Male
impotence - a woman's perspective
A Six-Step
Survival Guide for any woman who finds herself in a relationship
with an impotent male. Based on the experiences of several
women who came through it all - and survived.
his article
is a female-focused, step-by-step guide for women in relationships
with men who are impotent. The sexual, psychological and medical
issues you confront are addressed. This guide will be helpful
to women who desire an intimate relationship that includes having
sexual intercourse or whose relationship is challenged by the
loss of sexual intimacy. If you are willing to work together
with your partner to restore and enhance his sexual potency,
the suggested six-step process will facilitate successful problem-solving.
| MALE
ERECTILE DIFFICULTIES |
Impotence,
transient erectile problems and premature ejaculation occasionally
occur in all relationships. Chronic impotence (erectile dysfunction)
is the inability to achieve or to sustain an erection long enough
to complete sexual intercourse. It is an extremely common disorder
affecting 10% of the male population. In the US alone, there
are 30 million afflicted men.
Premature
ejaculation is the inability to exercise voluntary control over
the ejaculatory process. Although premature ejaculation is not
an erectile disorder, it is discussed in this article because
some of the treatments mentioned can be of assistance in resolving
this problem, too. Any sexual dysfunction, including premature
ejaculation, can deprive a woman of sexual pleasure and result
in subtle but significant personal and psychological distress.
| SIX
STEPS TO SUCCESS IN OVERCOMING MALE IMPOTENCE |
Your decision
to read this article affirms your commitment to take the first
step in overcoming male impotence. New opportunities for achieving
satisfying and successful intercourse open up to you as you
progress through each additional step. Although there are many
ways to express and experience love, chronic male impotence
can be a profound and often painful loss in the lives of women.
The SIX
STEPS TO SUCCESS in renewing intimacy through sexual
intercourse are :
- Admit
the effects of impotence on you and your relationship.
- Consider
your physical and psychological health.
- Explore
the relationship factors that predict successful treatment.
- Learn
about the causes and treatments for impotence.
- Discuss
this problem with your mate and determine your true sexual
needs.
- Seek
medical consultation
| STEP
1. EXAMINE THE EFFECTS OF IMPOTENCE ON YOU AND YOUR RELATIONSHIP
|
As you
begin to think about resuming sexual intercourse, it is important
to understand the influence that impotence has on you and your
partner. Feelings, thoughts, and behaviors in relation to impotence
reflect on your physical and psychological well being. STEP
I considers these factors.
ADMIT
THE PROBLEM
THE
CASE OF ELLEN AND PAUL
Ellen has
been married to Paul for 35 years. One year ago, Paul had triple
by-pass surgery. Since that time, their sexual relationship
has silently dwindled. Ellen tearfully described a recent evening
together, "Paul and I were finally alone after a busy week -
no telephones, no distractions, no interruptions. I'd been looking
forward to this special time together to share a fulfilling,
intimate experience. But in spite of my caresses and cuddling,
Paul couldn't seem to respond. The more I tried, the more anxious
we both became. He was embarrassed and apologetic. Feebly, Paul
admitted, 'I just haven't been myself lately.' I felt disappointed,
frustrated, and frankly, a little angry. This wasn't the first
time this had happened. Sometimes, in the middle of intercourse,
he'd lose his erection and we'd have to stop. So, once again,
I tried to be supportive, ' It's OK, Paul, it doesn't matter,
being together is enough.' But it isn't...I know it...and so
does he."
Any woman
who has tried to have intercourse with an impotent man can identify
with Ellen's feelings. It isn't just men who experience frustration
and disappointment. Women do too.
Many couples
maintain a conspiracy of silence surrounding the problem of
impotence. Ellen and Paul both knew that there was a problem,
but typically were reluctant to talk about it. Paul didn't want
to accept the reality of his impotence, and neither did Ellen.
They were caught in a double bind. If they openly addressed
the issue, much anxiety and stress would be generated. If they
chose to ignore the problem, opportunities for emotional and
sexual closeness were lost. As they became more physically distant,
the quality of their marital relationship began to deteriorate.
