Psychosocial and Relationship Issues in Men With Erectile Dysfunction

Patrick J. DiMeo, BSN, RN, OCN


Urol Nurs. 2006;26(6):442-446. 

In This Article

The Effects of ED On Relationships

An intimate relationship between two people is very personal and private. When a man has ED, it may affect and/or change his relationship with himself and his partner(s). The man may be embarrassed and even feel guilty, making it difficult to talk to his partner about this issue. ED has a direct impact on how it affects a man's life and marriage. It is suggested that ED is involved in one in five failed marriages (Wespes et al., 2002). ED not only affects the man but his partner as well. Table 1 lists quotes from men in the author's clinical experience when describing how ED was affecting their lives. These quotes cannot be quantified but the impact is tremendous.

Partner Relationship

A common issue among couples dealing with ED starts with failures of sexual advances. This can have an effect on issues of trust, intimacy, and closeness. The man withdraws emotionally and physically because of fear of failure. The partner starts to believe that the man is losing interest in her, thereby impacting self-esteem and feelings of attractiveness. In reality, the man is not losing interest but may be manifesting signs of frustration and humiliation of not being able to complete the sex act. Many men think it is inappropriate to need nurturance, admit that he needs a hug, or seek affection. So, they frequently do without the comfort and emotional support often more available for women. When a man cannot perform intercourse and satisfy his own and his partner's sexual needs, he can feel devastated and very much alone. From this cascade of events, the couple starts to alienate themselves emotionally and physically (Roy & Allen, 2004).

Partners who measure their self-esteem, femininity, and desirability by how men respond to their sexuality are particularly vulnerable to fears of abandonment and rejection. Men's emotional detachment feeds into these fears. Partners may worry that their mates may be impotent with them, but potent with another person, leaving them with fantasies of betrayal and infidelity. This issue can drive a couple apart because of fears and misconceptions when in reality the couple needs to communicate (LoPiccolo, 1999).

When a man or a woman loses a loving sexual relationship due to ED, either or both individuals may choose to withhold their partner from any other type of sexual experience. After experiencing the pain associated with rejection and lack of empathy from their partner, men and women will divert their attention to other matters in order to compensate for the loss of their sexual partner. Sometimes potency problems are a screen for more serious emotional or relationship issues. At this point, there may be other relationship issues between the couple that take priority before focusing on ED issues. This is an appropriate time for a man or the couple to be referred to a marriage counselor or sex therapist. Even the most sophisticated couples can benefit from opening lines of communication about sex and learning how best to utilize their functional capabilities (Padma-Nathan et al., 1997). Counseling may be able to rekindle the romance and redirect energies into the relationship.

Social/Work Relationships

ED affects not only the relationship with his partner but may also affect how the man interacts with friends and co-workers. A man may lose his confidence, his enjoyment in life, and morale. Outwardly, a man might project a macho image but inside may not feel like he measures up (Tomlinson & Wright, 2004).

Productivity at work can also decrease because of lack of self-esteem and confidence. The co-worker/social relationship can change based upon the attitude of each person and how each deals with the issue. Because ED is not discussed openly, a man may feel isolated and alone.

From another perspective, difficulties at work can factor into problems with ED. Most men view their careers as the center of their lives. When an unfavorable or difficult situation affects their careers, a man may see himself as a failure. Not moving up the chain of command, becoming financially sound, or getting the respect of peers can affect a man's sex life. Any monetary setback can affect a man's self-worth because today's society views that as a measure of success. If a man is not performing well at work, he may find it difficult to perform well in the bedroom (Jack, 2005).


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