Erectile Dysfunction

Erectile dysfunction, or ED, is the most common sex problem that men report to their doctor. Erectile dysfunction is defined as trouble getting or keeping an erection that’s firm enough for sex. It affects as many as 18-30 million men in the USA, or 1 in 5 American men 20 years or over.  By the age of 75, greater than 75% of all men will have some degree of ED.  So if you are reading this and you have ED, know that there are many, many others suffering from this.  Aside from the commercials for things like Viagra, no one talks openly about it, so for many people, it’s a really awful secret.

Erectile Dysfunction is a very challenging medical diagnosis for many reasons, but especially because of the emotional toll it takes on a man and his partner.  It can disconnect a couple emotionally and can leave both partners feeling bad about themselves.  They often have no idea how to help themselves manage their feelings, and to help one another to maintain their intimacy and their feelings of self-worth. Neither partner knows what to do to “fix” things and it feels overwhelming, embarrassing, and hopeless.

How does the person with ED respond?

Typically, erectile dysfunction causes someone to feel intense shame.   He may feel betrayed by his body.  It becomes both embarrassing and frustrating to have trouble with erections, especially with a partner.  He may beat himself up, feel like he isn’t a “real man” and feel like a failure.  He may think he won’t be able to sexually satisfy his partner and my worry that his partner won’t want to stay with him because of his erectile dysfunction.  He may not know what to do or what to say when he is unable to maintain an erection. Often, his frustration can cause him to shut down or to get angry.  Either response can hurt his partner’s feelings. 

Anxiety about not getting an erection or losing an erection before intercourse may become overwhelming and he may begin to avoid all types of intimate encounters out of fear of what might happen. He may even avoid things like romantic dinners because they often lead to sex. Any of this can leave his partner feeling rejected and unloved.

What about partners of men with erectile dysfunction?

Partners also struggles with the fallout of erectile dysfunction.  The partner may feel such sadness for the person with ED and they may be equally frustrated about what to do.   They may feel afraid about what their intimacy will look like in the future if erectile dysfunction continues. They may blame themselves and worry that they aren’t attractive or exciting enough for their partners to stay hard. Often, they want to say something loving and reassuring but they don't know what to say. Sometimes, they say hurtful or inappropriate things. This can make things even worse. 

Even though medical treatments exist to help with erectile dysfunction, the plethora of painful emotions and residual performance anxiety can be too much for most individuals and couples to cope with on their own. Just popping a magic pill or using a penis pump or injection is not going to fix the emotions both partners feel.  

Access to accurate information about ED and help navigating the impact on your relationship are key to you managing erectile difficulties in a manner that allows you and your partner to stay close and having pleasurable sex and intimacy. 

Sources:

NIH Consensus Conference. Impotence. JAMA 1993:270;83-90

Rogogatis LR and Burnett AL. The epidemiology of sexual dysfunctions. J Sex Med 2008;5;289-300

United States, Dept Health Human Services 1987

Martin-Morales A et al. Prevalence and independent risk factors for ED in Spain. JUrol 2001:166;569-74

Panser  LA et al. Sexual Function of men 40-79 years – the Olmsted County Study of Urinary Symptoms. J Am Geriatr Soc 1995

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