Over time, they gradually began to drift apart. Silence reinforced
their estrangement.
If having
intercourse is important to you, admit it to yourself and to
your partner. Don't pretend it doesn't matter.
EXAMINE
YOUR FEELINGS
Men and
women have similar feelings about impotence; yet they rarely
acknowledge it to themselves, let alone one another.
| Feelings
Women Experience |
Feelings
Men Experience |
| Disappointment |
Despair
|
| Frustration |
Frustration |
| Embarrassment
|
Embarrassment |
| Fear
of rejection |
Fear
of failure |
| Anger |
Anger |
| Guilt
& betrayal |
Guilt
& shame |
| Fear
of abandonment |
Fear
of rejection |
| Self-blame |
Self-blame |
| Depression |
Depression |
| Grief
& loss |
Grief
& loss |
Ellen looked
in the mirror. At 57, she thought that her beauty was definitely
fading. New wrinkles seemed to appear on a daily basis. A recent,
unwelcome weight gain testified that her body was losing the
war with gravity. The prospect of aging disturbed her, as it
does most women, and she was left with a vague sense of unhappiness.
When Ellen
realized that Paul's sexual interest had diminished, she began,
as many women do, to blame herself. Although Ellen loved Paul
a great deal, she felt emotionally insecure and ambivalent about
their sexual problems. She tried to cover her confusing feelings
by focusing her energies on family, friends and career. Other
matters slowly assumed greater priority in her life.
Many women,
like Ellen, blame themselves and the effects of aging on their
partner's decreased sexual interest. The distractions of life
serve to only temporarily dissipate the feelings of loss and
grief over diminished sexual intimacy.
Paul longed
for the emotional and sexual satisfaction he used to receive
from making love with Ellen. He recalled a talk with his physician
who reassured him that sexual activity would not endanger his
physical health, but this reassurance did not assuage his anxieties.
'It's not fair to burden Ellen with my problems. How can I tell
her I'm not sexually capable anymore? Now I'm only half a man.
Men's feelings
of sexual insecurity can cause them to question their masculinity.
As a result, low self-esteem can generalize to other areas of
the relationship. After repeated failed attempts at intercourse,
men may feel powerless, defeated, and hopeless. They may cope
by unwittingly desexualizing their partner to protect themselves
against fears of abandonment and rejection. They are apprehensive
about acknowledging this and worry about being perceived as
failures in the eyes of their partners.
These negative
feelings can be intense and illogical. Even when there is an
understanding about why we feel the way we do, this insight
does not necessarily help us to change our behavior. Impotence
can be perplexing and requires examination of the differences
in how men and women think and behave.
EXAMINE
YOUR THOUGHTS AND BELIEFS
WHAT
WOMEN THINK ABOUT IMPOTENCE
When confronted
with their partner's sexual dysfunction, women begin to explore
possible reasons for this problem. After initial feelings of
self-blame, women share many of the same concerns.
"Maybe
he's sick and there's a medical reason for this problem."
Approximately
85% of all cases of impotence are caused by specific, diagnosable,
physical conditions. Most of these problems are treatable and
some are curable. Men who are sexually impaired should have
a medical evaluation.
"I
wonder if something is wrong with our relationship?"
Sometimes
potency problems are a screen for more serious emotional or
relationship issues. If there is loving affection and a committed
friendship between partners, almost all problems can be a good
place to begin problem-solving and bridging communication gaps.
"Maybe
he's angry with me. Maybe I'm angry with him, too."
Anger,
whether or not openly expressed, interferes with sexual desire
in many couples. Anger evoked by daily irritations or disagreements
is present in almost all relationships. But profound anger,
fear or anxiety related, must be resolved in order for medical
treatment to be effective.
"Is
he having an affair? Is he going to leave me?"
Women who
measure their self-esteem, femininity and desirability by how
well men respond sexually are particularly vulnerable to fears
of abandonment and rejection. Men's emotional detachment feed
into the fears. Women may worry that their mates may be impotent
with them, but potent with other women, leaving them with fantasies
of betrayal and infidelity.
