Erectile dysfunction (ED), or the inability to get and sustain an erection suitable for satisfying sex, has both medical and psychological causes. Lifestyle factors can also worsen ED.
ED can affect people at any age, including those in their 20s and 30s, and it has a significant impact on their partners as well — especially long-term partners. Dealing with ED can be isolating for both men and their partners as they each wrestle with their own feelings and perceptions about the cause of ED and what it might mean for their relationship.
In research by Tomlinson and Wright, one participant summed up his feelings about ED:
“I suppose, in the most simplistic terms, I associate getting an erection with being a man.”
Other participants in the survey expressed concern that ED would limit their ability to forge new relationships and that a decline in self-confidence associated with ED would also impact their day-to-day relationships, both work-related and personal.
Partners of men with ED may feel concerned, frustrated, rejected, scared, or lonely. They may experience any or all of these feelings.
Partners may also develop feelings of insecurity or misperceptions that ED is a reflection on them, their appearance, or youthfulness. It is common for partners to believe that a lack of attractiveness or interest causes ED. If these feelings fester, the relationship will become strained as each partner withdraws. The opportunity to problem-solve may be lost to blaming the other.
ED affects approximately 30 million men in the United States, with nearly a quarter of men with ED under forty. According to recent research, 8% of men aged 20 to 30 have experienced ED. This is a widespread health issue that is not being adequately addressed, as many men with ED do not seek treatment. Despite the fact that there are very effective treatments available for ED and more information available online than was ever accessible before, in a study of six million men with ED, only 25% actually received treatment.
A conversation about ED is best held in a non-threatening, non-sexual setting. As a partner of someone who has ED, it is easy to feel hurt, rejected, or even suspect that your partner is involved in outside relationships.
Many men associate the ability to have erections with masculinity, which is an assumption that is often reinforced in popular culture. Having ED can negatively impact a person’s self-image, leading to low self-esteem, depression, anxiety, and guilt.
Most medical professionals are careful to wait until their patients are dressed and sitting in a comfortable environment before discussing difficult diagnoses with them. This is significant because the conversation must take place in an environment in which the patient feels comfortable asking questions, rather than one in which they may feel at a disadvantage.
The same is true when it comes to discussing a difficult topic in a relationship. Neither partner should feel uncomfortable or at a disadvantage in the discussion.
Arousal is a complex process that involves the nervous, cardiovascular, and endocrine systems. Blood vessel disease is the root cause of 80% of ED cases. ED is not a result of your partner not being “turned on” by you. ED is not something you are responsible for, nor is it something you can fix.
The most common causes of ED include:
In a survey of 1,000 men and 1,000 women, participants identified anxiety/stress/lack of sleep as the most common cause of ED, followed by alcohol and drug use, followed by caused by a health condition. All these options are potential causes, but it is important to note their order of frequency. Anxiety, stress, and a lack of sleep were identified as the most common causes of ED by survey participants (both male and female). These are lifestyle causes of ED. The good news is that they are modifiable. This can also be bad news, because it may assume the person with ED has more control over whether they develop ED than they actually do.
In the same survey, female respondents answered as to their initial thought when their partner experienced ED:
Being the partner of someone with ED has a psychological and potentially a physical impact on health. Feelings of frustration, empathy, and sadness may give way to apathy and acceptance, which can lead to a lack of intimacy and closeness in the relationship.
While it is important to avoid pressuring your partner into sexual activity, it is also important not to downplay the problem. Saying it doesn’t matter minimizes the importance of sex as part of your relationship.
It’s important not to withdraw or to increase pressure. Withdrawing physically and emotionally from your relationship will only compound the problem as the gulf between you and your partner widens.
On the other hand, don’t believe you can cure ED either. Putting more pressure on your partner by becoming more erotic will only make matters worse. It is important to recognize that you are not the cause of your partner’s ED, and you can’t fix it.
Communicating with your partner about ED may be difficult and will feel awkward. No one wants to bring up a topic of conversation that may hurt someone they care about. However, ignoring the issue will be damaging to the relationship. Discussing ED openly can help reduce uncertainty and the risk of jumping to the wrong conclusions. It is important to acknowledge that your partner has feelings of stress and anxiety as a result of ED, but it is also important to give voice to your own feelings as well.
