Sexual Dysfunction and Relationships

The Erectile Dysfunction-Relationship Cycle

Erectile and sexual dysfunction in an ongoing relationship usually reflects difficulties between the partners. Relationship problems interfere with sexual feelings and cause or worsen erectile dysfunction.  Any experience that hinders the ability to be intimate, that leads to a feeling of inadequacy or distrust, or that develops a sense of being unloving or unlovable may result in erectile dysfunction.  Successive episodes of impotence are reinforcing. The man becomes increasingly anxious about his next sexual encounter. Erectile dysfunction is worsened by anticipatory anxiety about achieving and maintaining an erection interferes.  Sexual dysfunction interferes with pleasure in sexual contact and reduces ability to respond to sexual stimulation.

Erectile Dysfunction in the relationship cycle

In the early years of the relationship

• Lack of knowledge - there is a refractory period after sex before you can get the next orgasm. This refractory period increases gradually from a few minutes in teenagers to many days  in the elderly. Misguided enthusiasm after a period of separation causes a one-off problem with erection. This  is transient erectile problem is further reinforced by succeeding anxiety.
• Lack of privacy - the young couple moves into the parental home and has minimal access to privacy. Sex is a hurried activity with the focus on orgasm. Intimacy is not fostered. Subsequently there is dissatisfaction and a further build-up of anxiety.
• Stressors - careers with long working hours, night shift work and work from home leaves little time for the emotional intimacy that is requisite for sexual intimacy.

Middle phase

• Lifestyle changes - a sedentary  life style coupled with an indiscriminate diet result in obesity, a leading risk factor for erectile dysfunction. Excessive alcohol intake, and smoking have a direct impact on sexual functioning.
• Infidelity - is a major cause of anxiety and erectile dysfunction in the middle phase of the relationship. This  is especially so when the infidelity arises from insecurity - the man or woman attempting to prove continued youthfulness and desirability outside the relationship.

Later years

• Medical issues - chronic illnesses such as diabetes, and heart disease are commonly associated with erectile dysfunction.

What to do

• Don't panic - anxiety worsens erectile dysfunction. An occasional problem with  erection is not a reflection on your masculinity, and does not necessarily indicate a long term erectile dysfunction. Don't immediately try  to 'prove' yourself. Give it a days break to be safely out of the refractory period. There  will be  no trouble in the  next sexual encounter.
• Communicate - reassure your  partner of your continuing sexual interest in her. Communicate openly about  your condition. Involving your  partner improves the outcome of treatments for erectile dysfunction.
• Quit smoking
• Lose weight, exercise regularly
• Get treatment for alcohol or drug problems
• Work through relationship issues. Consider counseling if unable to work through  problems on your own.
• Depression, anxiety and stress related mental health issues should be addressed. Don't ignore them.

Whom to see for sexual dysfunction

• Consult a qualified psychiatrist. He or she  is the only person with the knowledge, training, and experience to deal with the psychological and medical issues that result in sexual dysfunction. The psychiatrist will also address issues in the relationship that are perpetuating the erectile dysfunction.
• Avoid self-styled sex therapists and sexologists

References:

1. Kubin M, Wagner G, Fugl-Meyer AR. Epidemiology of erectile dysfunction. Int J Impot Res. 2003 Feb;15(1):63-71.
2. McCabe M, Althof SE, Assalian P, Chevret-Measson M, Leiblum SR, Simonelli C, Wylie K. Psychological and interpersonal dimensions of sexual function and dysfunction. J Sex Med. 2010 Jan;7(1 Pt 2):327-36.
3. Metz ME, Epstein N. Assessing the role of relationship conflict in sexual dysfunction. J Sex Marital Ther. 2002 Mar-Apr;28(2):139-64.
4. Nina Bingham. Research Findings on Sexual Dysfunction, Intimacy and Conflict in Heterosexual Couples. Accessed 30-Jun-2012