"Honestly,
I'm secretly relieved. I don't miss not having sex any more."
Some women
are quietly relieved that their partner is impotent. For a variety
of reasons, they have never found sexual intercourse to be emotionally
gratifying or physically satisfying. Strong negative attitudes
or previous negative sexual experiences may undermine the success
of any medical or psychological intervention.
WHAT
MEN THINK ABOUT IMPOTENCE
"If
I can't have normal sex with my wife, I'm a failure as a man
and lover. I feel like a real loser and I can't stop thinking
about the problem."
Men who
equate sexual satisfaction solely with performance may think
of themselves as failures. This problem causes a lapse of confidence
and a crisis in self-esteem. Men commonly report that the problem
occupies a lot of their mental energy and that they can't seem
to stop thinking about their problem.
"If
I show her affection, she'll want to have intercourse and then
what?"
Men with
erectile difficulties tend to emotionally and physically withdraw
from their partners. They fear that any physical affection will
precipitate a request or desire for intercourse from their mates
and remind them of their inability to achieve an erection. Compounding
the problem, women may also cease being affectionate.
"Something
must be wrong with me. I feel that I have no control over my
own body and now that sex is out, I'm lonely. She won't touch
me anymore."
Many men,
especially older ones, think that it is inappropriate to need
nurture and affection. So, they frequently do without the warmth,
comfort and emotional support often more available to women.
It is frequently considered inappropriate for a man to admit
that he needs a hug and someone to hold him. When a man cannot
perform intercourse and satisfy his own(and his partner's)sexual
needs, he feels emasculated, devastated and very much alone.
"If
I can't meet her sexual needs, she will leave me."
Men, too,
share fears of abandonment. Younger men, particularly, feel
vulnerable and concerned that their partner will seek a new,
more fulfilling, less problematic relationship. To some extent
their fears are realistic. A younger woman may want to have
an active sexual life and over a long period of time be less
patient and supportive.
"Before
I developed my erectile problem, I found my partner sexually
stimulating. Not any more. The thrill is gone. I wonder if I've
fallen out of love? She just doesn't appeal to me anymore."
When a
man or woman loses a loving sexual relationship due to impotence,
either or both individuals may choose to "desexualize" their
mate. Paul describes his feelings about Ellen. "I used to be
very frustrated about being impotent. I'd feel excited, but
my body wouldn't respond. I'd think about how wonderful our
relationship was for so many years and get so damned depressed.
Now I try to block everything out and think of Ellen as my sister."
Feeling
enormously guilty, Paul could not confide in anyone about his
lack of sexual desire and his fear that he had "fallen out of
love."
Intellectually,
he just turned himself off. Sometimes women do the same thing.
After experiencing the pain associated with rejection and partner
apathy, women divert their attention to other matters in order
to compensate for the loss of their sexual partner.
It may
take counseling intervention before couples can rekindle romance
and "reprogram" themselves and once again think of each other
as desirable, stimulating sexual companions.
EXAMINE
YOUR BEHAVIOUR
Men and
women are socially conditioned to behave in different ways.
The process of gender role socialization prescribes appropriate
male and female behavior regarding sexuality. Individuals absorb
these values and appropriately comply with acceptable standards
of behavior. Most people naturally go along with their assigned
roles. Sometimes, these roles are contrary and detrimental to
getting interpersonal needs met. What you really feel and need
sexually is frequently in conflict with how you are supposed
to think and behave. Consequently, impotence tends to divide
and distance couples, creating conflict and pain.
Men and
women also share similar behaviors when dealing with impotence.
These behaviors, although sometimes dysfunctional, enable couples
to cope with the stresses they experience. These behaviors include
:
IGNORING,
DENYING OR MAKING EXCUSES FOR THE PROBLEM
Impotence
generally does not respond well to neglect. Some erectile disorders
do improve with the passage of time, but chronic impotence usually
has an organic basis and requires medical attention. Couples
sometimes intentionally, or unintentionally, choose to ignore
or deny the problem, prolonging recovery and decreasing chances
for a positive treatment experience.
