A quarter of men under the age of 40, and half of those over 40, will not always get an erection. Photo / 123RF
A quarter of men under the age of 40, and half of those over 40, will not always get an erection. Photo / 123RF
Sex is – we are told – the most natural thing in the world. So perhaps it should not surprise us that men who suffer from erectile dysfunction (ED) are often plagued by a sense of failure.
One in five of those in relationships worry their partner will leave as a result,while almost two-thirds of single sufferers feel anxious about embarking on a new sexual relationship, according to research funded by erectile dysfunction treatment Eroxon.
“It’s a real irony,” says Catherine Hood, a specialist in psychosexual medicine, who works both in private practice and within the NHS and is an adviser to Eroxon. “Often, those men who really value their relationship are so worried about the effect that ED might have on their partner that this anxiety contributes to the problem.
“Meanwhile, that partner is worried that it’s a reflection of how he feels about them; that he might be less attracted to them than he was before.”
Talking about the problem is, she says, as essential as it is daunting. “Twenty-six per cent of men under the age of 40, and 50 per cent of those over 40, will not always get an erection. So this is something that’s really quite common. We need to break that narrative that sex will just always happen automatically, and break the taboo around ED too.”
Ignoring the problem, she says, will only increase anxiety and pressure for both partners. “And the more the pressure builds, the more men will go into sex worrying about their performance,” says Hood.
So how best to go about it?
Do your homework first
A little knowledge can be a powerful thing when broaching such a sensitive subject, says Dr Janine David, a GP who specialises in sexual health. “If you have done a little research in advance, then you can tell your partner, with confidence, just how common this issue is, and how fixable too.”
Sometimes, the problem can be resolved through simple lifestyle changes, like cutting back on drinking, stopping smoking, or losing excess body weight, she says – a reassuring and practical point to raise in conversation.
Don’t talk about it in bed
Erectile dysfunction is likely to loom largest in both your minds in the direct aftermath of attempted sex. This, however, is the worst time to discuss the issue, Hood says. Emotions may be running high, and tension in the bedroom can exacerbate ED and disrupt intimacy. “Just reassure each other, have a kiss and a hug. Leave discussions till you’re in a setting that has no connection with sex, at a time when you’re not expecting to have it.”
Do talk and walk
Talking about ED while you're walking or driving together can alleviate the pressure.
“I don’t think you should talk about it over the dinner table either,” says David, “because that’s an intimate setting. You’re looking into each other’s eyes and the pressure can build quickly.”
In the new survey, 67 per cent of sufferers and their partners reported that stress and anxiety can trigger ED. “You’re better off going for a walk or a drive, in a neutral setting, where there are other things to look at and alleviate that pressure.”
Don’t be tempted by Dutch courage
It may be hard to resist the lure of a glass of wine before a difficult conversation, but just as booze actually depresses the central nervous system, making it more difficult to get, and maintain, an erection, it is also a false friend when it comes to discussing the problem.
“You want the conversation to be calm and controlled,” David points out. “Booze may give you confidence, but it might also raise emotions. It’s vital that you avoid blame and accusations if you want the conversation to be productive.”
Do sandwich the tricky subject
If you are in a long-term relationship, then “start the conversation by emphasising how much you love them”, suggests David. “And end the conversation by reiterating that. So even if you’ve covered some difficult areas in the middle, you’re opened in a comforting, supportive way that makes open dialogue easier, and ended on a note that brings you closer together too.”
Do be specific
If you’re struggling to find the right words to broach the subject, then get specific, suggests Hood. “Try to recount what has actually happened, without emotion. You might say, ‘The night before last, when we were in bed, I noticed that erection was difficult.’ It may not be an issue, but I just wanted to talk about it, rather than ignore it.”
Do approach it as an ‘Us’ problem and not a ‘You’ problem
If it is likely that lifestyle issues are at the root of the problem, you might both be able to cut back on the booze, quit smoking, or take up an exercise regime. Photo / 123RF
Simply using the word “we” instead of “you” can help, adds David. “If you say, ‘I know we’ve had a bit of an issue in the bedroom’, instead of ‘I know you’ve been struggling’ it means that responsibility for the issue is shared, not piled onto one person.”
The solution can sometimes be shared too, she suggests. If it is likely that lifestyle issues are at the root of the problem, you might both be able to cut back on the booze, finally quit smoking, or take up an exercise and healthy eating regime. If stress is a contributing factor, you might both try regular meditation or mindfulness sessions. Embarking on this project together, and emphasising the health benefits to you both, can make your partner feel less isolated.
Don’t push a conversation
Erectile dysfunction is a difficult, emotive subject for many men, says Hood, so your partner may not be ready to open up about it straight away. “Just say, ‘if you don’t want to talk about it right now, that’s absolutely fine’,” she suggests. “You’re opening a door to communication, not pushing it, and hopefully that in itself will take the pressure down for your partner.”
Do visit the GP together
Over a third of sufferers canvassed in the survey reported that they had avoided discussing their ED with a healthcare professional due to embarrassment. But erectile dysfunction can be an early sign of serious problems such as heart disease or diabetes, so if you are in a relatively new relationship, encourage your partner to book an appointment with their GP.
If you have been with your partner for a while, however, David is strongly in favour of visiting together. “As a GP, I often suggest that patients come with their partner,” she says. A doctor can add structure, unemotive objectivity and a pragmatic treatment path to the discussion, she says. They should also reassure the sufferer that the problem is common, and their partner that it is unlikely to be any reflection on them. In fact, Eroxon’s research suggests that nearly three-quarters of those who open up to someone other than a sexual partner find it helpful.
Do tell the truth about what turns you on
“A lot of men worry about rejection as a consequence of ED because they may assume that it’s more important to their partner than it is,” says Hood. “But a lot of women get a lot of enjoyment from aspects of sex and intimacy other than penetration. So use this supportive and open conversation to explore others ways to make each other happy. There are lots, after all.”
