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A Six-Step Survival Guide for any woman who finds herself in a relationship with an impotent male. Based on the experiences of several women who came through it all - and survived.
This article is female-focused, step-by-step guide for women in relationships with men who are impotent. The sexual, psychological and medical issues you confront are addressed. This guide will be helpful to women who desire an intimate relationship that includes having sexual intercourse or whose relationship is challenged by the loss of sexual intimacy. If you are willing to work together with your partner to restore and enhance his sexual potency, the suggested six-step process will facilitate successful problem-solving.
MALE ERECTILE DIFFICULTIES
Impotence, transient erectile problems and premature ejaculation occasionally occur in all relationships. Chronic impotence (erectile dysfunction) is the inability to achieve or to sustain an erection long enough to complete sexual intercourse. It is an extremely common disorder affecting 10% of the male population. In the US alone, there are 30 million afflicted men.
Premature ejaculation is the inability to exercise voluntary control over the ejaculatory process. Although premature ejaculation is not an erectile disorder, it is discussed in this article because some of the treatments mentioned can be of assistance in resolving this problem, too. Any sexual dysfunction, including premature ejaculation, can deprive a woman of sexual pleasure and result in subtle but significant personal and psychological distress.

SIX STEPS TO SUCCESS IN OVERCOMING MALE IMPOTENCE
Your decision to read this article affirms your commitment to take the first step in overcoming male impotence. New opportunities for achieving satisfying and successful intercourse open up to you as you progress through each additional step. Although there are many ways to express and experience love, chronic male impotence can be a profound and often painful loss in the lives of women.
The SIX STEPS TO SUCCESS in renewing intimacy through sexual intercourse are:

1. Admit the effects of impotence on you and your relationship.
2. Consider your physical and psychological health.
3. Explore the relationship factors that predict successful treatment.
4. Learn about the causes and treatments for impotence.
5. Discuss this problem with your mate and determine your true sexual needs.

Seek medical consultation
STEP 1 – Examine the Effects of Impotence on You & Your Relationship

As you begin to think about resuming sexual intercourse, it is important to understand the influence that impotence has on you and your partner. Feelings, thoughts, and behaviors in relation to impotence reflect on your physical and psychological well being. STEP 1 considers these factors.

ADMIT THE PROBLEM

The Case of Ellen & Paul

Ellen has been married to Paul for 35 years. One year ago, Paul had triple by-pass surgery. Since that time, their sexual relationship has silently dwindled. Ellen tearfully described a recent evening together, "Paul and I were finally alone after a busy week - no telephone, no distractions, and no interruptions. I'd been looking forward to this special time together to share a fulfilling, intimate experience. But in spite of my caresses and cuddling, Paul couldn't seem to respond. The more I tried, the more anxious we both became. He was embarrassed and apologetic. Feebly, Paul admitted, 'I just haven't been myself lately.' I felt disappointed, frustrated, and frankly, a little angry. This wasn't the first time this had happened. Sometimes, in the middle of intercourse, he'd lose his erection and we'd have to stop. So, once again, I tried to be supportive, ' It's OK, Paul, it doesn't matter, being together is enough.' But it isn't...I know it...and so does he."

Any woman who has tried to have intercourse with an impotent man can identify with Ellen's feelings. It isn't just men who experience frustration and disappointment. Women do too.

Many couples maintain a conspiracy of silence surrounding the problem of impotence. Ellen and Paul both knew that there was a problem, but typically were reluctant to talk about it. Paul didn't want to accept the reality of his impotence, and neither did Ellen. They were caught in a double bind. If they openly addressed the issue, much anxiety and stress would be generated. If they chose to ignore the problem, opportunities for emotional and sexual closeness were lost. As they became more physically distant, the quality of their marital relationship began to deteriorate. Over time, they gradually began to drift apart. Silence reinforced their estrangement.

If having intercourse is important to you, admit it to yourself and to your partner. Don't pretend it doesn't matter.

EXAMINE YOUR FEELINGS

Men and women have similar feelings about impotence; yet they rarely acknowledge it to themselves, let alone one another.

Ellen looked in the mirror. At 57, she thought that her beauty was definitely fading. New wrinkles seemed to appear on a daily basis. A recent, unwelcome weight gain testified that her body was losing the war with gravity. The prospect of aging disturbed her, as it does most women, and she was left with a vague sense of unhappiness.

When Ellen realized that Paul's sexual interest had diminished, she began, as many women do, to blame herself. Although Ellen loved Paul a great deal, she felt emotionally insecure and ambivalent about their sexual problems. She tried to cover her confusing feelings by focusing her energies on family, friends and career. Other matters slowly assumed greater priority in her life.