WITHHOLDING
AFFECTION AND AVOIDING SEXUAL SITUATIONS
Erectile
dysfunction can cause a warm and loving partner to withdraw
affection and avoid any situation that might stimulate romance
or a sexual encounter. The man doesn't want to start something
he can't finish. The woman doesn't want to remind her mate of
past failures or create additional tension.
GIVING
AND RECEIVING "DOUBLE MESSAGES"
Women sometimes
pressure reluctant partners to seek treatment. When an ambivalent
woman feels she cannot be honest about her feelings and misgivings,
double messages are sometimes communicated to the partner. Situations
are occasionally created where a seemingly cooperative female
partner will inadvertently speak or behave in a way that sabotages
the success of treatment or a sexual encounter. Timing and clear
communication are one critical variable in the successful treatment
of impotence.
Individuals
who are unable to authentically communicate negative feelings
to their partner frequently turn frustration inward and neglect
their own appearance, physical or mental health. This suppression
of feelings can create somatic problems including : headaches,
backaches, anxiety, insomnia, panic attacks and a range of other
health problems. Some people become physically unattractive
in an effort to alienate their partner and discourage sexual
advances.
ABUSING
SUBSTANCES
Alcohol,
drug abuse and other addictive/compulsive behaviors have negative
sexual side-effects. Some individuals deal with sexual anxiety
by becoming workaholics or exercising excessively.
| STEP
2. CONSIDER YOUR PHYSICAL AND PSYCHOLOGICAL HEALTH |
Women who
contemplate resumption of intercourse after a long period of
abstinence have physical, psychological and health needs to
consider.
PHYSICAL
HEALTH ISSUES
When a
monogamous couple considers resumption of sexual activity after
a long period of abstinence, both partners are faced with a
physiological and psychological adjustment. Women contemplating
the resumption of intercourse after a significant period of
time should have a comprehensive gynecological examination.
With appropriate medical consultation and treatment, most women,
regardless of age, can resume normal sexual activity with no
difficulty. Since the average age of an impotent man is 55-65
years and his partner is usually of similar age, medical issues
due to aging are important.
AGE-RELATED
PHYSICAL HEALTH ISSUES
Women from
different generations have contrasting attitudes and values
regarding sexuality. These attitudes and values have health
care implications. In general terms, younger women may view
the sudden loss of a sexual partner due to illness or traumatic
injury as catastrophic. For an older woman, the gradual decline
in sexual interest and activity may be considered a normal part
of the aging process.
The medical
considerations regarding resumption of intercourse vary depending
on age. Particularly for the older woman, prolonged sexual abstinence
can contribute to several physical problems, including vaginal
dryness, loss of vaginal muscle tone, hormonal imbalances, cystitis,
non-specific vaginitis, and painful intercourse. Regardless
of age, most problems can be resolved in consultation with the
physician.
It is important
to be aware of the many sexual changes associated with aging
for both men and women.
PRESCRIPTION
AND RECREATIONAL DRUGS
Prescription
drugs and alcohol often have side effects that impair sexual
functioning. It is important to evaluate the effect of these
drugs on each person's capacity and desire for sex.
| Physiological
Changes Associated with Aging |
| WOMEN |
MEN |
| Estrogen
decreased |
Testosterone
decreased |
| Size
of Cervix, Uterus, and Ovaries |
Production
of Sperm |
| Thickness
and Elasticity of Vagina |
Size
of Testes |
| Lubrication |
Viscosity
and Volume of Ejaculate |
| The
Effects of Aging on Sexual Responsiveness |
| WOMEN |
MEN |
| Slowed
Response/Excitement |
Slowed
Response/Excitement |
| More
Stimulation Required |
More
Stimulation Required |
| Clitoral
Response Intact |
Erection
Less Firm |
| Orgasms
of Shorter Duration |
Orgasms
of Shorter Duration |
| Multi-Orgasmic
Capacity Retained |
Multi-Orgasmic
Capacity Impaired |
PSYCHOLOGICAL
HEALTH ISSUES
FLUCTUATIONS
IN SEXUAL DESIRE
Sex
therapists document that low sexual desire is the number one
complaint that brings couples into treatment. Many professionals
believe that is you do not have sexual thoughts, fantasies
or urges more than two times a month, there may be a problem.