Because ED can test a relationship, it is important for both partners to be supportive of the other. One way to do this is to focus on emotional and physical intimacy. Communicating your needs, relaxing more, trying new things, focusing on romance and foreplay, expanding your definition of sex, and embracing toys are all ways both you and your partner may benefit when you decide to have sex. These strategies can help whether your partner has ED or low libido. They can help either of you get in the mood, especially as you get older.
Seek support for yourself. Losing or changing intimacy will affect your relationship, so talk to a trusted friend, family member, or counselor about your feelings. Experiencing this change in your relationship, though temporary, can bring up long-suppressed anxieties about body image and self-esteem. Professional counseling may be needed to help you work through your emotions.
Take care of yourself by eating healthily, exercising regularly, and working on reducing anxiety and managing stress in other aspects of your life. The risk factors for ED are also risk factors for cardiovascular disease. You and your partner can both make any necessary lifestyle changes to improve your overall health. For example, cooking together, gardening, going for a walk, trying yoga, or meditation can strengthen your relationship as you spend enjoyable time together.
Wait until you are both relaxed and open to talking about ED before bringing it up. Minimize distractions by turning off the TV and silencing cell phones. Focus on discussing ways to seek help and treatment for ED and steps you can both take, rather than how ED affects your relationship.
When discussing ED with your partner, it is critical to be supportive without dismissing the problem. This should not be a discussion about who is to blame or how ED affects your relationship. Instead, it should be a problem-solving discussion in which an important health topic is discussed gently and supportively.
A candid conversation in which each person is given the space to express their needs and fears is ideal but sometimes difficult to start.
In a study by the Impotence Association (now the Sexual Dysfunction Association),
ED is a common medical condition with both physical and emotional causes that can be treated. Don’t accept ED as a condition that must be tolerated in your relationship (at least until you have fully investigated medical treatment options). Perhaps, start your research online, but make it your ultimate goal to seek medical advice. Understanding the causes of ED as well as potential treatment options can help you and your partner ask questions and make decisions that best suit your relationship.
Maintaining intimacy in your relationship is key. Sex is an important aspect of intimacy in a relationship, but so are other forms of physical touch. Intimacy is a sense of being close, connected, and supported. Emotional and physical intimacy are both important and involve sharing your thoughts and feelings with your partner. Being intimate with a partner entails taking risks as you share your thoughts and feelings. However, it is worth the effort because having healthy and intimate relationships is important to overall mental health.
Frequently, lifestyle changes can help ED. Many people feel empowered and less helpless when they can actively make lifestyle changes that improve their overall health and decrease the risk of ED. Partners can be supportive by also making healthier lifestyle choices.
Consider adjusting your lifestyle in the following ways:
Most ED cases are treatable with medications and lifestyle changes. There are many treatment options available, and the best one will be determined by the underlying cause of ED. It is important not to become discouraged if one treatment option fails and another is tried.
Testosterone deficiency is a risk factor for ED, especially as men age. Low testosterone levels can cause low libido, ED, reduced fertility, mood swings, lower muscle mass, and increased fat mass. However, testosterone supplementation (TRT) will not help with ED unless testosterone levels are low, so it is important to get them tested if low testosterone is a potential cause.
Other ED treatment options include:
As with any medical condition, the first step is to educate yourself on the condition and develop a list of questions. Then, approach the conversation with your partner in the same nonjudgmental manner that you would if you were discussing another health issue. Share your knowledge of ED with him and encourage him to see a doctor.
Ask your partner if you might accompany him to a doctor’s appointment to learn about potential treatment options. Be encouraging. The first treatment option may not work as well as you both would like. It is important to discuss your needs and feelings and work together to seek a solution.
You cannot fix your partner’s ED. You can help, encourage, and support him in seeking treatment, but you cannot assume responsibility for it. It is a dangerous assumption to believe your appearance or behavior in the bedroom will cure or even reduce the frequency of ED.
While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.