For the estimated 152 million men worldwide experiencing erectile dysfunction (ED), having a normal sex life has probably become an issue. But has anyone stopped to consider the female partner? What her perception of her male partner's condition is? And how she should react to it?
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Health24 spoke to sexologist Caren Hadders and looked at a few research studies to get some answers.
Sex important for both parties
Sex seems to be just as important to the female partners of men who suffer from ED, or impotence, than it is to the men themselves.
A recent international study, called the "Strike up a Conversation Study", indicated that more than 80% of men with ED – as well as their partners – rate sex as playing a somewhat to extremely important role in their relationships.
Unfortunately, ED can have a dramatic impact on a couple's sex life, influencing both the male and female partner's psychological and relationship health, their self-confidence and their overall quality of life.
ED has an impact on the partner
Women are by no means unaffected by ED.
There may be a correlation between ED and female sexual dysfunction, says Dr Prithy Ramlachan, a Durban-based sexologist. 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, there are two main reasons why women are affected by ED: the first being that ED has such a strong emotional impact on the male, the second being simply that penetration is inhibited.
"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, the man gets progressively distant, grumpy, depressed and anxious," Hadders says, referring to the emotional impact ED has on the male partner.
The result is that the woman, who is generally more intuitive and emotional, 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, however, another important factor – and not just for the men. Research has shown 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 discuss the problem with their partners. In fact, an Italian study has shown that only 59% of men with ED have spoken to their partners about their sexual dysfunction. For many, ED is still regarded a taboo subject.
Partners of men with ED are also strongly inclined to wait for a signal of some kind from their partner before talking about the subject themselves, write the authors of the "Strike up a Conversation Study" conducted in Germany, the UK and Spain.
And 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 make matters worse, only 30 - 50% of men with ED consult a doctor about their condition. Men are either too embarrassed to discuss the problem, feel that the problem is only temporary, or don't think ED is a medical problem at all.
Others, who do seek treatment, fail to adhere to the treatment regime, and many doctors are still hesitant to prescribe drugs like Viagra, Levitra and Cialis (all PDE5-inhibitor-type drugs) that have been proven to be effective in the treatment of ED.
How should women handle ED?
There is no doubt 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. There are a lot of taboos and myths doing the rounds," Hadders says.
Women should talk openly to their partners about ED. "As ED can be a marker of underlying disease, it is very important for the woman to encourage her partner to consult a doctor," Hadders says. "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.
As a last comment, Hadders encourages young couples to speak openly about sex. "Then it is just so much easier to speak about dysfunction if it should be necessary." – (Carine van Rooyen, Health24, updated February 2008)
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