This yardstick is certainly arbitrary, but when either or
both partners avoid sexual activity on a regular basis, something
is amiss.
Women
reach their orgasmic prime in their forties and fifties. It
is not unusual for a mid-to-post menopausal woman to experience
an increase in sexual interest as she ages. Simultaneously,
men begin to experience cardiac and prostate disease, which
can cause impotence. At a life period when many women are
most interested in making love, their partners begin to lose
their ability to perform.
When
a woman experiences a lack of interest in sexual activity,
there is usually a good medical or psychological reason. If
you are not orgasmic, find out why. Discuss this problem with
your physician and consider your treatment options.
DEPRESSION
Depression
frequently accompanies sexual dysfunction in both women and
men. In the general population, depression appears to more
commonly affect females and older adults. It is important
to have this problem evaluated if it is severe. If any individual
experiences more than two of the following symptoms, he/she
should consult a physician: suicidal feelings, impaired concentration,
low energy, lack of interest in usual pleasurable activities(that
includes sex), sleep disturbance, and significant weight loss
or gain.
| STEP
3. EXPLORE THE RELATIONSHIP FACTORS THAT PREDICT SUCCESSFUL
TREATMENT |
Successful
treatment of any sexual dysfunction is directly related to
the quality of your relationship. You can determine whether
you and your partner can benefit from medical treatment and
opportunities for renewed intimacy by answering the following
question :
*
Are you committed to working with your partner on solving
this problem? Is your partner motivated to work with you?
Research
indicates that couples who are in love and share a strong
commitment to their relationship benefit most from medical
treatment and/or psychological counseling.
*
Do you both share a successful history of problem-solving?
Good
communication skills are essential in identifying and solving
most problems.
*
Are you and your partner interested in learning about impotence?
There
is no substitute for accurate, up-to-date information upon
which to base informed decisions. You and your partner will
need to educate yourselves about sexual functioning, impotence
and treatments available.
*
Are you and your partner willing to jointly participate in
the evaluation process?
Impotence
is not just a "man's problem." Successful treatment depends
on joint cooperation and involvement in the problem-solving
process.
*
Do you have a sense of humor?
While
impotence is no laughing matter, couples who are able to share
a smile in times of stress seem better able to survive life's
trials. Some levity can make formidable tasks less arduous.
*
Are you willing to have a frank discussion with your partner
about his impotence and its effect on you?
Communication
and motivation are the key to effective sex therapy. It takes
a delicate balance of courage, tact and skill to discuss this
sensitive subject honestly and openly.
*
Did you and your partner have a good sexual relationship prior
to the onset of impotence?
A
normally active, fully functioning sex life is a good indication
that you can, once again, recapture the sensuality you once
enjoyed.
*
In spite of impotence, are you and your mate sexually attracted
to one another?
Sexual
desire for your mate is a predictor of favorable outcome for
sex therapy.
*
How long has the erectile dysfunction existed?
Prompt
treatment of an erectile problem ensures the most positive
results. As with any problem, the longer it lasts, the more
difficult it is to resolve. But, even long-standing impotence
can be resolved when there is proper motivation and appropriate
treatment methods are explored.
*
Can you be realistic about the benefits of restored potency?
The
ability to obtain an erection is not a quick-fix for on-going
conflicts and disagreements between partners. However, medical
intervention and counseling can be effective in ensuring long-term
benefits.
