Erectile Dysfunction: A Woman's Point of View
Advice for women on how to cope with their partner's erectile dysfunction.
Brunilda Nazario, MD
The TV commercials make it all seem so simple: He can't get an erection so he pops a pill. The next thing you know, his partner is cooing about how her guy is back to his old wild and romantic self.
What the commercials don't show you: The painful distress a woman can experience when her man suffers with erectile dysfunction (ED).
"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.
ED, or erectile dysfunction, is medically defined as the inability to achieve or sustain an erection long enough for sexual intercourse. Virtually all men experience some erection failures at certain points in their lives. It can be the result of stress, depression, or sometimes even for no reason at all. For some, the problem becomes chronic. When it does, a diagnosis of ED is made. According to the American Foundation for Urologic Disease, it's a problem that affects about 18 million men in the U.S. alone.
Although many women -- and men as well -- continue to view ED as a sexual issue, in truth, the most common causes are undiagnosed physical conditions such as diabetes, high cholesterol, or even the earliest stages of heart disease. Even more often, it can be the result of certain medications used to treat these conditions, particularly some high blood pressure drugs.
Unfortunately, experts say a lack of education about the causes of ED are frequently behind a woman's self-blame, as well as her increasing anxiety, and sometimes, even feelings of hurt and anger when the problem occurs.
"Most women usually start with a line of questioning that often has some anxiety or hurt to it. She may suspect her partner is having an affair, or that he just doesn't find her desirable anymore, so she begins to hint around at these possibilities," says Sallie Foley, MSW, a professor at the graduate school of social work at the University of Michigan and co-author of Sex Matters For Women.
Often, says Foley, a man suffering with ED will interpret her questions -- and her hurtful attitude -- as an attack on him, so he pulls back.
"She then experiences this pulling back as a confirmation that she has done something wrong, and so she retreats even further," says Foley. As she does, increasing levels of anxiety or depression can set in, along with suspicions about what's going on with him, as well as a continued belief that there is something wrong with her.
The end result: The couple can stop communicating altogether -- not only in the bedroom, but in all aspects of their relationship. And that, say experts, can only make problems worse for both partners.
"The one thing a woman should never do is withdraw because that is a formula for relationship disaster," says McCullough. When one partner pulls away, he says, the other withdraws as well, and "this kind of dance goes on where you stop touching each other, then you stop talking, and before you know it you are not communicating at all."
Women and ED: Striking a Balance
While pulling back may not be helpful, trying harder isn't the answer either. Indeed, while many women jump ship in troubled waters, others take the opposite approach and try to drown their mate in eroticism, believing the problems will disappear if they simply try harder. Not only is this not true, experts say this approach can make things worse.
"If you suddenly start trotting out all your old Victoria's Secret underwear -- or buy some sexy new clothes -- well, that's only going to put more pressure on him, and it's not going to help the ED one bit," says Foley.
Neither, she says, will more arduous attempts at making love. "Stroking him harder isn't going to matter either because you have to remember, this isn't a problem related to being turned on," says Foley. As such, the more and the harder you try, the worse it's going to be for him -- and for you -- when it doesn't happen, says Foley.
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