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Erectile dysfunction (ED) doesn’t just affect people who have it—it affects their partners, too. That’s why it’s crucial to avoid any embarrassment and talk to your partner(s)—and a healthcare provider—at the first signs of this common, but often treatable condition.
Although many people generalize ED—which is characterized as issues getting or maintaining an erection—as a chronic problem, it can also be random or occasional. A sexual partner is often the first person to notice subtle changes in the strength and frequency of a partner’s erections. That’s why it’s important that people should feel comfortable talking to their partner(s) about any changes. This is also of vital importance because ED is actually quite common.
- Erectile dysfunction is a condition characterized by trouble getting or maintaining an erection.
- ED doesn’t have to be chronic. It can also be occasional or random.
- Roughly 30 million people in the United States have erectile dysfunction.
- ED has been shown to impact both the patient and their partner(s).
- Partners are often integral to treatment and need to understand that ED isn’t just about arousal.
ED is more common than you think
Although getting accurate stats about ED is difficult, the numbers we have do reveal that it’s more common than people may think. Researchers involved with one study that looked at 27,000 men from eight different countries found that only 58% of participants with ED had ever sought help from a medical professional for the condition. So though they found that roughly 8% of men 20–29 and 11% of men age 30–39 have ED, the true numbers of men experiencing this common condition may be higher (Rosen, 2004). A 2019 study found that between 3% and 76.5% of men experience ED globally (Kessler, 2019). In the United States specifically, it’s estimated that 30 million people suffer from ED (Nunes, 2012).
How does ED affect relationships?
What isn’t overestimated is how much ED can affect relationships. The Impotence Association (now the Sexual Dysfunction Association) conducted an online survey to find out exactly how ED affected men: 62% of participants reported that ED lowered their self-esteem, 29% said that it had affected their relationship, and 21% indicated that a relationship had ended as a direct result of the condition (Tomlinson, 2004).
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It’s generally accepted that self-esteem has a direct impact on relationship quality, but science also backs it up. High self-esteem is correlated with more relationship satisfaction for both the person with this quality as well as their partner (Erol, 2016). But the problems for the relationship go deeper. One study found that the partners with ED experienced emasculation and depression in addition to the fall in self-esteem reported in other studies. The same men reported feeling unable to tell their partners and worried that they were letting their partners down and that their partners would leave them and go elsewhere (Tomlinson, 2004).
But it’s not just the partner experiencing the ED who is affected. Although research has found that around 80% of cases of ED have an organic cause (such as an underlying hormone issue or circulation problems), female partners of a person with ED report feeling unattractive and worrying that their partner is with someone else (Yafi, 2016; Li, 2016). The end result is similar to that of the partner with ED: Dealing with this issue in a relationship can lead to anxiety and depression for the female partner (Li, 2016). As you may have guessed, it also impacts a couple’s sex life. Females report engaging in less sexual activity after their partners are diagnosed with ED and rate their sex life as less satisfying (Fisher, 2005).
Although more research is needed on how a partner’s ED affects male partners, one study did note that it can cause conflict between partners as well as fear of intimacy and fear of rejection (Vansintejan, 2013).
How to talk about ED with your partner
In some cases, a healthcare provider will start this process on behalf of the patient. Researchers on sexual health and intimacy have long encouraged practitioners to involve partner(s) in the initial clinical conversation about ED—even asking them to come in for the first conversation in-office about the issues. Partners may reveal an aspect of the underlying cause of ED that the person experiencing the issue may downplay or withhold altogether (Dunn, 2004). In fact, it’s been found that involving a partner in the initial medical discussion about erectile issues alters the patient’s diagnosis or prescribed treatment as much as 58% of the time (Chun, 2001).
Starting the conversation about ED with a medical expert present may be one way to contextualize the problem from the beginning. No one is at fault for erectile problems. Starting the conversation in a medical context may help underscore that the problem likely has underlying health causes, removing any potential blame. That’s vital since sexual performance anxiety (SPA) is all too real, affecting between 9% and 25% of men. This specific type of anxiety contributes to premature ejaculation and ED (Pyke, 2020).