Although
there is no way to accurately predict your chances for successful
treatment of impotence, the more positive your responses,
the greater likelihood that treatment will be effective.
| STEP
4. LEARN ABOUT THE CAUSES AND TREATMENTS FOR IMPOTENCE |
Studies
affirm the positive results women experience when their partners
find a successful means to manage their impotence. This section
of the guide will focus on the causes and diagnosis of impotence,
present a brief description of all treatment options, and
explain the many benefits associated with each option. Special
concerns for women will be explored and important questions
answered.
DIAGNOSIS
OF IMPOTENCE
Impotence
may be diagnosed by a comprehensive physical examination,
blood work, laboratory analysis, and a variety of simple tests.
These tests are conducted on an out-patient basis under the
supervision of a physician who specializes in the diagnosis
and treatment of sexual dysfunction.
| Origins
of Impotence |
| Physical
Causes |
85% |
| Psychological
Causes |
15% |
| Total |
100% |
PHYSICAL(ORGANIC)
IMPOTENCE
Erectile
disorders of any kind demand medical consultation, diagnosis
and treatment. More than four out of five cases of impotence
are the result of a medical problem. Physical impotence can
be caused by many conditions, including diabetes, diseases
of the blood vessels (arteriosclerosis, coronary artery disease,
hypertension), prostate, bladder, colon, endocrine and hormonal
disorders, as well as nerve damage, radiation therapy, prescription
drugs, and substance abuse. There is often some psychological
involvement, even when the cause is physical.
PSYCHOLOGICAL
(NON-ORGANIC) IMPOTENCE
Emotional
or psychological causes of impotence can include stress-related
disorders secondary to depression, addiction, or problems
caused by work or family.
CURRENT
TREATMENTS FOR IMPOTENCE
There
are several routes possible for the treatment of male impotence.
A brief discussion is available in the article "What
every Adult needs to know about Impotence".
| STEP
5. DISCUSS THE PROBLEM WITH YOUR MATE AND SEEK MEDICAL
CONSULTATION. |
COMMUNICATION
WITH YOUR PARTNER
Through
the eyes of women, communication between the sexes is complex.
Many excellent books detail strategies to improve the quality
of sexual communication between partners. One reference that
may be of interest is a book by Bernie Zilbergeld, The
New Male Sexuality (1992). Under the best circumstances,
sexuality and impotence are sensitive subjects. Your attitude
and approach will make a critical difference in encouraging
a reluctant partner to seek treatment or discuss feelings
and options. As you take this final step, your relationship
is on the way to becoming more gratifying than ever before.
The
suggestions presented here are relatively simple. They involve
diplomacy, honesty, and common sense. You know your partner
better than anyone else. After carefully examining communication
options, you will know which approach will be most effective
in your individual situation. If the process suggested here
proves ineffective or results in any escalated conflict, a
profession counselor should be consulted.
CONSIDER
HIS POINT OF VIEW
Although
a woman can empathize with the feelings of an impotent partner,
she can never really comprehend the problem from a man's unique
perspective. A woman can fake an orgasm, but a man cannot
fake an erection. The secret is out and cannot be hidden.
So men use all sorts of stratagems to deal with the problem
- making excuses, pretending it does not bother them, avoiding
intimacy. Blaming himself, ashamed of himself, and fearful
of the future, all his thoughts are focused on his inability
to perform. He may sometimes forget the parts he can still
do - kissing, fondling, caressing, speaking of his love. His
mind focuses not on giving pleasure to his partner, but on
trying to meet his own performance standards. For a man not
to be able to participate in intercourse is a devastating
loss. He feels he has failed not only himself but his lover.
Some
men prefer to solve erectile problems with no help or assistance
from their mate. Some even choose to seek medical advice and
treatment without their partner's knowledge. They may have
a strong sense of pride and resent any intrusion on their
privacy. Communicating with your partner and seeking a solution
together is vital to the success of any treatment. Lack of
partner involvement in seeking treatment is the number one
reason for non-use of an external vacuum device and also accounts
for why more than 10% of the men treated with a penile implant
never use the prosthesis for intercourse. Your support is
essential. You can certainly offer gentleness, kindness and
understanding. Ask him directly, "What can I do to be supportive
of you?" He will probably give you a straight answer. Respect
his position, but try to take good care of yourself, too.
