Hi Steph,
Your situation is not unique by any stretch, and even couples who have
been married for years when experiencing sexual issues (this includes
females too) it becomes a very delicate situation on when, where, and
how to discuss the problem.
Simply take the first step and begin a warm, caring, and honest conversation.
It's quite possible that he has a minor problem (such as a blood flow
problem), or it's his age, or even he could be worrying so much about
his ED that the anxiety and worry about not functionins is causing the
problems.
One thing you'll need to consider (because of the newness of the
relationship) if his reticence to rectify the situation is something
you want to go along with. It certainly isn't something you'll want
to approach over and over again, and find yourself frustrated and
upset because it just might be he's not willing to address and find
answers for the problem.
However, the very most bottom line is: He should get a checkup with
his urologist to be sure what's what.
With that said, I've provided some articles for you to peruse which
will help you find a way to find the right moment.
=================================================
I found "The Woman's Side Of Erectile Dysfunction" - Written By Katie
Rose to be quite informative:
http://www.clitical.com/archive/men/erectile_dysfunction_female.php
"The following is designed to better help women to focus on their
relationship with their partners who are impotent. This 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 set you on the right track.
There are five steps to successfully overcoming male impotence.
* Admit the effects of impotence on you and your relationship.
* 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
Many couples maintain a conspiracy of silence surrounding the problem
of impotence.
If they openly addressed the issue, much anxiety and stress would be
generated. If they choose to ignore the problem, opportunities for
emotional and sexual closeness are lost. As they became more
physically distant, the quality of their marital relationship begins
to deteriorate. Over time, they gradually begin to drift apart.
Silence reinforces their estrangement. If having intercourse is
important to you, admit it to yourself and to your partner. Don't
pretend it doesn't matter.
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."
[edit]
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."
[edit]
EXAMINE YOUR BEHAVIOUR
"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.
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. 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."
[edit]
* 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.
[edit]
* 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.
[edit]
STEP 4. 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.
*****THIS IS THE IMPORTANT PART*****
"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 house in 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, where, and when 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."
=================================================
http://www.homehealth-uk.com/medical/impotence.htm
What should I do if I believe my partner might be suffering from impotence?
If your partner is avoiding any sexual contact and is constantly
making excuses for not wanting sex or is not available for sex, then
he may be trying to hide an impotence problem. Examples of this could
include:
Staying up late to ensure you are asleep.
Working longer hours.
Complaining of headaches or exhaustion at bedtime.
Going to bed very early and falling asleep before you have chance to join him.
Going out more at weekends to avoid sex during the day.
Inviting people over on a regular basis, to reduce the time you are alone.
If your partner is trying to hide the problem this can make matters
worse, as the longer it goes on, the more pressure he will be feeling.
Try discussing sexual habits with your partner, many men think that
only penetrative sex is satisfactory. Reassure your partner that other
forms of sexual activity are just as enjoyable. The man may then feel
less pressure and feelings of guilt could be relieved, once he feels
less pressure, his ability to get an erection may improve.
=================================================
Many men still feel it's a shameful secret
http://lifewise.canoe.ca/LifewiseHeartVal00/1012_val_sun.html
=================================================
http://www.andrology.com/Edpartnerhelpline.htm
MY HUSBAND CAN'T PERFORM - Corrine, USA
My husband has not been able to perform sex for the past few weeks
because he can't get an erection. I was very upset, thinking he did
not see me as sexally attractive. He said it was not that. I then said
that I have noticed this happening over the past times we have tried
to have sex. He has a bad back and said this was the cause plus one
time we got chilled, laying on top of the bed and not under covers and
said this was the problem. His back has never stopped him from
performing before. Now I have noticed that he doesn't want to have
sex. He is 50 and I am 40. We have been married for 19 years. He has
an appointment to get some blood work done and also a complete
physical this and next week. I am afraid that he will not tell our
doctor that he has been having this problem. He does not go to the
doctor very often, hardly ever. He made this appointment by himself.
Do you think he thinks something is wrong? What do you think could be
the problem? What can I do to help him with this?
Dr. Sudhakar Krishnamurti replies...
Unfortunately, there's little you can do unless your husband
understands and accepts that there's a problem and chooses to do
something about it. He must tell his doctor about his problem and seek
a suitable specialist's opinion.
*****
PHYSICAL PROBLEM
My husband is 56 years old. For past one year he is unable to have
complete erection. He cuddles me, hugs, kisses and the penis does
become bigger but not strong for penetration. I feel bad and satisfy
him by oral intercourse. He has been hypertensive for past 8 years. No
other problem. Is taking Covergyl tablets.
Dr. Sudhakar Krishnamurti replies...
If your husband has been all right all these years and has developed
this problem only over the last year, then it's most likely to be
physical in origin. There could be a combination of factors viz.
reduced arterial blood flow to the penis (inevitable in hypertensive
patients), drug-related (what is Covergyl ?), low testosterone etc..
The cause and severity need to be diagnosed. After that, treatment can
be planned. I can assure you that it is a curable situation. 56 is a
young age.
=================================================
The following article was written by a male nurse for Urology Nurses
Online - and much of it applies to how female nurses should approach
the male patient in the office when discussing ED - however, the
article provides a wealth of information.