Broach the subject delicately, but frankly
Above all, “your partner has to know this is important to you” when starting this discussion, underscores Dr. Pepper Schwartz, Ph.D. That goes for people suffering from ED looking to broach the subject with their partners as well as those who may have noticed erectile problems in their partners. Another big takeaway: “Definitely do not do this in bed, or bring it up right after the problem has occurred,” she advises. No matter who is broaching the subject, Dr. Schwartz says a couple of things might help, including:
- Bringing materials on the subject that you can refer to for expertise
- Starting the conversation in a non-threatening situation, such as over breakfast
- Having a drink, such as coffee or wine, to fill awkward pauses that may come up
The emotional tone you set when approaching your partner about their potential ED is crucial. “Don’t ever make your partner feel cornered,” Dr. Schwartz says. “Tell your partner that you love making love with them, but you just don’t get enough of them, and you’d like to prolong intercourse.” This is where prior research can come in handy. Dr. Schwartz suggests reassuring them that the condition can be treated and then asking your partner if they’ll work with you on this. Remember that ED affects everyone in the relationship, so it’s fitting to pose this as a team effort.
Materials may help if your partner is defensive
It is a possibility that your partner will feel embarrassed and get defensive, Dr. Schwartz warns. How you approach your partner may help, but it’s a conversation that many people seek to avoid, she explains. If he gets mad or defensive, don’t pursue the issue—but don’t let your partner think you’re dropping it, either. “Back off but tell them you really need to follow up on this,” Dr. Schwartz suggests, adding that you can also end the conversation on a positive note: “Reassure them that you think they’re sexy and that you’re bringing it up because you feel your relationship is strong enough to work on this and make things better.”
If your partner claims they don’t have a problem when you know something is wrong, you can use materials as a gentle way to guide the conversation. “If your partner says they’re ‘normal’ and it’s your problem, show them some written material and ask them if it describes the two of you together,” Dr. Schwartz advises. “You can tell them that this condition is common, but one reason you are worried is that it often is a sign of a much worse problem and you would like to get a check-up for their continued health as well as for your sex life.”
Even that doesn’t always go according to plan, though. “If they really dig their heels in, maybe schedule some marriage counseling,” Dr. Schwartz suggests. “There may be some root causes of their refusal to deal with erectile problems or premature ejaculation that need to be solved first before you can tackle sexual issues,” she explains.
What you and your partner(s) need to know about ED
As you can see from some of the studies, ED can cause some harmful beliefs between couples that affect their relationship. These beliefs, and the fear they cause, may make it more difficult to talk openly about erectile issues. But breaking down some of the common misconceptions about the condition may help. Here’s what you need to understand:
ED isn’t just about arousal
While arousal is an important part of getting an erection, ED isn’t necessarily about “not being turned on.” ED can sometimes be caused by serious underlying health conditions like high blood pressure, high cholesterol, diabetes, depression, nerve damage, low testosterone, and heart disease. Anxiety, guilt, and stress can also make ED even worse. But factors as small as slight dehydration can also cause ED. Arousal is just one part of the complicated process that goes on in order to achieve an erection. (It’s worth noting that this is also why ED medications don’t just cause spontaneous erections; arousal is a necessary component, even with prescription medication.)
ED is treatable
Getting help, accurate information, and support as soon as possible are important parts to successfully treating ED. There are numerous treatments for ED, ranging from lifestyle modification to oral medications to surgery. If you’re experiencing ED, talk to a healthcare provider about what may be best for you. If your ED is caused by an underlying medical issue, that problem will need to be addressed. But if there’s no underlying problem, prescription medication may be a viable solution. Many ED medications are now available in generic versions, meaning they’re accessible within a wider range of financial situations than ever before.
Treatment may help both partners
In one paper, researchers argued for the importance of involving couples in clinical trials of ED medications and therapies, highlighting that men and their partners would both be affected by erectile difficulties. In fact, they argued that “impotence”—a term the medical field is moving away from—should be referred to as “couple impotence” because all parties in a relationship are so affected by the health issue (Wagner, 2000). Partners were involved in some studies, in fact, and their findings reveal that ED treatments do indeed benefit all people involved in a relationship.
Past research that looked at male partners on PDE-5 inhibitors, one type of ED treatment that includes well-known medications such as Viagra and Cialis, found that their experience and that of their female partners were intertwined. Men were more likely to continue treatment when their female partners were more satisfied with their sex life, and their own perception of that satisfaction was higher (Dean, 2006).