In erectile dysfunction, anxiety is worse than the disease itself
James, a 40-year-old lecturer in a public university, was referred to me by another doctor with a diagnosis of “idiopathic headache, rule out sexual dysfunction causes”.
What you need to know:
- From the time he suffered erection failure, James rarely slept.
- He spent hours in their sitting room pretending to watch TV or work on his laptop until the wee hours of the morning.
Headache is a common problem. You may therefore think that a doctor can easily treat it. On the contrary, it is one of the mind-boggling diagnoses that a doctor can face. This is because of the uncountable causes associated with it.
I was therefore not surprised when James, a 40-year-old lecturer in a public university, was referred to me by another doctor with a diagnosis of “idiopathic headache, rule out sexual dysfunction causes”. The man was accompanied by his wife, Diana, a 30-year-old school teacher. The couple had two children and had been married for six years.
“My troubles started six months ago when my erection failed. I could not rise to the occasion when my wife was in dire need,” James explained. “I have suffered ever since!”
From the time he suffered erection failure, James rarely slept. He spent hours in their sitting room pretending to watch TV or work on his laptop until the wee hours of the morning. Many times he went to bed at 3am. Even then, he would not fall asleep immediately. He basically slept for only two to three hours.
“I dread getting my wife awake in bed. I fear disappointing her. I always think the erection will fail,” he explained. I realised his eyes were welling up with tears. He was a traumatised man. Erection failure is not something that a man faces and remains in the right state of mind.
But many times, it is not the incidental erection failure that is a problem. When erection fails, one slides into anxiety which can be quite severe.
“And what is that exactly?” James asked, interrupting my explanation.
You see, erection failure can make you dread sex. When you think of your erection failing, a reaction happens in the body akin to what happens when you are faced by a life-threatening situation such as an attack by a snake. Your body immediately goes into fight and flight mode!
This response is characterised by high energy. You will not get sleep. Your heart rate goes up and you can feel your heart racing. You feel sweaty even when the weather is cold. You get a throbbing headache and lose concentration.
Most people with erectile dysfunction face this very scary reaction. It makes them use every reason to stay away from their wives so as to avoid being intimate since every erection failure escalates the reaction.
While some may keep off the bed until the wife falls asleep, others immerse themselves in alcohol to escape reality. Some seek transfer to work away from their home town where the wife is. In some unfortunate incidences the man may get violent to keep the wife off.
In fact, anxiety can happen in any sexual dysfunction – men with premature ejaculation face it. Women who have lost desire for sex or who have pain during sex or any other sex problem can similarly face it.
“So, what do we do to help James, doctor?” Diana, who had been quietly listening, interjected. “Is it the end of our sexual lives?”
Well, having a supportive partner when a sex problem happens limits effects of performance anxiety. Unfortunately this is not always the case. Most spouses react negatively when their partner gets a problem. This escalates the anxiety.
Treating the anxiety in addition to the root-cause of the erection failure is important for recovery. James, for example, was fatigued. He was sleep deprived. He had not been eating well. His mind was clogged. He needed medicine to treat anxiety and help him sleep and rest. That was the first immediate line of care.
It took a few days to stabilise James. Once his mind was clear, I took a longer medical interview to find possible leads to the cause of his erectile dysfunction. I also ordered for tests to further confirm the diagnosis. Everything pointed to a stressful lifestyle combined with stresses in the relationship and reduced intimacy. All these factors led to erection failure.
The ultimate treatment was sex therapy. Anxiety as well as erection failure due to dwindling intimacy could only be reversed through a series of sessions of therapy. This needed several weeks of treatment.
“Once again I can stand to the occasion!” James proclaimed on his last day of visit to the clinic, his words interrupted by bouts of staccato laughter.
“That monster of anxiety was hard to slay but you did it my dear, I always knew you would overcome!” Diana replied as the two hugged and walked out of the clinic holding hands.
