Monday, December 13, 2021

A Partner’s Guide to Erectile Dysfunction

 


Anne, 63, of Medford, OR, knows a thing or two about erectile dysfunction (ED). Her husband, now 58, first started taking medication for it about 5 years ago.

“At first you think, oh, you’re getting older and slowing down. But it got to the point where it was really bothering him, and he was unable to have sex without the drugs,” says Anne, who asked that we use her middle name only,

He is far from alone. Some 18% of all men in the U.S. have ED, and the odds of developing it increase sharply after age 40.

People who have diabetes, as Anne’s husband does, are three times more likely to have ED than men who don’t have diabetes. The disease can damage the blood vessels and nerves needed for an erection.

Having a partner with ED can be difficult to deal with, but think of it from their perspective. “We as women cannot even imagine how frustrating it is for them -- at least, that’s what my husband tells me,” says Anne.

Get to the Root of ED

Although it can feel personal, you shouldn’t blame yourself for your partner’s erectile dysfunction. It usually has a combination of causes -- and, experts say, you probably are not one of them.


“It’s pretty rare for the source of ED to be the person that he’s having sex with,” explains sex and relationship expert Ian Kerner, PhD.

“Some women will feel like, ‘He’s not attracted to me, he’s not into me, or he’s bored by me.’ And that’s really relatively rare compared to the other more likely factors.”

In older men, blood vessel problems tend to be the main reason for ED. In fact, since the blood vessels in the penis are smaller than those in the heart, heart disease may show up in the penis first. Eighty percent of men who land in the ER with a first heart attack say they developed ED at some point in the 3 years before, says Daniel Shoskes, MD. He is a professor of urology at Cleveland Clinic.

In younger men, Shoskes says, the problem is most often psychological. Stress, depression, and performance anxiety, especially when in a new sexual situation, can be the cause.

Medications, especially beta-blockers for high blood pressure and certain antidepressants, also can lead to erection problems.

In most of these cases, ED medications like Cialis, Levitra, Staxyn, Stendra, and Viagra can help. “They work, they have few side effects, and they’re not addictive,” says Kerner.


 If pills don’t do the trick, there are other options, including vacuum pumps, injections that the man gives themselves, and implanted devices. If you have a heart disease, though, these medications may not be right for you. Talk to your doctor.

In some cases, frequent masturbation may cause a man to be unable to perform with a partner.


If your partner’s problem is low testosterone (symptoms include lack of sex drive and very low energy), testosterone therapy can lead to “dramatic improvement,” says Shoskes.

What You Can Do

These six suggestions can make it easier to cope with your partner's ED.


1. Try something new. “Very often a big, big first step is just enhancing arousal,” says Kerner. This can mean ramping up foreplay, reading or watching something sexy together, or coming up with a suggestion for something you haven’t tried before, says Kerner.


2. Take the pressure off. Take the emphasis off the penis, says Kerner, and “try something else for a little bit of time.” That can include oral sex, sex toys, and a vibrator, he says. “Try putting his hand on the vibrator and showing him exactly what feels good.”


3. Have a conversation. Start with your own feelings about the situation, and be empathetic, says Kerner.


4. Go with your guy to the doctor. “The patients who are the most successful are those where the sexual partner is a true partner,” says Shoskes. “If the woman can come in, that’s a huge help.”


5. Have patience with pills. These drugs work, but erections don’t happen on command.

6. Encourage them to get heart-healthy. “Good heart and vascular health ends up being good penis health,” says Shoskes. “It may not reverse erection problems that are there already, but it certainly may reduce their progression.”

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