Many women, like Ellen, blame themselves and the effects of aging on their partner's decreased sexual interest. The distractions of life serve to only temporarily dissipate the feelings of loss and grief over diminished sexual intimacy.

Paul longed for the emotional and sexual satisfaction he used to receive from making love with Ellen. He recalled a talk with his physician who reassured him that sexual activity would not endanger his physical health, but this reassurance did not assuage his anxieties. 'It's not fair to burden Ellen with my problems. How can I tell her I'm not sexually capable anymore? Now I'm only half a man.

Men's feelings of sexual insecurity can cause them to question their masculinity. As a result, low self-esteem can generalize to other areas of the relationship. After repeated failed attempts at intercourse, men may feel powerless, defeated, and hopeless. They may cope by unwittingly desexualizing their partner to protect themselves against fears of abandonment and rejection. They are apprehensive about acknowledging this and worry about being perceived as failures in the eyes of their partners.

These negative feelings can be intense and illogical. Even when there is an understanding about why we feel the way we do, this insight does not necessarily help us to change our behavior. Impotence can be perplexing and requires examination of the differences in how men and women think and behave.

EXAMINE YOUR THOUGHTS AND BELIEFS

What Women Think About Impotence?

When confronted with their partner's sexual dysfunction, women begin to explore possible reasons for this problem. After initial feelings of self-blame, women share many of the same concerns.

"Maybe he's sick and there's a medical reason for this problem."

Approximately 85% of all cases of impotence are caused by specific, diagnosable, physical conditions. Most of these problems are treatable and some are curable. Men who are sexually impaired should have a medical evaluation.

"I wonder if something is wrong with our relationship?"

Sometimes potency problems are a screen for more serious emotional or relationship issues. If there is loving affection and a committed friendship between partners, almost all problems can be a good place to begin problem-solving and bridging communication gaps.

"Maybe he's angry with me. Maybe I'm angry with him, too."

Anger, whether or not openly expressed, interferes with sexual desire in many couples. Anger evoked by daily irritations or disagreements is present in almost all relationships. But profound anger, fear or anxiety related, must be resolved in order for medical treatment to be effective.

"Is he having an affair? Is he going to leave me?"

Women who measure their self-esteem, femininity and desirability by how well men respond sexually are particularly vulnerable to fears of abandonment and rejection. Men's emotional detachment feed into the fears. Women may worry that their mates may be impotent with them, but potent with other women, leaving them with fantasies of betrayal and infidelity.

"Honestly, I'm secretly relieved. I don't miss not having sex any more."

Some women are quietly relieved that their partner is impotent. For a variety of reasons, they have never found sexual intercourse to be emotionally gratifying or physically satisfying. Strong negative attitudes or previous negative sexual experiences may undermine the success of any medical or psychological intervention.

WHAT MEN THINK ABOUT IMPOTENCE?

"If I can't have normal sex with my wife, I'm a failure as a man and lover. I feel like a real loser and I can't stop thinking about the problem."

Men who equate sexual satisfaction solely with performance may think of themselves as failures. This problem causes a lapse of confidence and a crisis in self-esteem. Men commonly report that the problem occupies a lot of their mental energy and that they can't seem to stop thinking about their problem.

"If I show her affection, she'll want to have intercourse and then what?"

Men with erectile difficulties tend to emotionally and physically withdraw from their partners. They fear that any physical affection will precipitate a request or desire for intercourse from their mates and remind them of their inability to achieve an erection. Compounding the problem, women may also cease being affectionate.

"Something must be wrong with me. I feel that I have no control over my own body and now that sex is out, I'm lonely. She won't touch me anymore."

Many men, especially older ones, think that it is inappropriate to need nurture and affection. So, they frequently do without the warmth, comfort and emotional support often more available to women. It is frequently considered inappropriate for a man to admit that he needs a hug and someone to hold him. When a man cannot perform intercourse and satisfy his own(and his partner's)sexual needs, he feels emasculated, devastated and very much alone.

"If I can't meet her sexual needs, she will leave me."

Men, too, share fears of abandonment. Younger men, particularly, feel vulnerable and concerned that their partner will seek a new, more fulfilling, less problematic relationship. To some extent their fears are realistic. A younger woman may want to have an active sexual life and over a long period of time be less patient and supportive.

"Before I developed my erectile problem, I found my partner sexually stimulating. Not any more. The thrill is gone. I wonder if I've fallen out of love? She just doesn't appeal to me anymore."