You can ignore the parts such as "Start the session with a firm
handshake" and "Thank you for coming to our clinic, Mr. Jones." :)
Self Esteem and Depression in Men Who Present with Erectile Dysfunction
http://www.duj.com/Nier.html
It is not possible for a man of any age to lose his erectile function
and feel that he is a "real" man. The inability to perform is a direct
threat to a man's core belief in himself. Loss of vaginal lubrication
is an annoyance to a woman; loss of erectile function is a traumatic
event to a man. Every man with self-reported sexual dysfunction has a
psychologic component to his problem. Successful treatment of the
impotent man involves attention to both his physical and psychologic
aspects. On the one hand, nursing as a profession is overwhelmingly
female. On the other hand, most men who present with erectile
dysfunction are past 50. The greatest problem a female nurse, and
especially a young female nurse, faces with her impotent male patients
is how to establish a relationship where discussion is open and
relatively unembarassed. Few older men will be comfortable discussing
their "failure" as a man with a woman young enough to be their
daughter or granddaughter. The comfort ability must originate with the
nurse, and many nurses could benefit from some suggestions about how
to attain a relaxed, professional atmosphere.
The Introduction
Start the session with a firm handshake. Look the man straight in the
eye. Do not look down at your clipboard. Read his written responses to
your office questionnaire before you enter the room. Speak in a level
business tone. Do not sprinkle your sentences with tentative phrases
such as: you know, uh, ah, well. Communicate verbally and nonverbally
your confidence and knowledge. Do not laugh or tell jokes. Allow
plenty of time for a discussion. Do not look at your watch. Dress
conservatively and professionally with minimal makeup and cologne.
Avoid any appearance of personal interest.
A conversation that starts with a simple statement of the truth may be
helpful: "Thank you for coming to our clinic, Mr. Jones. My name is
Mary Jo Brown. I'm a registered nurse with special training in
urology. Many men find that talking to a female nurse about their
erection problems is embarrassing or uncomfortable. I know that I have
some embarrassment every time I talk to my male gynecologist about my
problems. So, I guess it works both ways. You need to know that
everything we say here is completely confidential. The questions I ask
you are important for an accurate diagnosis of your problem. Let's
start, if we could, with you giving a general description of your
problem. Is that OK?"
Or: "Thank you for coming today, Mr. Jones. My name is Mary Jo Brown.
I'm a registered nurse with special training and certification in
urology. I want you to know from the start that at our clinic we
believe that a problem with erection, also known as impotence, is a
medical problem. Many men become depressed when they lose their
erectile function, and we can talk about that. It's like a spiral down
into a swamp: You don't perform well, you start to worry; the more you
worry, the worse the problem. After a while, you're caught in the
swamp of worry and you can't think yourself out of it. Sex becomes a
major source of stress and worry rather than a source of pleasure. Our
job here is to reverse that spiral. Most of the time we are successful
treating erectile problems; and we have seen that when your problems
reverse, then you feel better about yourself. So our first job is to
identify the medical cause of the erectile difficulty. I have to ask
you some questions and maybe even do some tests. I know they may be
embarrassing. Sometimes I find asking these questions is even
uncomfortable for me. But the reason for my questions is to pinpoint
the problem. If I ask you something that's too embarrassing, will you
let me know? Let's begin, if we could, with you giving a general
description of your problem."
Men rarely discuss their sexual difficulties with friends,
acquaintances, or even their regular physicians. It is often the case
that they are in your office because their partners have pushed them
to a urologist after years of declining function. In classic denial,
the pain of their loss of manhood is too great to face. We know that
most impotence is caused by reversible factors including undiagnosed
diabetes, hypertension, medication side-effects, and prostatitis. Our
patients do not see their dysfunction clearly; their view is clouded
by the inevitable depression and low self-esteem that accompanies the
loss of their perceived manhood. As nurses, our primary job is to find
a way around those barriers to treatment.
The Questions
The first "real" question in any discussion of impotence can be: "Do
you have erections when you wake up in the morning, very first thing?"
The question establishes the clinical tone and hopefully projects that
my interest is in the man's erectile function and not in a judgement
about his performance. Be prepared for the man to resist answering the
question if he had low scores on the depression and self-esteem tests.
Push the conversation: "It's basic biology that young men have many
erections at night when they're asleep. And it's normal for this
activity to diminish somewhat with age. Has this been your general
pattern, too? Or have your nighttime erections dropped off more than
that?" Followup questions can steer away from performance and focus on
function: "Did this loss of full erections come on gradually, like
maybe over a year or so, or was the loss real fast, like in a week or
two?" Organic impotence due to a chronic condition usually develops
gradually. Impotence due to prostatitis or with a psychogenic cause
(divorce, bankruptcy) develops quickly.
The Answers
Your patient may only give you short, terse answers. Do not mistake
depression and embarrassment for rudeness. Understand that the patient
may never overcome his discomfort of discussing with a woman his
failure as a man. Hopefully, you will be able to assist the man to
conquer the initial fear and embarrassment of a conversation he has
probably not had with anyone else. In that case, the interview will be
successful.
[edit]
Conclusion
On a personal note, the nurse co-author of this paper is a male over
50, short, and nearly bald. I make it easy for patients to establish a
level of trust with me by acknowledging their emotional fragility at
the same time I project competence in our diagnostic procedures and
confidence in a positive outcome. Hopefully, some of the suggestions
given in this article will assist other nurses who practice in the
area of male sexual dysfunction."
==================================================
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Best regards and Good Luck!
tlspiegel |
