Erectile dysfunction can involve blood flow, nerve function, hormones, medication, stress, sexual pressure, relationship dynamics, or several of these factors at once. Treating it as nothing more than a performance problem misses the larger—and often more treatable—picture.

You can love someone deeply and still become exhausted by the way the relationship is functioning. Some relationships do not collapse in one dramatic moment. They wear people down through a thousand ordinary ones.

You probably don’t have a sex problem. You have an honesty problem. Not screaming honesty. Not blow-up-the-marriage honesty. I’m talking about the quiet kind. The kind that sounds like: “I’m fine.” “It’s okay.” “Whatever you want.” “Maybe later.” When your body is saying something completely different.