CONSIDER
YOUR POINT OF VIEW
Women
are confronted with a dilemma. How do you tactfully broach
the subject of impotence without inflicting more pain or embarrassment?
What do you say to prevent an escalation of existing conflict?
How can you recover a conversation that is deteriorating and
re-focus it in a more positive direction? These are complex
questions with few simple answers. However, the process we
describe is a basic format for initiating effective communication
about impotence.
The
place to begin is with yourself. You now have an understanding
of what your partner is thinking and feeling. Now you need
to consider how this problem is affecting you and determine
your personal and sexual needs. Once this information is available,
you are ready to develop goals and formulate an effective
plan.
There
are two important variables affecting successful communication
with your partner. One variable is a positive attitude that
demonstrates caring and compassion. The other is your willingness
to tackle the problem. Although everyone theoretically recognizes
that impotence is a shared problem, for the purposes of an
introductory conversation with your partner, you must be willing
to take responsibility for your needs, desires and feelings.
Whatever the nature of your feelings, they belong to you alone.
In a spirit of friendly cooperation, you must solicit your
partner's support in solving the problem. A simple statement,
"I have a problem and I need your help in resolving it," obviously
takes him off the defensive and promotes attentive listening.
DEFINE
WHAT IT IS YOU WANT
Think
about your personal feelings and sexual needs. Translate your
feelings and needs into short sentences. Example: "I feel
lonely and I want more affection." Statements that begin with
"I feel..." encourage open sharing of feelings, are non-demanding
and should be well accepted by your partner.
TRANSLATE
YOUR FEELINGS AND WANTS INTO A SPECIFIC BEHAVIORAL REQUEST
"I
want you to hug and kiss me when you leave the housein the
morning and when you come home in the evening." Sometimes,
the message you intend to convey is not the one your partner
receives-so make an effort to develop clear requests. Hinting
or suggesting may not be sufficient. Some women expect their
mates to magically understand what they want and need. This
doesn't work well. Try to be sensitive, yet assertive, and
avoid manipulation, subtleties, or double messages.
DECIDE
HOW, WHEN AND WHERE TO COMMUNICATE WHAT YOU WANT TO YOUR PARTNER
Choose
a place and time that are stress-free, perhaps out of the
house in a neutral setting, when you are both well rested
an in a fairly good mood. [Helpful hint: Never discuss sexual
problems in the bedroom.] Be aware that your tone of voice
as well as the words you speak will contribute to the spirit
of cooperation you are trying to foster. Be positive. Talk
about what you want, rather than what is wrong. Verbally acknowledge
your share of responsibility for the problem.
PLAN
AND REHEARSE WHAT YOU ARE GOING TO SAY, ANTICIPATE QUESTIONS
AND HAVE WRITTEN MATERIALS AVAILABLE IF HE SEEMS RECEPTIVE
Focus
on "the" problem and on "your" feelings about it. Keep your
one goal clearly in mind...that you both seek a solution to
impotence together. You care too much about him, and miss
your previous intimacy too much to think about sacrificing
it permanently. Plan what you are going to say, write it down
in the form of a "script," and try to anticipate his responses.
PREVENT
ESCALATION OF CONFLICT AND RE-FOCUS NEGATIVE DIALOGUE
Conversations
about potentially volatile subjects tend to sour or escalate
when the topic or question is changed, expanded, contradicted
or diverted. Try to agree ahead of time to limit and contain
discussion to one specific issue at a time. Example: "How
can we get medical advice concerning impotence?" Stick with
your planned agenda and redirect conversation back to the
original subject as necessary.
ASK
FOR FEEDBACK, PREPARE TO LISTEN TO HIS THOUGHTS AND FEELINGS
An
accepting, non-critical attitude and reflective listening
can encourage him to discuss painful feelings. You may not
agree with what he thinks, but you can support his feelings,
positive as well as negative.
