How fear of failure interferes with intimacy

It had been four years since I first met Margaret and Andrew. I remember our first meeting very clearly. I had had a busy day at the clinic without time to look at my phone, and when I finally picked it up, I found 15 missed calls from the same number. I called back.

“I am upset, why are you not picking calls?” the voice came. “I am trying to help a nervous man who cannot even call you and discuss his sex problem and you are similarly being difficult!”

The lady, Margaret, was quite agitated. I asked what the problem was and how I could help. “This man has no erection, I am beginning to wonder if I got married to a fellow woman, burekabisa!” Margaret shouted back. I requested that the couple comes to the clinic.

The next day they were in the clinic. Margaret was a police officer, quite a built lady with a no-nonsense approach to issues. She was 38 years old and a mother of two. Andrew, her husband, was a businessman operating a fleet of matatus.

“I have work to do, I am a very busy person, yet this man cannot take initiative to solve his erection problem,” Margaret explained. “This is my last attempt to help him. If he cannot get erections I will eject him out of my house, mimi sipendi ujinga!” The couple was living in police quarters and the house was allocated to Margaret.

Andrew was 42 years old. He had been well until he hit 41 when his erections started to dwindle. This coincided with the time when his business got quite busy. He slept for only three hours a night. He was always exhausted. The problem was compounded by Margaret’s reaction. The first time the erection failed, Margaret made hell. She shouted, accused Andrew of infidelity and threatened to shoot him and the purported girlfriend. Andrew’s defence fell on deaf ears.

Andrew started dreading bed time. Whenever he tried sex the fear of failure would overwhelm him and his erection would vanish. He decided to avoid sex altogether.

“So it has been six months without sex. I want to know who is satisfying his sexual needs,” Margaret railed. I examined Andrew and did not find any physical abnormality. Laboratory tests were also all normal. I made a diagnosis of erectile dysfunction (ED) caused by physical exhaustion and worsened by negative reaction from the spouse.

I advised Andrew to change his lifestyle. He had to work for no more than 10 hours, make time to eat, and sleep for at least seven hours. Exhaustion has a serious effect on erectile function. Similarly, adequate sleep is important for the production of chemicals and hormones involved in erection and any man who wants to have strong erections should sleep for no more than seven hours a night.

Women also have to learn to care for their men. It is usual for a busy man to lose erection once in a while. If the lady reacts negatively however, the man develops performance anxiety.  “So you mean Andrew is lacking erection because of my reaction?” Margaret asked. I nodded. She shook her head and walked out of the consultation room.

That evening Andrew called to let me know that he had been thrown out of the house. I called Margaret repeatedly but she did not pick my calls. Andrew put up with a friend for some time and later rented his own house. He changed his lifestyle as recommended. His attempts to reconcile with his wife were futile. She went ahead to filed for divorce, which was granted.

Six months ago Andrew called to let me know that he was getting married to a different person. Last week, he passed through the clinic to give what he called a progress report on his ED. “I have not lost erection at all, in fact my new wife thinks that I like sex too much,” he laughed. I nodded and smiled back. I was once again convicted of the fact that most sexual problems are as a result of how partners react to each other’s sexual performances; it can cause permanent damage or be an opportunity to show care and love to each other.