By Dr. Sean A. Castellucci, Urology Partners –
It is now more common than ever to discuss erectile dysfunction (ED) or low testosterone. We see it explained and discussed on commercials in between almost every TV sporting event. It is on medical TV shows during the day and even discussed at dinner parties with friends. It is good that people know that there are solutions to urological medical problems. But, the one topic that is sometimes left out is HOW IS YOUR RELATIONSHIP affected by erectile dysfunction or low testosterone?
Treating issues like low testosterone and erectile dysfunction requires a two-prong approach. To completely resolve any effects of these issues, both the physical medical problem and the emotional aspects must be addressed.
First, we will discuss the medical issues themselves that are often the underlying cause of problems between partners in the bedroom.
Importance of Testosterone
Testosterone is one of the most important hormones in a man’s body. It helps the body regulate cholesterol, maintain a strong immune system, improve mood, and protect the brain from cognitive disorders. It is no secret that as men get older, testosterone levels decrease. From about age 40, testosterone levels decrease about 0.3% – 1% per year. Younger men under stress from school, jobs and family often have suppressed testosterone levels, as well. Research has shown that men with CAD (Coronary Artery Disease), had significantly lower total testosterone, free testosterone, and bioavailable testosterone. Low testosterone levels result in reduced muscle mass, strength, sexual desire and mental capacity, while also increasing the risk of obesity, brittle bones and heart attack.
Erectile Dysfunction (ED) Explained
Erectile dysfunction is the inability to achieve and sustain an erection suitable for sexual intercourse. It may take longer for a man to achieve an erection and may require more direct stimulation and foreplay.
A common misconception is that age causes men to lose erectile function. The truth is, erectile dysfunction is considered a common issue for men of all ages. ED is a medical condition and not caused by a lack of sexual desire, or problems with ejaculation and orgasm. There are several factors that increase a man’s risk of developing ED, including: vascular disease, diabetes, hypertension, low hormone levels (testosterone), and personal habits such as smoking. There are also more than 200 different prescription drugs that may prevent normal erections.
Effects on the Relationship
Now that the medical part is out of the way, let’s shed some light on the interpersonal behavioral effects of low testosterone and erectile dysfunction.
Dr. Castellucci says that when a patient comes into his office with medical complaints about trouble in the bedroom, there are other components that need to be addressed. “Some patients do not realize that we here at Urology Partners can treat the physical problem related to sexual dysfunction, but it might not get fully resolved until we truly evaluate the emotional issues that can stem from the physical problems. Oftentimes, the emotional issues are more difficult for couples to address than the medical problems themselves, resulting in relationship changes at home.
It is not uncommon for a woman to harbor self-doubt and be insecure about her ability to arouse her partner. These feelings, if not addressed, can unintentionally cause extra strain on the relationship. If feelings and emotions are left unspoken, treating the medical problem may not always solve the issues in the bedroom. These emotional effects are often overshadowed by the medical issue and usually not given proper attention. Correcting the medical issues aren’t always enough; if these emotional concerns are not addressed there will still be problems within the relationship.
An initial one-on-one consultation is definitely warranted, but eventually in most cases we will recommend bringing your significant other to the next office visit. A medical problem affects the sex life of the patient and the partner, making this a couple’s issue, not just an issue for the patient. “Let’s have a consultation all together or should I say a conversation?
“Both parties really need to be on board with what is happening,” says Dr. Castellucci. There are some cases when a solitary cause, such as blood flow issues, can be determined. This is not true for all cases. More times than not, the couple has to overcome the medical condition as well as some emotional issues that can arise from insecurities and doubts caused by the condition. These emotional relationship issues are exactly why Dr. Castellucci recommends that the couple be evaluated together, because without treating all of the issues, one-sided treatment will not be successful. In fact, Dr. Castellucci’s patients who actively involve their partners have experienced the most success at overcoming difficulties in the bedroom.
Dr. Castellucci has helped many men and woman with urological issues. Our medical niche is one that is intimate, we are talking about issues that many men and women do not routinely, or ever, like to discuss. We uncover the real issue that brought them to the office in the first place…intimacy and lack of it in either partner. This problem can be ongoing for multiple years. We can correct the medical issues that can lead to organic erectile dysfunction, but that was only one of the issues within the relationship. Dr. Castellucci finds that the spouse may need a nutritional and hormonal work-up. The issue can also be a physical issue by either party, such as a problem with vaginal prolapse (vaginal issues) or foreskin; both of which are correctable. If you just address one person in the relationship, you are only addressing half of the problem.
This is a team approach, both parties have to be working together to improve the issues. Let’s get to the root of the problem,” explains Dr. Castellucci. For some people, this approach of actively involving the partner can be uncomfortable. “I did not say talking about the relationship part would always be easy. Now, don’t you wish I would stop talking about relationships and just start talking about ED medication again?”
“Sometimes relationships are the hardest component for a couple to discuss. We here at Urology Partners, are here to help facilitate that conversation. There are a multitude of treatments available, and not just medications. We can help get you to where you want to be. Put us to the test.”
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