They cope as well as men do – which is not very well most of the time. The first few times women encounter impotence, they may not say anything, but if the problem persists, it will raise all their insecurities and they will start wondering if they are slim enough, attractive enough or young enough. They will also wonder if they have been replaced by an affair.
Most couples have adequate rather than terrific sex lives. Minor stresses such as demotion, moving or illness can cause them to drop into the dysfunctional band. Usually there is little in reserve.
In most cases involving older couples, erectile difficulties begin gradually. There are increasing stresses, and two or three episodes of impotence associated with tiredness, alcohol or arguments can signal the beginning of a downward spiral. After a few more episodes, the woman may become angry, insecure, suspicious and in need of validation.
As this occurs, the issue of intercourse becomes fraught with emotional difficulty and they refrain for I or 2 months. The longer they wait, the more difficult it becomes, as anxiety grows about who will initiate sex and whether it will work.
Younger women with higher sex drives can be intimidating, becoming angry at impotence and feeling that their partner is withholding his erection. But he is probably terrified, and men generally can’t get an erection when they are terrified.
Simply put, most women take impotence personally. They think that if a man is with a naked woman he should become aroused. There is an expectation that an erection is an automatic reflex, and when it is not there, women feel offended and confused. They don’t know what to do because almost everything they do makes it worse. The one thing everyone knows about erections is that the harder you try the softer it gets.
Although many women are supportive and understanding about impotence, plenty are hostile and punitive. It is astounding just how horrible women can be to men about their loss of erections.
Impotence may be a sign that the relationship is in difficulty. Some women forget that a man makes love with his heart and his mind too. They abuse, criticise and reject him and then still expect him to have sex with them. Osbon Medical Systems, the US company that first manufactured vacuum devices for impotence more than 20 years ago, now supplies its clients with a special booklet for partners, which gives a woman’s perspective on impotence.
The booklet highlights the subtle but significant distress the condition causes women. While acknowledging that there are all kinds of ways to express love and receive it, the booklet describes long-term male impotence as deeply distressing for many women.
The booklet emphasises that women experience frustration and disappointment too. It notes that many couples maintain a conspiracy of silence about impotence, unaware that they are caught in a double bind. If they openly address the issue, anxiety and stress may be generated. If they ignore the issue, opportunities for emotional and sexual closeness are lost.
It warns that impotence does not respond well to neglect and encourages women to explain their feelings to their partner and admit if intercourse is important to them.
Numerous women blame themselves for not ‘turning on’ their partners. Their partners avoid intimacy. They won’t even give their wives a kiss or a cuddle. This happens because men will often not become intimate unless they know there is a possibility intimacy can progress to intercourse. They won’t let women have one without the other, and they also don’t want to start something they feel they cannot finish. Impotence can cause previously warm, loving men to withdraw affection and avoid anything that might stimulate romance. And they won’t want to talk about it either.
It is a sign of a good relationship when couples discuss the problem openly. There may be a lot of self-blame. The woman blames herself and the man blames himself. They often find that sorting out this problem can be like starting again.
But there are women who think it is 100 per cent his fault. These men are deflated. They are told they are not as good as the next man, or worse, that they were never any good. This dynamic is a good indicator of the state of the relationship. Erectile difficulties don’t cause rifts in relationships; they widen existing rifts.
Some women, of course, privately welcome impotence. Although they may miss the physical closeness, they welcome the relief from obligatory sex. When, without prior discussion, their husbands return from an impotence clinic or from a doctor with a script for Viagra or injections, these women think ‘Oh dear’.
Before treating men for impotence, doctors should investigate the wife’s interest in sex. Although men regularly claim they are ‘doing it for her’, they are notoriously unreliable reporters in this regard.
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