Q: I’ve started to lose my erection during sex. At first, my wife was cool, but then she got frustrated. She swears I’m cheating. I’m not. Lately, she’s started insulting my manhood. I don’t want to leave her, but the disrespect has to stop. What should I do?

A: You are describing erectile dysfunction (ED), a common problem men of all ages face. ED occurs because not enough blood gets to the penis for an erection to occur or because the blood “leaks” out, causing you to lose your hard-on. Its causes range from heart disease and diabetes to certain medications to emotional issues, like job or relationship stress or having been abused. What to do? Ask your partner for uninterrupted time to discuss your condition and possible causes. Because it’s frustrating and humiliating, ED can damage a good relationship. She needs to know what having ED is like and that her behavior and mistrust make matters worse. You need to know that she feels rejected.

The sexual partner of a man with ED needs to be subtle, understanding and supportive. I have never met a man who wants to lose an erection, yet partners often become impatient, pressuring men to “perform.” Instead, you both need to use good communication skills: no insults or demeaning comments; be honest about the relationship; don’t threaten to leave unless you mean it; and commit to finding a solution.

Agree not to have intercourse for a few weeks. Instead, plan a weekly date night, spend time talking, relax, cuddle and express your appreciation for each other. Fall in love again. Also get a medical exam to identify any physiological causes. If you drink, smoke or use drugs, tell your doctor; these habits can affect sexual performance. Counseling can help if you’ve experienced previous abuse. Make sure you are emotionally ready before attempting sex again. ED medications may help, but talk to your doctor—don’t take too much or try to overperform. A loving, relaxed environment and healthy lifestyle, including healthful foods and exercise, will help your body respond and your erection return when the time is right.