Women should be caring when their partners are dysfunctioning sexually


January 26, 1993|By Dr. Genevieve Matanoski | Dr. Genevieve Matanoski,Contributing Writer

At least 10 million American men have problems with sexual function. And those are just the ones who have sought help. Whether the cause is the aging process, an injury, side effects of medication or a disease such as diabetes, interruption of normal sexual relations is a complicated and intensely personal issue.

Women who are partners of men with sexual dysfunction often don't know what their role should be. Peter Fagan, director of the Sexual Behaviors Consultation Unit at the Johns Hopkins Hospital, advises couples that coping with this change in their lives involves honest conversation and an understanding of the physical and emotional factors that may cause the dysfunction.

Q: What are male sexual function disorders?

A: Men who are dysfunctional have an interruption in the normal sexual process of desire, arousal and orgasm. Disorders include problems with erection, ejaculation and orgasm.

Q: What are the physical causes of erectile dysfunction?

A: Men have an erection when the nerves of the penis are stimulated and they think sexually arousing thoughts. Chemical substances are triggered and cause an increased blood flow into the penis and a slowing of blood flow outward. The result is pressure and firmness.

Other than radical surgery or injury to the pelvic organs, there are three primary causes of the interruption of the normal process:

* Diseases, such as diabetes, neurological problems or vascular problems. Scientists estimate that about 50 percent of men with diabetes experience at least partial inability to have an erection.

* Aging, when the prostate may cause dysfunction indirectly or when there is minimal or no direct stimulation of the penis. This may not be necessary for a younger male, but is for an older man.

* Psychological factors can be the initial cause or the result of sexual dysfunction. Whatever the reason, psychological support is key to a good outcome.

Q: How do men react to a change in sexual ability?

A: Men often won't talk about it, no matter what the underlying cause. And that cuts across all socioeconomic classes. Some would like the problem fixed without having to talk with their partner about it.

Q: How can a woman help?

A: Don't take it as a sign of lack of love or loss of attractiveness. Inability to have an erection is not necessarily related to the level of caring. And it need not indicate a change in the total relationship. Try to understand that many men feel pressure to perform, despite any changes which may prevent it.

Q: What are some options for couples?

A: Talk, talk and more talk. Couples often drift to the other side of the bed, and that's the time to begin honest dialogue. If that is difficult, seek the help of support groups that deal with the root cause. For example, there are patients and professionals who meet regularly to talk about the effects of multiple sclerosis, spinal cord injuries, diabetes and other physical conditions. Check their numbers through the phone book. Go to the library and look up all the information you can find.

There are psychological, medical and surgical means of correcting erectile dysfunction. Consider talking with a pharmacist; they generally are happy to explain how medication affects sexual ability. Prepare specific questions for the primary physician, particularly if a new medication is prescribed for a physical problem.

Perhaps most important, Dr. Fagan says, is the willingness to look at a sexual relationship with new expectations. Intimacy may now require planning rather than spontaneous actions. Allow time to explore options to intercourse. Perhaps more understanding and less energy are needed.

For specific information about dealing with sexual dysfunction, contact the Hopkins Sexual Behaviors Consultation Unit at (410) 955-6318.

Dr. Matanoski is a physician and professor of epidemiology at the Johns Hopkins School of Public Health.

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