Accounts of the impact of erectile dysfunction on heterosexual couples from men seeking erectogenic treatment and their partners

Abstract

Introduction:

Erectile Dysfunction (ED) is known to impact on the lives of men but few studies have sought to assess the impact of ED on women and there are no qualitative studies that have compared accounts from women and their partners on the impact of ED on the relationship. Current trends in prescribing of ED treatment focus on men and consider ED to be a male medical problem.

Aim: The aim of this study was to obtain knowledge on how ED affected the lives of women and their partners and to gain insight into the impact of ED from a couple’s perspective.

Methods: Qualitative accounts from women on the impact of ED were obtained from one to one semi structured interviews and from clinical interviews with their partners. Interviews were audio taped and tape recordings transcribed. The study sample consisted of heterosexual couples and compared feedback on the impact of ED from interviews with men seeking erectogenic treatment and their partners. Men attended routine appointments at a secondary care specialist clinic following referral to the clinic by their GP and were interviewed. Feedback from interviews with men was recorded in hospital case-notes. Men with severe ED that met the inclusion criteria were invited to participate in the study and if they agreed were asked to deliver information about the study to their partners. Interview appointments were arranged for women that agreed to participate in the study and informed consent was obtained from both partners. Transcriptions of interviews with women were analysed using grounded theory. The size of the population sample was dictated by the theoretical relevance of the data in relation to the research enquiry. New concepts and new avenues of enquiry ceased to emerge from analysis of transcriptions after fifteen interviews.

Results: Women expressed that ED consumed their partners and reported that their partner’s perception of “solving the problem” focussed on restoration of erectile function. These data were verified by men. Women expressed that they attempted to confront “the problem” by encouraging their partners to seek help but men delayed seeking help due to embarrassment. Women felt isolated and upset at the lack of reciprocity and struggled to make sense of their partner’s perspective, as men communicated to women that the sexual act was of optimum importance in terms of defining the relationship. Men expressed concern that their partners might seek sexual activity “elsewhere” which reinforced perception among women that men defined the relationship in terms of sex. Women were concerned that ED was a symptom of an underlying condition yet men ignored their advice to seek help. Erectile dysfunction affected men’s confidence and caused lack of self esteem. Men reported that ED impacted on their masculinity. Women expressed that ED caused significant disruption to their lives and agreed to their partners using treatment if it was likely to improve their quality of life by having a positive effect on their partner’s mood.

Conclusions: Women were aggrieved and disappointed that ED had such a devastating influence on their relationship. The emotional trauma that women experienced and expressed suggested that feelings of hurt might prevail regardless of treatment outcomes. Women were disappointed that the bond in their relationship was weakened by ED and their partner’s reluctance to communicate. Men expressed fear of “losing everything” and felt that restoration of erectile function would solve all of theirs and their partner's problems. Lack of communication resulted in men and women relying on perception of how ED affected their partners. Although this study did not provide solutions to the problems that couples experienced it produced data that was unique in terms of insight into the impact of ED on women and their partners and identified the importance of considering the couple’s perspective on the problem when assessing ED. Further research is required into the impact of ED on couples as understanding of how ED impacts on a couple’s relationship is poor.