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If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.
Erectile dysfunction (ED) occurs when you can’t get or maintain an erection sufficient for satisfying sex. That might include erections that don’t last as long as you want or aren’t as firm as you’d like. It may also lead to reduced sexual desire for the person affected and their partners.
Many men think of erectile dysfunction as a personal problem. But ED doesn’t just impact people who have it—it affects their partners, too. If your partner has ED, it’s important to know that most guys deal with it at some point in their lives.
ED is actually the most common sexual dysfunction. It’s estimated that more than 30 million American men have experienced erection problems at some point. Even among younger men, it can happen. Some estimates show that up to 30% of men under 40 experience erectile dysfunction (Nguyen, 2017).
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How does ED affect relationships?
For many men, their sexual performance is a matter of pride, and if they can’t perform the way they wish, it impacts their self-esteem.
According to an online survey, 62% of participants reported that ED lowered their self-esteem. Another 29% said it affected their relationship and the remaining 21% indicated a relationship ended as a direct result of the condition (Tomlinson, 2004).
It’s generally accepted that self-esteem has a significant impact on the quality of your relationships. And science backs this up. High self-esteem is correlated with more satisfying relationships for all parties involved (Erol, 2016).
The problems ED can cause in relationships may also run much deeper. Many men feel unable to tell their partners and worry that they’re letting them down. They also might fear the person they’re with will leave. In heterosexual relationships, female partners of a person with ED have reported feeling unattractive and worried that their partner is with someone else. This can trigger anxiety and depression in some (Li, 2016).
Although more research is needed on how ED affects same-sex relationships, one study found it also can cause conflict between partners and create a fear of intimacy or rejection (Vansintejan, 2013).
My boyfriend has erectile dysfunction. What should I do?
A sexual partner is often the first to notice subtle changes in the strength and frequency of a partner’s erections. That’s why it’s important that you feel comfortable talking to your partner about any changes you notice.
Researchers on sexual health and intimacy have long encouraged practitioners to involve partners in conversations about ED—even asking them to come into the office for the first conversation about it. The individual with ED may reveal an aspect of the underlying cause that they’ve downplayed or withheld altogether (Dunn, 2004).
Starting the conversation in a medical context may also help underscore that ED has underlying causes, removing any potential blame and emphasizing that no one is at fault for erectile problems. That’s vital since sexual performance anxiety—the fear or concern that you won’t meet your partner’s expectations during sex—is all too real, affecting up to 25% of men and women (Rowland, 2019).
If you’ve noticed erectile issues in your partner, here are some strategies to approach the subject.
Erectile dysfunction (ED): causes, symptoms, and treatment
Broach the subject delicately, but frankly
Above all, “your partner has to know this is important to you” when starting this discussion, says sexual health expert Dr. Pepper Schwartz, Ph.D.
That goes for people living with ED and those who’ve noticed the condition in a partner. 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 topic that you can refer to for expertise
- Starting the conversation in a non-threatening environment, such as over breakfast
- Having a drink like 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,” 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. Schwartz suggests reassuring them that ED is treatable and then asking your partner if they’ll work with you on it. 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 possible that your partner will feel embarrassed and get defensive, 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. That said, don’t let them think you’re dropping it, either.
“Back off, but tell them you really need to follow up on this,” Schwartz says. She adds that it can be helpful to end the conversation on a positive note. “Reassure them that you think they’re sexy, and you’re only 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, use research or educational 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,” Schwartz advises. “You can tell them that this condition is common, but one reason you’re worried is it can be a sign of a worse problem, and you’d like to get a check-up for their continued health––as well as for your sex life.”
Be prepared as even that doesn’t always go according to plan. “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 needs to be solved first before you can tackle sexual issues.”
Sex therapy: a method to rejuvenate your sex life
What you need to know about ED
As you can see, ED can harness harmful beliefs between couples that affect their relationship. These beliefs and any fears they cause may make it more challenging to talk openly about erectile issues. Breaking down some of the common misconceptions about the condition may help. Here’s what you need to know about ED.
