Erectile Dysfunction and Relationships

How to deal with the issue and its influence on the couple’s everyday life.

Erectile Dysfunction is the inability to get and/or maintain an erection suitable for sexual intercourse and it is the most common sex issue reported by men. ED affects approximately 140 million men worldwide, and half of all men between the ages of 40 and 70 suffer from the dysfunction to some degree.

The causes are multiple: it can come from emotional factors such as anxiety, depression, relationship conflicts, stress or medical factors such as diabetes, blood circulation issues, some pharmaceuticals, cancer treatments (radiations for example), damaged nerve signals, surgeries/injuries affecting the pelvic area, etc.

In many cases, ED is the result of an emotional issue, therapy will help the patient returning to his normal self. For all the other cases, a lot of different treatments are available to help with the condition, which is a subject we will touch in a later article.

Sex is an important part of our lives. The ability to perform usually is connected to one’s confidence but can also definitely be a cause for performance-pressure and high levels of stress. Men suffering from ED will be less and less likely to want to initiate intercourses, because of the fear to have the issue occurring again. Adding emotional stress to the condition will only tend to make things worse and can enhance the frequency of ED happening during sex.

The issue can quickly become a relationship problem, especially when the couple is not able to be intimate anymore. Talking about it can be a very difficult thing to do for men, as it is often seen as a shameful situation. “Men who develop ED feel terrible about themselves, as men” says Abraham Morgentaler, associate clinical professor of urology at Harvard Medical School.

Women, on the other hand, generally wouldn’t know how to approach the topic without hurting or embarrassing their partners. Moreover, they might -wrongfully- think they are the root of the issue. “Women internalize things, they tend to blame themselves first, thinking it’s because they have done something wrong, or that they are no longer attractive to their partner. In fact, the first thing a woman thinks when a man can’t get an erection is that it’s her fault, and nothing could be further from the truth” says Andrew McCullough, MD, director of sexual health and male infertility at NYU Medical Center in New York City.

It is important to follow a certain “pathway” with erectile dysfunction. Denise Knowles, sex therapist, advises the couple to initially work on finding out what is causing the ED. An appointment with your GP and correct testing will determine if the cause is medical or not. If it is, an appointment with a professional (Urologist or Andrologist) will help in finding the correct treatment for the condition. If the causes are emotional, instead, help can be found with a sex therapist or couple counselor. 

Both parts of the couple should make sure not to take erectile dysfunction personally, continues Dr. Knowles. Women should understand the issue is not relative to their partners’ desire for them, and men should remember most men experience ED at some point in their life. Communication is key. Erectile dysfunction is a touchy subject and a difficult one to tackle, but free speech in the couple is essential for both Mrs. and Mr. Talking about the issue, you might want to start looking into sexual alternatives in order to ensure that desire and intimacy, in any form, are still a part of the relationship.  

Finally, Dr. Knowles advises the couple to try on going to therapy, as one. Whether is it sex therapy, couple counseling or basic therapy, depending on the patient’s psychological needs.

The main message here is, you are not alone. You aren’t alone struggling with this condition: neither around the globe nor in your relationship.

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