Men's Health: Sexual Health

An Erectile Dysfunction Expert Speaks Up

What is that experience like? Talking with couples about erectile dysfunction?
There's a lovely thing that happens. At first, the conversation is often heavy and filled with resignation and sadness. But often, after two or three minutes, we're laughing about the erectile dysfunction. And when you start laughing, it's almost like the job is finished. It has put things into perspective. There are treatment options. He is now in control. He is not a victim of the situation anymore.

Can you give an example?
Sure. I had a patient who had had radiation therapy for prostate cancer. He was in his seventies, and he developed erectile dysfunction, and for two years after that, he was really miserable. And apparently his erectile dysfunction was a big complaint. So when he came in with his wife, her primary goal was to get him to stop complaining.

We started to talk about the mechanics of the sex they were having. And you have to admit it, it's funny. I mean, here you are all together in this consultation, and you're all picturing the couple in the bedroom, and it's romantic, and they start foreplay, and he goes to insert his penis, and it's limp. But instead of skipping over the story because it's uncomfortable, I ask for more detail. We really get into the nitty gritty. And then it gets to the point where it's not uncomfortable anymore.

So what did you talk about next with the couple?
At that point we started talking about treatment options, and this gentleman just said, "You know what? I'm happy the way I am. And it was great talking to you." And he was no longer a victim, because he had made a decision. He was back in control of his own body. When they walked out, his wife was relieved, and he had discovered a renewed sense of dignity. And two weeks later they called me, and said that they had great sex. That's amazing. Yes. But without intercourse. So that was great. And because he had recovered his dignity, he now became attractive to her like he was before.

What do people learn from going into such detail with you about sex?
When they come to me, they're hoping that their erectile dysfunction will go away by itself. By dwelling on the details of the sexual dysfunction, and being very specific about it, and starting to laugh about it, they're able to accept the dysfunction. This is you now. It's permanent. And once they realize that it's permanent, then they can stop hoping, and start really considering what they want to do about it.

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