ED isn’t just about arousal
While arousal is integral to getting an erection, ED isn’t about “not being turned on.” Arousal is just one part of the complicated process involved in achieving 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 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 may also worsen ED (McMahon, 2019).
ED is treatable
Many causes of erectile dysfunction are treatable with medication and simple lifestyle changes. What’s most important is identifying the root cause of your ED so it can be treated in the most effective way possible.
If you’re experiencing ED, talk to a healthcare provider who can suggest medication or other natural remedies. If an underlying medical issue causes your ED, that problem will need to be addressed; otherwise, prescription drugs can help. Many ED medications are available in generic versions, making them more accessible and affordable than some brand-name drugs.
ED treatments also benefit all people involved in a relationship. Research has found that male partners on PDE-5 inhibitors (a type of ED treatment that includes well-known medications like Viagra [generic name sildenafil; see Important Safety Information] and Cialis [generic name tadalafil; see Important Safety Information]) reported that their female partners’ experiences were intertwined with their own. Men also said they were more likely to continue treatment seeing their partners satisfied (Dean, 2006).
- Dean, J., Boer, B. D., Graziottin, A., Hatzichristou, D., Heaton, J., & Tailor, A. (2006). Partner Satisfaction and Successful Treatment Outcomes for Men with Erectile Dysfunction (ED). European Urology Supplements, 5(13), 779-785. doi:10.1016/j.eursup.2006.06.006. Retrieved from: https://www.eu-openscience.europeanurology.com/article/S1569-9056(06)00204-1/fulltext
- Dunn, M. E. (2004). Restoration of Couple’s Intimacy and Relationship Vital to Reestablishing Erectile Function. The Journal of the American Osteopathic Association, 104(3 Suppl), S6-S10. Retrieved from https://pubmed.ncbi.nlm.nih.gov/15083993/
- Erol, R. Y. & Orth, U. (2016). Self-Esteem and the Quality of Romantic Relationships. European Psychologist, 21(4), 274–283. doi: 10.1027/1016-9040/a000259. Retrieved from: https://psycnet.apa.org/record/2017-05125-004.
- Li, H., Gao, T., & Wang, R. (2016). The role of the sexual partner in managing erectile dysfunction. Nature Reviews Urology, 13(3), 168–177. doi: 10.1038/nrurol.2015.315. Retrieved from https://pubmed.ncbi.nlm.nih.gov/26832165/.
- McMahon, C.G. (2019). Current diagnosis and management of erectile dysfunction. Medical Journal of Australia, 210(10):469-476. doi: 10.5694/mja2.50167. Retrieved Dec. 10, 2021 from https://pubmed.ncbi.nlm.nih.gov/31099420/
- Nguyen, H., Gabrielson, A., & Hellstrom, W. (2017). Erectile dysfunction in young men – a review of the prevalence and risk factors. Sexual Medicine Reviews, 5(4), 508–520. doi: 10.1016/j.sxmr.2017.05.004. Retrieved from https://pubmed.ncbi.nlm.nih.gov/28642047/
- Nunes, K. P., Labazi, H., & Webb, R. C. (2012). New insights into hypertension-associated erectile dysfunction. Current Opinion in Nephrology and Hypertension, 21(2), 163–170. doi: 10.1097/mnh.0b013e32835021bd. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004343/
- Rowland, D. L., & van Lankveld, J. (2019). Anxiety and performance in sex, sport, and stage: Identifying common ground. Frontiers in Psychology, 10, 1615. doi: 10.3389/fpsyg.2019.01615. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6646850/
- Tomlinson, J., & Wright, D. (2004). Impact of erectile dysfunction and its subsequent treatment with sildenafil: qualitative study. BMJ, 328(7447), 1037. doi: 10.1136/bmj.38044.662176.ee. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC403839/
- Vansintejan, J., Vandevoorde, J., & Devroey. (2013). The GAy MEn Sex StudieS erectile dysfunction among Belgian gay men. International Journal of General Medicine, 527. doi: 10.2147/ijgm.s45783. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3704453/