For the 152 million men worldwide who experience erectile dysfunction (ED), having a sex life is an issue. To find out how the condition impacts relationships, Health24 caught up with sexologist Caren Hadders.
Sex is just as important to the partners of men who suffer from ED, or impotence, as it is to the men themselves.
The Strike up a Conversation study (2005) indicated that more than 80% of men with ED – as well as their partners – rate sex as important. ED can, thus, have a dramatic impact on a couple, influencing both partners' psychological and relationship health, their self-confidence, and their overall quality of life. The study was conducted in Germany, the UK and Spain.
Sexual dysfunction is 'catchy'
There may be a correlation between ED and female sexual dysfunction, says Durban sexologist Dr Prithy Ramlachan. Painful intercourse, inability to reach orgasm and decreased sexual desire are common complaints of women who suffer from sexual dysfunction.
But, according to sexologist Dr Caren Hadders, partners are affected by ED mostly because it has such a strong emotional impact on the sufferer himself. "The man withdraws, because he feels that there's something wrong with his masculinity. He works harder, goes to bed earlier or later, and avoids touching his partner, because he 'wouldn't want to begin something that he can't finish'. Emotionally, he gets progressively distant, grumpy, depressed and anxious," Hadders says.
The result is that the partner feels rejected and starts wondering what she did wrong, whether her partner may be having an affair, or whether he finds her unattractive.
Penetration is another important factor – and not just for men. Research indicates that penetration is the way in which about 25% of women climax.
"As a sex therapist, I find it important to teach couples that you can make love in many ways and not just by means of penetration. But thanks to the excellent ED medication now available, penetration doesn't have to be excluded anymore," Hadders says.
Treatment obstacles considered
There are many obstacles on the way to better sexual health for the ED patient and his partner.
One of the major issues is that men tend to be hesitant to raise the problem with their partners. In fact, an Italian study showed that only 59% of men with ED have spoken to their partners about their sexual dysfunction. The Strike up a Conversation study added that partners of men with ED are strongly inclined to wait for a signal of some kind from their partner before raising the subject themselves.
When either of the partners finally strikes up a conversation, misunderstandings prevail: men often find empathy and support humiliating, while reassurance by the partner is seen as an indicator that the sexual relationship is of little importance to the partner.
To compound the issue, only 30 to 50% of men with ED consult a doctor about their condition. Men are too embarrassed to discuss the problem, feel that the problem is only temporary, or don't think ED is a medical problem at all.
Many others, who do seek treatment, fail to adhere to treatment regimes, which mostly involve drugs such as Viagra, Levitra and Cialis (PDE5-inhibitor-type drugs).
How should partners handle ED?
Experts believe that open communication is key to ensuring that ED doesn't affect the couple's relationship in the long run.
"People talk about everything in life, but find it very difficult to talk about sex," Hadders says. She suggests that partners of sufferers should talk openly about the issue. "And as ED can be a marker of underlying disease, it's very important for the woman to encourage her partner to consult a doctor. The woman could also share info about ED with her partner. Most men like facts."
Active efforts, instead of passive responses, tend to be more effective when it comes to supporting a partner with ED, researchers of the Strike up a Conversation study say.
Being supportive, letting your partner know that the two of you can tackle ED as a couple, reinforcing your partner's masculinity, and suggesting that your partner sees a physician, will have a positive effect on helping him to resolve his ED problem.
On the other hand, passive responses, like "giving him space" and "wanting to let him sort the problem out by himself", will do little to solve the problem, Hadders concludes.