Prime Time - Jane Fonda [97]
The sexual pharmaceutical drugs are not meant to treat delayed ejaculation. There are, as of this writing, some off-label drugs designed for this purpose but nothing that is FDA-approved.
The Problem of Denial
Then there’s the problem of denial. Dr. Perelman explained that the average man spends two to three years in denial about his erectile dysfunction before he seeks help. By then a new sexual equilibrium has taken place between the couple; they may have simply adjusted to not having much sex or to having a different kind of sex or to no sex at all. “What makes things worse for many partners of these men,” said Dr. Perelman, “is that the men will begin to avoid any kind of intimacy, especially affection, because the presumption is that if they are affectionate, she may mistake this as an initiation of sex and he doesn’t want to fail. Who wants to do what they won’t do well, if you will?”
I find it so sad that couples will deprive themselves of the sensuality of touch, of playing, of the whole cornucopia of intimate and sexy things they could do without thinking about intercourse. Almost nothing brings home to me as forcefully as this the toxic nature of masculinity as it is currently defined by our culture and internalized by men and boys. They are so vulnerable to being shamed because they might not perform the way they think they should that they and their partners miss out on pleasure.
Communication Between Patients and Doctors
As I have said before, simply writing a prescription isn’t enough. Erections, with no context, aren’t enough. I think many doctors need to spend more time talking with their patients so as to get a holistic understanding of the landscape of the particular relationship. Along with others in his field, especially some of the women doctors, Dr. Perelman is a big advocate of getting the partner into the consultation session. “We should see both people,” he said. “Not just the men. So, I did a little study of sexual medicine specialists who are urologists, across the country, and found out that less than one out of ten of them ever saw a partner at all, let alone every time that they saw the guy. For the most part, some of the men do not want the partner to come in, some of the men are not even telling their partners that they are going for help because they are so embarrassed about it, and in a very small percentage of cases they are not telling the partner because they plan on using it elsewhere.”
Dr. Tom Lue told me that it isn’t that doctors don’t want to see the partners but that, very often, the partners don’t want to come in. “Interestingly,” Lue said, “if the men become impotent because of medical reasons like a prostate cancer operation, radiation, or whatever, 90 percent of the time the wife will come with the man. She will feel sympathy: ‘My man has cancer, I should help him.’ But if the man becomes impotent for other reasons—diabetes, high blood pressure, because those happen gradually—then quite often the woman thinks the man must be having an affair, or the man does not like her anymore. In those situations, the women don’t come.”
If the partner wants to come in and the man wants her to come in, then discussing their issues together with the help of a sex therapist can lead to big changes. Consider this scenario that Dr. Perelman described: “If the man has always been insensitive to her needs and she has satisfied herself with masturbation without him knowing about it for forty years, but she always secretly hoped or was too shy to ask him to touch her, then if you can actually get her into the office and have a consultation and discover that information, and find a sensitive way of communicating that to him that doesn’t humiliate him or embarrass her, it is actually a win-win, and those are very happy people when they leave. Because now you have reestablished a new sexual script that is actually designed to satisfy her, not just to satisfy