Medicine not enough to curb failure to rise

Health Matters: Medicine not enough to curb failure to rise

The first time I assessed George in the Sexology Clinic I concluded that his failure to have an erection as a result of a multiplicity of factors. Even though his thyroid hormones were deranged, he also had significant relationship problems with his wife. Over time, he had also developed severe psychological stress as a result of the erectile dysfunction.

"For now all I need is for you to treat the thyroid problem and medicine to address my rising issues," George said.

I had asked George to bring his wife to the clinic so that we resolve the long-standing marital conflict through couple's therapy but George didn't see the need to involve his wife of 17 years.

"Fix the erection problem and I will reverse engineer the relationship to what it used to be," he insisted.

"But you are also quite affected psychologically and need help in that line, you need therapy," I said, getting frustrated.

Self-confidence

In my assessment, I had noted that his ego had crushed and his self-confidence was long gone due to his waning sex drive. He had dropped out of the master's degree program that he had been pursuing; he had received a warning letter for poor performance from his place of work and he no longer went to church where he had been given a leadership role. His life was in shambles.

What I was trying to make George understand is that erectile dysfunction has multifaceted causes and outcomes. It is not just a bedroom issue. Outcomes are manifested in all spheres of life. When it comes to treatment, therefore, the approach must similarly be multifaceted. The biological approach to treatment is definitely important in fixing physiological problems. Treatment must however also deal with psychological stress including anxiety and depression in some cases.

Even more important is the involvement of your spouse in the treatment. Many men’s condition worsen as a result of their partner's negative response to their situation.

There have been instances when the woman gets annoyed and calls the man nasty names when erection fails. There are other times when the woman threatens to seek sexual satisfaction from elsewhere. All these only serve to worsen the psychological as well as erection failure.

In many relationships, emotional connection wanes as soon as erection fails. Some women take it as a sign that they are no longer attractive to the man. Others think that the man is having an affair.

Bedroom failure

The end result of all these difficult thoughts is that normal communication fails and people become harsh towards each other. Some men even become abusive as a way to compensate for bedroom failure. These complexities in the relationship are only solved through couple therapy.

But George would hear none of it. I had to oblige. I gave him the medicine.

A week later George was back in the clinic. His wife had refused to cooperate. She pushed him off and said she no longer desired him. She was not ready to be subjected to his failed experiments again.

"Can we just stick to my multifaceted line of care to avoid this circus?" I asked George.

He dialed his wife. When she picked the call he told her to talk to the doctor and passed the phone over to me.

After explaining my diagnosis and the approach I wanted to take to treat erectile dysfunction, Joyce, George's wife, accepted to come to the clinic. We had several sessions thereafter, some individually between me and Joyce and also with George and some with the couple.

Both had suffered severe psychological stress. Their intimacy was broken and they no longer had an emotional connection. Joyce had been ready to move out.

At the end of the treatment, a lot more time and resources had been spent on treating the psychological problems, intimacy failure, and couple conflict than in treating the erection failure, confirming that managing sexual dysfunctions is far more complex than swallowing tablets as many people would like to imagine.