Sexual Wellness Resource Center
For Adults over 50.

Strap Ons for ED: Are They An Option, and How Do They Work?

By Michael Bates, M.D.

Using a strap on, couples can still enjoy sexual pleasure even when erection is not possible.

In this final article in our series on options for coping with erectile dysfunction (ED) I am going to write about “strap ons.”  

Before we get started I want to emphasize that ED can be a symptom of other health problems like high blood pressure, diabetes or heart disease. The place to start to resolve this problem is a visit to your doctor.

OK, back to strap ons. Just what is a strap on?

A strap on is a dildo attached to a jock-strap-like harness that secures the dildo against the body so one doesn’t have to hold on to it. Is it used for penetrative sex. Using a strap on, couples can still enjoy sexual pleasure even when erection is not possible.

Well, then, what is a dildo?

A dildo is an erect penis-like object that may or may not look realistic. Dildos are usually more rigid than an erect penis and were originally intended for self-stimulation.  

Size matters: Bigger may not be better. If a dildo is too long it can cause pain with deep penetration; if it is too wide it can cause pain with insertion. Lubrication is a must.

When might a couple use a strap on in dealing with ED?

Strap ons for management of ED are an option for couples when medical treatments have failed and the male is not interested in a surgical implant.

The following is the story of a man who was treated for prostatic cancer—first with surgery, followed by radiation, and finally with Lupron. Lupron is a form of androgen deprivation therapy (ADT) and reduces dramatically testosterone production from the testicles. It is also called medical castration. Testosterone, critical for male sexual function, is also fuel for prostatic cancer growth.

This is the narrative of loss of sexuality, the resulting despair, and the joy of recovery with the use of a strap on.

HIS STORY

 

Neither Viagra nor a vacuum erection device worked for me. I am loath to

inject drugs into my penis or have a surgically implanted penile prosthesis,

the remaining medical options for treating ED. Not surprisingly, like so

many other cancer patients sexually incapacitated by modern medicine, I

was clinically depressed within a few months of starting hormonal therapy.

This situation began to change when a close lesbian friend, who was

aware of my cancer treatments and the sexual dysfunction they had caused,

refused to accept my giving up on life. She told me that she uses a strap on

dildo. She claimed that she got genuine sexual satisfaction from this and

thought I could too. I was very skeptical. A dildo is not innervated, and

I imagined that sex performed with such an appliance would be wholly

contrived and not a sensual act at all. My friend persisted in encouraging me,

arguing that sexual satisfaction is as much in the brain as in the groin.

It took me more than a year to act on her suggestion. I was embarrassed

to go into a sex shop to buy a dildo. I had never used sex toys. I was

afraid that I would feel foolish and humiliated by using a strap-on penis.

To do so meant facing fully, frontally (so to speak), the functional failure

of my own flaccid phallus. Despite my reservations, I eventually agreed to

experiment with a strap-on dildo. My expectations, though, were muted. At

most, I thought I might be able to please my partner. But I honestly did not

envision recreating a fully satisfying sexual experience.

 

My lesbian friend took the initiative to get me going on this project. She

fabricated a harness that was customized to fit me and took me shopping for

a dildo, which she insisted I consider “a toy.” I don’t think I could have even

walked into the sex shop without her. I was worried that I might be identified

and mocked by someone who knew me. In the store I debated buying a

dildo that looked relatively natural or one that was beyond the realm of real

anatomy. I finally selected one that was similar in size, shape, and angle

to my erect penis before cancer treatments, to the best of my recollection.

It is made of silicone, which makes it durable, appropriately stiff, yet still

flexible, like a natural erect penis. Beyond that, the dildo that I bought bears

little resemblance to a human penis. Granted, it has an expanded “head,” like

the real glans penis but a uniformly smooth shaft, with none of the irregular

surface texture caused by real-life veins. And it is purple! Clearly, it does

not constitute a realistic bio-mimetic prosthesis. I knew then that I could not

seriously think of this piece of purple plastic as a medical appliance. This

was important in my reconceptualizing the situation. Whatever I was going

to do with the dildo was not in anyway a “cure” for ED nor was it meant

to restore my masculine sense of sexuality. If this was going to work, it was

because it was something completely different. I had to stop thinking about

this clinically and accept the idea that I was heading into the theater of the

absurd, and I was going to play the part of a lesbian!

 

Before this purchase, I discussed extensively with my partner whether

she was willing to have sex with me wearing a strap-on dildo. She was at

first hesitant but ultimately supportive of the exploration. We have now used

the dildo many times. It caught me by total surprise how natural intercourse

felt with this strap-on device. I discovered that my hip movements with the

dildo on were the same as during normal intercourse. Our body contact and

embrace was full and natural, as well. The first time that we used the dildo,

my partner reached down and held my penis in her hand. She had coated her

hand with the same lubricant used to coat the dildo and stimulated my penis

in synchrony with my pelvic movements. There was little sensory difference

between this act and intercourse—my penis was not in her vagina but it

did not know that. It was in a wet, warm place being firmly mechanically

stimulated. My hindbrain took over, and I carried the act through to orgasm,

to the sexual satisfaction of both my partner and myself.

 

My partner had not discussed with me her plan to hold my glans penis, so

I was totally surprised by that action. I had not expected to achieve an orgasm

and was astonished that it happened. At first I, thought it was the novelty

of her holding my penis that brought me to climax. I thus feared that being

aware, and then self-conscious, of this activity would defeat its effectiveness.

