Maintaining a healthy relationship in the face of sexual dysfunction

Intimacy is an important component of a healthy relationship. It is the one thing that we share with our partner and with no-one else. Sometimes when there is conflict between partners, intimacy may be ignored, compounding relationship strain.

However, the converse is also true. Sexual dysfunction may have adverse psychological consequences for both the man and his partner, leading to a lack of intimacy and relationship difficulties. Men with erectile dysfunction (ED) often develop anxiety and depression, which in themselves may worsen his sexual problem. Men often lose their self-confidence and suffer from low self-esteem and avoid intimacy with their partner. Female partners, on the other hand may misinterpret his withdrawing from her, she may feel guilty about the ED, wondering whether it is her fault. Studies show that women partners of men with ED tend to develop their own sexual dysfunction problems after he develops ED. Some of these include a loss of interest in sex, lubrication disability and difficulty achieving orgasm.

It is not surprising that ED may be associated with relationship problems and the psychological effects of ED and distress in the relationship may adversely affect all areas of life – at home, socially and at work. Furthermore, relationship problems may also be a cause of, or further compound existing ED.

Open communication between partners about sexual problems and seeking treatment for sexual dysfunction is essential. Successful treatment is available for the majority of men with ED and treatment success has been shown to improve sexual quality of life for both men and their partners and improve relationship problems that were present before treatment. However, one also has to be realistic about expectations from treatment. If there are deeper relationship issues present, or other problems, such as financial concerns that are placing a strain on the relationship, then merely treating sexual dysfunction without addressing the other issues directly is unlikely to improve the relationship.

Men and women have different expectations about sex. Often for a man, the ability to achieve an erection, penetration and orgasm is regarded as successful treatment, whereas women enjoy the emotional intimacy of sex and touching, cuddling or holding each other. These different expectations need to be considered when seeking treatment and need to be discussed between partners and with a healthcare professional. Sometimes it may be worth considering seeking counselling or assistance from other professionals who have the skills to help with problems that need to be addressed in the relationship.

BY Dr David Webb BSc(Hons), MBBCh