VERBALLY
AND PHYSICALLY REINFORCE POSITIVE BEHAVIOR
Always
recognize and appreciate the energy he invests in trying to
resolve this sensitive problem. Attempt to rekindle your relationship
with touching and expressing words of love.
| STEP
6. SEEK MEDICAL CONSULTATION |
If
you are experiencing erectile dysfunction, medical care is
essential. Many primary care physicians are assuming a more
active role in the diagnosis and treatment of impotence. This
involvement by the non-surgeon is increasing because of the
development, in recent years, of non-surgical treatment alternatives,
and because most impotence is experienced by patients who
are already under the care of a family physician for other
disorders.
When
the resolution of erectile dysfunction demands medical consultation,
evaluation, diagnosis and treatment from a specialist, your
physician may refer you to a urologist. Urologists are physicians
who specialize in the treatment of the genito-urinary system,
which includes the kidneys, ureters, bladder, prostate and
the genitals. Urologists may prescribe any of the treatments
discussed in this article.
Your
physician should inspire trust and encourage you, as well
as your partner, to be an important part of the treatment
process. When your partner(and hopefully you) has made a decision
to seek medical consultation, these suggestions may make your
visit to the physician more informative and productive.
For
the first medical consultation, the ideal situation is for
the couple to see the physician together. However, as discussed,
some men simply prefer to go alone and wish to have their
preference respected. You are in the best position to determine
whether or not to accompany your partner.
Prepare
in advance for your first visit with the physician. Write
down your questions and concerns ahead of time. Some of the
information conveyed by the doctor may be technical and difficult
to remember. This is no time to be shy. You need to fully
understand all of your options. In order to make a sound,
mutual decision about the appropriate medical approach to
this problem, you need to have all of your question answered.
Bring a notebook along if you would like to take notes as
you are talking. A tape recorder can also be helpful if all
participants in the discussion agree. You can also bring this
article along and share it with your doctor.
A
NEW BEGINNING FOR ELLEN AND PAUL
Ellen
became increasingly concerned about Paul's withdrawn and uncharacteristic
behavior. She strongly suspected that their sexual problems
accounted for his depression and her own unhappiness. Ellen
decided to confide in her personal physician. She received
reassuring advice and accurate information about impotence.
As her knowledge increased, so did her confidence and determination
to solve their shared problem. She then thoughtfully planned
a positive, tactful intervention with Paul, using simple,
effective communication techniques such as those outlined
in this guide.
Ellen
and Paul were fortunate. They had a solid relationship based
on trust, caring and friendship. As a couple, their communication
and problem-solving skills were good. They sought medical
consultation together, recognizing the importance of mutual
decision-making. Their choice of treatment was a well-informed
and successful one.
After
six months, Ellen and Paul were engaging in intercourse 4-6
times per month. Each reported improvements in mood, self-esteem
and marital satisfaction. Anxious and futile attempts at love-making
were replaced by renewed confidence and pleasure. This couple
considered the treatment they had chosen an investment in
their future relationship. A new beginning for the years ahead.
A
NOTE TO MEN
On
a personal level, men and women both wish the problems associated
with impotence would just go away. A man does not want to
live with feelings of inadequacy and failure. A woman does
not want her partner to need an implant, injection or external
vacuum device to achieve an erection. Everyone would like
the resolution to be a pill or some simple treatment not visible
in the bedroom. Unfortunately, this is not always possible.
Yet couples want the difficulty to be resolved. This article
describes the realities of impotence for both sexes and the
current treatment options available
Your
partner is greatly affected by your erectile difficulty. This
problem is not your fault. You are not to blame. The fact
that you are reading this article is evidence of your positive
motivation to understand how your partner feels. She may feel
that you are no longer attracted to her and worry that she
has lost her power to "turn you on." You can do a great deal
to offer her reassurance. Tell her that she is loved and desired,
that you want to have sexual intercourse and are even willing
to use one of the medical treatments available just to be
close and prove your love for her. Ask for her cooperation
in renewing your bond of intimacy.
(
Adapted from a booklet published by the Osbon Medical Foundation,
Georgia, U.S.A. )