This, however, has not been the case. If anything, sexual satisfaction has

become easier, because both of us have come to accept the dildo as part

of our sex play. Each time we use it, it becomes further imbued with the

knowledge of the previous sexual satisfaction it has provided. It is thus now

both a normal and at the same time erotic part of our lives.

 

We have both been able to have orgasms many times using the dildo.

The knowledge that it will never become flaccid means that my having an

orgasm need not prohibit further penetrative sex. The dildo gives me the

sexual capacity to serve my partner more reliably than I might have been

able to achieve as a potent male (with or without Viagra). Significantly, my

partner claims that she could not previously have an orgasm simply by penile

penetration. However, with the dildo, I am able to continue pelvic thrusts

long and hard enough that she now regularly achieves an orgasm in the

missionary position. We have also used the dildo with me lying on my back

and my partner sitting on it, so she has control of the movement. This was

sexually pleasurable for her, although I have not achieved an orgasm in this

position.

 

When I had a prostate gland, sexual arousal that did not lead to ejaculation

was frustrating, and I found it incomprehensible when a woman claimed

she had pleasure from sexual stimulation yet had not had an orgasm. After my

prostate was removed, I discovered that I too could have incremental pleasure

from sexual stimulation and enjoy sex without orgasms. I can also have

multiple orgasms! Without a prostate gland, my orgasms are less anatomically

focused, radiating across my pelvis. They are of variable intensity but sometimes

massively cathartic. When I have multiple orgasms, they are usually 2

or 3 within one minute or 2. I find it easiest to achieve orgasms when my

partner wants me to, especially in the context of mutually satisfying dildo

intercourse, but far more difficult on my own.

 

I am fascinated by the eroticism that has developed between my partner,

myself, and our dildo. For example, one morning, after having sex the night

before, I went to the bathroom and found the dildo sitting upright on the

counter-top wearing one of my favorite neckties. My partner had decided to

personify and personalize it. I interpreted this as a signal to me that the dildo

pleased her and did so because of its association with me.

On another occasion, I was waiting for my partner’s arrival and decided

to put on the harness and dildo ahead of time. I covered myself and the

dildo with a bathrobe, but there was no mistaking the fact that when I looked

down there was sticking out what looked like a large firm erection. For a

brief instant, it brought back my fear that wearing a dildo would force me

to confront in a demoralizing fashion my own failed phallus, my mutilated

masculinity.

 

But that was not at all what I felt. Instead, I felt joyfully empowered.

My thoughts went to a glib one-liner from my lesbian friend: “A dyke with

a dildo can outlast a male anytime.” I realized that that was equally true

for a prostate cancer patient with a dildo, and I almost started laughing. I

was playing a role and doing it better than I ever could before I became

impotent. I had acquired a performance capability that surpassed “male” and

 

I was thoroughly enjoying the “play” part of sex.

When I reported this experience to my lesbian friend, she suggested that

my partner and I explore oral sex with the dildo. Once again, my first thought

was, “That’s absurd.” But since everything else she suggested had worked

better than I could have imagined, my partner and I took on the challenge.

Simply stated, there has now been enough acceptance of the dildo as a sexual

object—and transference from “object” to “organ”—that the visual image of

my partner mouthing the dildo was indeed highly erotic in the context of

our sex play. On another occasion, in order to tease me, my partner started

playing with the dildo in a flirtatious fashion outside of the bedroom. I found

the activity erotic and sufficiently distracting that I had to ask her to stop so

that I could concentrate on what I was doing.

[Warkentin, K.M., Gray, R.E., & Wassersug, R.J. (2006). Restoration of Satisfying Sex for a Castrated Patient with Complete Impotence: A Case Study. Journal of Sex & Marital Therapy, 32, 389-399.]

How did the use of a strap on help this couple rediscover their sexual life together?

The strap on and manual penile stimulation allowed a fully impotent man to become orgasmic again and to satisfy his partner. This was only possible because of the  acceptance, cooperation and participation of his partner. The dildo was not “his” dildo, but “their” dildo.

The strap on allowed for natural thrusting movements without fear of coming out of the vagina. This permitted sensual belly to belly, breast to breast, and eye to eye contact.  The penis was external, so it could be stimulated manually, particularly the head. The moist environment provided by the partner’s lubricated hand, with firm and rhythmic manual penile stimulation, resulted in orgasm. Enhanced vaginal stimulation was more satisfying for the female, allowing orgasm during penetration.

What is the take-home message?

  • Sexuality, sexual satisfaction, and orgasm are deeply rooted in the brain.

  • Orgasm can occur in the absence of testosterone.

  • Strap ons allow for natural pelvic movements, full body contact, effective mutual genital stimulation, and elimination of performance anxiety.

  • Strap on dildo sex is an effective option for those with ED who don’t respond well to medical treatment.

References

[Warkentin, K.M., Gray, R.E., & Wassersug, R.J. (2006). Restoration of Satisfying Sex for a Castrated Patient with Complete Impotence: A Case Study. Journal of Sex & Marital Therapy, 32, 389-399.]



About the Author

Michael Bates, M.D.

Dr Bates practiced obstetrics and gynecology for 34 years in Wichita, Kansas, until his retirement in 2011.

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