you are going through the same thing

Read more in ED: causes and treatment and Common couple problems. If you are taking medicine you are not sure about, stop and talk to a doctor. At Dr. Kris Clinic, I look after both sexual function and relationships. You can come alone or as a couple, at the clinic or online, including in English.