The vicious circle of erectile dysfunction
What do we really know about the distress of a man suffering from erectile dysfunction? When in the privacy of his bedroom, he is suddenly overcome with anxiety, seized by a genuine fear that can trigger a vicious circle of failure…
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Let’s take a closer look at this sequence of events and ways of addressing the problem.
Male stereotypes and erectile dysfunction
In our society, men feel that they must conform to the image of the strong, virile male. “The man’s interior world (his emotions and sentiments) is not part of this stereotype. Men must be high-performing and efficient; they’re not allowed to be weak.” So says Dr Sylvain Mimoun, gynaecologist, psychosomaticist and Director of Andrology at Cochin hospital in Paris.
The inability to get an erection is a complete disaster for a man. The image he has of himself, as an effective, high-achieving man, crumbles; his “failure” to perform triggers a fear that he is “not man enough.” Some men, desperately upset, react by trying twice as hard. Others just withdraw. They are incapable of expressing how they feel and bottle up their emotions.
These different ways of reacting all tend to aggravate the situation. To resolve matters, it’s important to communicate but men aren’t terribly talkative in these kinds of situations and they don’t seem to show much imagination either.
Less than a third encourage their partner to continue and try other ways of having sex, despite the fact that women derive as much sexual satisfaction from caresses and tenderness as from they do from the vaginal penetration.
From occasional erection problems to chronic dysfunction
It’s difficult to say what comes first: is it erectile dysfunction or fear of failure? It’s a real chicken and egg dilemma. Men who are affected mostly say that it’s the inability to get an erection that causes stress. However, many women say that stress causes erectile problems.
When there is a problem, the man can become totally obsessed and he allows it to permeate all aspects of his life and struggles to cope with his dented self-image. There are also differences in the way that couples view stress: men who are stressed find it easy to recognize the negative impact stress has on their sexual performance; women, however, tend to under-estimate its harmful effects.
Unfortunately these misunderstandings often remain unresolved. Taboos creep in, resulting in poor communication between partners. Despite this, few men choose to consult a doctor and all too often, they suffer in silence, without their partner’s support.
The vicious circle of erectile dysfunction
Normally, an erection is controlled by the central nervous system and, more particularly, by the sympathetic and parasympathetic systems. An erection only occurs when the cavernosal arteries and corpus cavernosum smooth muscle relax, a process that is regulated by local factors and the central nervous system.
The relaxation of the cavernosus muscle that allows blood to flow into the corpora cavernosa, resulting in an erection, is controlled by the parasympathetic nervous system. The sympathetic system (the only thing sympathetic about it is its name!), however constricts blood flow and inhibits erections.
Stress acts directly on the tonic inhibitory system. More worrying still, the anxiety resulting from previous failures can become a self-fulfilling prophecy. Caught in a vicious circle, the man fears failure. “Is it going to be OK this time?” His partner’s pleas for him to relax only serve to increase his stress and confirm his fear that things are getting worse.
His partner’s response the first time he fails to get an erection is critical. An aggressive attitude or offensive comment is enough to create, and sustain, the kind of chronic stress that is synonymous with future setbacks.
Various studies have highlighted the effect of erectile dysfunction on men’s quality of life and on their partner’s. Today, solutions exist to stop the downward spiral of failure. There’s a lot of good news out there for victims of erectile dysfunction, so there’s no need to lock yourself away in a painful silence.
The first and most important step towards breaking out of the vicious cycle is simply to talk to your doctor.
Copyright © 2010 Doctissimo
Posted 17.05.2011
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