By Rob Hamilton, M.D. Prestige Regenerative Medicine
One of the most shocking parts of our practice is when I consult with partners of men affected by erectile dysfunction. ED is a common medical issue that is often not acknowledged by the men who are affected by it.
Picture the table talk at dinner. “Honey, I think you have a problem in the bedroom. Let's talk about it.”
Crickets chirping. Not happening.
While some couples avoid the subject altogether, assuming that bedroom intimacy just isn't as important anymore, studies conducted by Pfizer have revealed that when it comes to quality of life, most women rank ED of higher importance than menopausal symptoms, infertility, allergies, obesity, and insomnia. In many cases, the lack of communication leads to the woman's disillusionment with the relationship instead of understanding the real medical issue at hand.
We will address how to best bring up the subject with your partner at the end of this article, but first, allow me to clarify misperceptions about ED and relationships from a medical perspective.
COMMON MYTHS
1. He must not be attracted to me anymore if he can't keep an erection long enough for intercourse.
Not true! ED gets more and more common as men age, and 50% of men over age 40 have difficulty getting and sustaining erections. The lack of ability to sustain an erection is not based on a lack of love or romantic feelings, but rather worsening circulatory problems and often declining testosterone levels as men age. In addition, ED can be caused (or worsened) by other factors such as stress, certain medications, alcohol, and some other treatments. We have taken care of many men who came to see us because they were worried that their ED was making their wives feel unloved, unattractive, or not desirable. One of the best parts of our practice is restoring intimacy to couples — it truly does improve relationships and lives.
2. Once men reach a certain age, sex isn't important to the relationship.
Many couples enjoy and treasure sexual relationships well into their 80s and beyond. Sex is a biological imperative and the closeness of sexual contact increases oxytocin levels — oxytocin is the hormone that is associated with pair bonding and love. Recent studies have even shown that sexual activity decreases the risks of cardiovascular disease, depression, stroke, and many other maladies, and it definitely adds to the quality of life for both men and women.
3. He may have lost his drive, but his health is just fine without sex.
Male testosterone level declines with age and that can also cause a decrease in libido (interest in sexual activity). Unfortunately, declining testosterone levels are also linked with overall worsening health including increased cardiovascular disease, risk of high-grade prostate cancer, worsening arthritis, risk of type 2 diabetes, dementia, and a host of other medical problems. A healthy sex life has been shown to increase dopamine and serotonin levels in men leading to overall better mood, more self-confidence, better sleep, and better health. Research is conclusive for both men and women — healthy sex lives leads to better mental and physical health.
4. If the pill didn't work, then I guess sex just isn't going to happen anymore.
Not true at all! Although they are effective for many men, the drugs commonly used to treat erectile dysfunction (Viagra, Cialis, Levrita, Stendra, etc.) work for only some men. In fact, some studies have shown that 50% of men never refill their prescription for these drugs after trying them. Even for the men who respond well to the drugs, the medications often come with significant side effects including mental cloudiness, gastric reflux, runny / stuffy nose, headache, flushing, and other bothersome symptoms that discourage men from using them again.
Fortunately, Prestige Regenerative Medicine offers a different approach to restoring erectile function. Our expertise is treating ED using a comprehensive, multi-modal approach, of which medications are just one small (and usually optional) part. Using our program, we have been able to restore erectile function to well over 75% of our patients! The cornerstone of our treatment is the unique and powerful regenerative acoustic wave therapy known as GAINSWave, but it is the holistic approach of our program that has led to success.
5. If he gets treatment for ED, he's going to want to have sex all the time.
Not likely! Men who are confident and have satisfying sexual relationships generally don’t badger their partners. They feel much healthier and secure in their relationships and tend to be much better partners in all areas of life, not just in the intimate domain, but in other aspects of daily life. It can help you both remember how and why your relationship started and help recapture some amazing together time. In addition, you may find that when your relations reach a satisfying conclusion, you also will be more interested in this important part of your life.
6. If he gets treatment for ED, sex is going to last longer and that sounds exhausting.
Also not true. Some of the medications can give an unnaturally long lasting or troublesome erection (notice how all the commercials end with the warning about the “erection lasting greater than 4 hours”) and that can be bothersome for both partners (believe it or not). Rather, GAINSWave Therapy helps restore normal, natural and younger blood flow to the penis and provides similar appropriately lasting erections to those he had when he was younger. This ends up being better for both partners, without the risk of the “4-hour erection."
7. If he gets treatment for ED, he's going to look outside of our relationship for sex.
In our vast experience of treating ED, most of our patients are looking to rekindle their relationship with their life partners. A healthy sexual relationship increases the level of a hormone called oxytocin, which is important in “pair bonding.” This is the “love hormone" that the brain releases in women during breast feeding and in both genders during orgasm. Lying in your partner's arms with oxytocin flowing in both of you does remarkable things to help reignite a relationship, and that spills over into everyday life.
We are so excited to have patients tell us every day that we have given joy back to their relationships and even saved marriages. Once our patients experience the life-changing benefits of what we do, they often bring their partners in for hormone replacement therapy and other treatments. That is the highest compliment we receive.
How do I bring up ED with my partner?
This is a challenging issue as Erectile Dysfunction is often an embarrassing and difficult topic for men to talk about. They often feel that it strikes at the very core of their masculinity. The psychological hit of not being able to “perform” and the subtle doubt it creates in a man makes it even worse the next time — so it is a self-perpetuating cycle that gets worse and worse as men age and the more problems they have.
When a man has a supportive spouse / partner it makes all the difference for them being able to accept this a treatable medical condition, and if the partner expresses an interest in helping, rather than judging, it can be huge. Some of our most poignant consultations occur when a couple shows up to talk about ED and how it can be managed. We can sense the depth of love and commitment in such relationships and we do everything we can to help.
That all having been said, here are three approaches you might consider.
1) Honesty and openness
This is the toughest (and most recommended) approach because it involves honest conversation about things even some couples never talk about: “Honey, I know we’ve both noticed that you aren’t getting erections as well as you used to. I really care about you and our ability to be intimate and so I’ve been trying to learn if there is anything that can be done about it. It’s such a common problem — did you know that over 50% of men have problems as they get older? I know it’s not because you don’t love me and I know that it is a treatable medical problem. Would you be interested in getting some help so we can enjoy each other again? Some doctors specialize in treating ED and I would like it if you would look into getting an appointment."
2). Humor and directness
“Looks like your get up and go has got up and went! One of my friends told me her husband is seeing a doctor that can get you back in the saddle again, and I’d like that! How about I make an appointment for you?”
3) Subtly and subconsciously
Share our blog site with him, www.prestigerm.com/blog. Tell him you miss the intimacy that you used to have and you’ll do what it takes to help regain it. Consider having your hormone levels tested and doing bioidentical hormone replacement therapy for yourself if you are not already on it — it can change your life too!
4) Do your own research first
Some women prefer to talk with a professional first to determine if their partner is experiencing ED. If you have questions about symptoms or treatment options that you would like to discuss privately, we suggest a phone consult with our Program Director. Phone consults are free, confidential, and can usually give you the information you need to address the subject with your partner. You can schedule online at www.prestigerm.as.me/menshealthconsult.
We know this is a difficult issue for both men and women to discuss, but we assure you that it is our specialty and most common topic of conversation. We are committed to a caring, supportive, and non-judgmental approach to treatment, and most importantly, we offer real and workable solutions. Cheers to intimate, healthy relationships!
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