Let's talk about ED

How often do you hear the mention of Erectile Dysfunction (ED) in regular conversations? Even if you do, it's mostly referred to as "problem hai" in hushed tones, or sniggered at like it's a sexual incompetence that ‘real men' don't face. This culture of denial, which prefers to only focus on sexual prowess, is reflected in a survey that pharmaceutical firm Pfizer Upjohn conducted among 527 men and 515 women. The recently released study found that while 78 per cent women were aware about ED, only 47 per cent men said they knew about it. Moreover, of the 307 health experts surveyed, 96 per cent agreed that partners play a significant role in the success or failure of a man's ED treatment.

While both Dr Shyam Mithiya, a Mumbai-based consultant psychiatrist and sexologist, and Dr Pavan Sonar, a sexologist and a relationship counsellor, agree that the partner's motivation influences decisions on ED treatment, they tell us that one needs to first address the cause of and the taboo around the disorder.

Performance pressure
According to a definition cited in the Pfizer Upjohn survey, "erectile dysfunction is the inability to achieve or maintain penile erection which leads to unsatisfactory sexual intercourse". Dr Mithiya says there can be three aspects to this - problem with the desire for sex; inability to get erection; or issues sustaining it. "While the cause can be either psychological or physical, more than 90 per cent times, it's the former or a combination of both," he adds.

Dr Sonar explains that the mind plays a key role in triggering a series of physical events that cause an erection, starting with sexual excitement. "This includes depression, anxiety or other mental health conditions; stress; or relationship problems." Both agree that one of the commonest causes is performance pressure. "This anticipatory anxiety stems from unrealistic expectations rooted in sexual acts they see in movies or pornography, or what they learn while talking to friends. None of these are the right sources to learn about sex or sexual problems," elaborates Dr Mithiya. Pointing to the large gap in awareness levels between men and women in the study, he, thus, adds, "It's not that men aren't aware. They prefer to live in denial as society expects them to be always ready for sex, and looks at ED as a thing to be made fun of."

Dr Pavan Sonar

Culture of silence
While 87 per cent men believe sexual intimacy is required in a relationship, only 56 per cent said they would like to discuss ED with their partners, the study stated. The doctors attribute this to lack of proper sex education and the taboo around the subject. "Often, couples prefer to brush their own sexual problems under the carpet for years. Take for instance, a Mumbai-based couple who were married for 10 years. The woman came to me for depression, and after delving into their case history, it was revealed that the man would lose his erection while having sex, so they stopped attempting it, complicating their relationship. All they had to do was seek help," illustrates Dr Mithiya.

Help at hand
The study states that 82 per cent women said they would ask their partners to visit a doctor to get the right treatment for ED, instead of talking to friends or relying on home remedies, as opposed to 42 per cent men who were willing to substitute medicines prescribed by a doctor with a cheaper option or opt for their pharmacist's advice. Dr Sonar, who confirms the fact, adds women today are opening up about their sexual needs, which goes a long way in helping men - a fact reflected in 96 per cent doctors agreeing that partners can play a crucial role in ED treatment. "Almost 70 per cent of cases I witness are brought in by women. They take initiative in addressing the problem," he shares.

Dr Shyam Mithiya

1,042
Men and women surveyed by Pfizer Upjohn

96%
Doctors feel partners play a significant role in a man's ED treatment

53%
Men unaware of ED

82%
Women said they would ask their partners to visit a doctor to get the right treatment for ED

Signs and solutions

. Accepting the problem is the first step.
. If the partner gets too irritated or frustrated, the fear to attempt again magnifies, and men start making excuses.
. Make your partner feel that it's okay to fail.
. Get scientific knowledge about sex and the disorder, so that you don't end up having unrealistic expectations.
. If things don't get better in six months to a year, approach a therapist.

Dr Shyam Mithiya and Dr Pavan Sonar

Lockdown connect

. The survey reveals that 35 per cent men and 47 per cent women think stress is the major catalyst for ED, and stress levels have been soaring during the pandemic.
. Dr Mithiya shares that though there is no increase in standalone cases of ED in the lockdown, it is an underlying factor in other problems that couples are reporting.
. To de-stress during this time, Dr Sonar suggests relaxation techniques like doing shavasana together, taking out time for each other, and addressing the stressor.

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