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This came up recently in a way that stuck with me.
A man called into a podcast. He was in his 60s or 70s. Widowed. Had been through a kidney and pancreatic transplant.
Now in a new relationship.
He described long, satisfying sex. Said he was using medication – something like Viagra – with the knowledge of his medical team.
And then he asked a simple question.
Do I need to tell her?
The Reaction
The responses were split.
A lot of people were supportive. Happy for him. Encouraging.
Some dismissed it as bragging.
And one comment stood out.
That it was deceptive. That he was misrepresenting who he is.
It read less like a thought and more like a verdict.
What That Assumes
That reaction depends on a specific idea.
That an erection, without medication, represents something real.
And with medication, represents something else.
Something less honest.
That’s where this gets complicated.
Because most erectile dysfunction isn’t a statement about character.
It’s vascular. Neurological. Hormonal. Often a mix.
The medication doesn’t create a different person.
It supports a function that’s limited for medical reasons.
What the Question Is Really About
When men ask this, they’re usually not trying to hide something.
They’re trying to understand what counts as honesty.
If sex is good. If both people are having a good experience.
What exactly would they be disclosing?
And what changes if they do?
Where It Gets Less Clear
There isn’t a clean rule here.
Context matters.
A long-term relationship is different from early dating.
A casual connection is different from a committed one.
Age matters. Expectations matter. The tone of the relationship matters.
So does intent.
Not telling someone something because you’re ashamed is different than not saying something because it doesn’t feel relevant.
Those aren’t the same.
Most people don’t open a conversation with a full list of everything that helped them get there.
The Comparison That Comes Up
It also raises a broader question.
Do we apply the same standard everywhere?
If a woman uses vaginal estrogen so sex isn’t painful, is that something she’s expected to disclose?
If she’s on hormone therapy that improves libido, does that need to be explained?
Most people don’t treat it that way.
The same is true for cosmetic changes.
Botox. Fillers. Surgery.
Those aren’t usually framed as disclosures required before intimacy.
They’re seen as part of how someone manages their body.
What I Think Matters More
When this comes up in clinic, the conversation usually shifts away from the medication.
And toward something simpler.
Does not saying anything feel neutral?
Or does it feel like you’re holding something back?
That line is different for different people.
But most men know where it is.
If She Asks Directly
If she asks, it’s different.
At that point, it’s no longer a question about timing or relevance.
It’s a question about being straightforward.
Most men find that answering simply – without over-explaining – lands better than trying to manage the moment.
Where This Leaves You
If you’re in that situation, there isn’t a universal answer.
But there are better questions.
What would change if you said something?
What would change if you didn’t?
And are you avoiding the conversation because it feels unnecessary or because it feels uncomfortable?
Those aren’t the same.