When a man or woman loses a loving sexual relationship due to impotence, either or both individuals may choose to "desexualize" their mate. Paul describes his feelings about Ellen. "I used to be very frustrated about being impotent. I'd feel excited, but my body wouldn't respond. I'd think about how wonderful our relationship was for so many years and get so damned depressed. Now I try to block everything out and think of Ellen as my sister."

Feeling enormously guilty, Paul could not confide in anyone about his lack of sexual desire and his fear that he had "fallen out of love."

Intellectually, he just turned himself off. Sometimes women do the same thing. After experiencing the pain associated with rejection and partner apathy, women divert their attention to other matters in order to compensate for the loss of their sexual partner.

It may take counseling intervention before couples can rekindle romance and "reprogram" themselves and once again think of each other as desirable, stimulating sexual companions.

EXAMINE YOUR BEHAVIOUR

Men and women are socially conditioned to behave in different ways. The process of gender role socialization prescribes appropriate male and female behavior regarding sexuality. Individuals absorb these values and appropriately comply with acceptable standards of behavior. Most people naturally go along with their assigned roles. Sometimes, these roles are contrary and detrimental to getting interpersonal needs met. What you really feel and need sexually is frequently in conflict with how you are supposed to think and behave. Consequently, impotence tends to divide and distance couples, creating conflict and pain.

Men and women also share similar behaviors when dealing with impotence. These behaviors, although sometimes dysfunctional, enable couples to cope with the stresses they experience. These behaviors include:

IGNORING, DENYING OR MAKING EXCUSES FOR THE PROBLEM

Impotence generally does not respond well to neglect. Some erectile disorders do improve with the passage of time, but chronic impotence usually has an organic basis and requires medical attention. Couples sometimes intentionally, or unintentionally, choose to ignore or deny the problem, prolonging recovery and decreasing chances for a positive treatment experience.

WITHHOLDING AFFECTION AND AVOIDING SEXUAL SITUATIONS

Erectile dysfunction can cause a warm and loving partner to withdraw affection and avoid any situation that might stimulate romance or a sexual encounter. The man doesn't want to start something he can't finish. The woman doesn't want to remind her mate of past failures or create additional tension.

GIVING AND RECEIVING "DOUBLE MESSAGES"

Women sometimes pressure reluctant partners to seek treatment. When an ambivalent woman feels she cannot be honest about her feelings and misgivings, double messages are sometimes communicated to the partner. Situations are occasionally created where a seemingly cooperative female partner will inadvertently speak or behave in a way that sabotages the success of treatment or a sexual encounter. Timing and clear communication are one critical variable in the successful treatment of impotence.

Individuals who are unable to authentically communicate negative feelings to their partner frequently turn frustration inward and neglect their own appearance, physical or mental health. This suppression of feelings can create somatic problems including : headaches, backaches, anxiety, insomnia, panic attacks and a range of other health problems. Some people become physically unattractive in an effort to alienate their partner and discourage sexual advances.

ABUSING SUBSTANCES

Alcohol, drug abuse and other addictive/compulsive behaviors have negative sexual side-effects. Some individuals deal with sexual anxiety by becoming workaholics or exercising excessively.

STEP 2 – Consider Your Physical & Psychological Health

Women who contemplate resumption of intercourse after a long period of abstinence have physical, psychological and health needs to consider.

Physical Health Issues

When a monogamous couple considers resumption of sexual activity after a long period of abstinence, both partners are faced with a physiological and psychological adjustment. Women contemplating the resumption of intercourse after a significant period of time should have a comprehensive gynecological examination. With appropriate medical consultation and treatment, most women, regardless of age, can resume normal sexual activity with no difficulty. Since the average age of an impotent man is 55-65 years and his partner is usually of similar age, medical issues due to aging are important.

Age-Related Physical Health Issues

Women from different generations have contrasting attitudes and values regarding sexuality. These attitudes and values have health care implications. In general terms, younger women may view the sudden loss of a sexual partner due to illness or traumatic injury as catastrophic. For an older woman, the gradual decline in sexual interest and activity may be considered a normal part of the aging process.

The medical considerations regarding resumption of intercourse vary depending on age. Particularly for the older woman, prolonged sexual abstinence can contribute to several physical problems, including vaginal dryness, loss of vaginal muscle tone, hormonal imbalances, cystitis, non-specific vaginitis, and painful intercourse. Regardless of age, most problems can be resolved in consultation with the physician.

It is important to be aware of the many sexual changes associated with aging for both men and women.

PRESCRIPTION & RECREATIONAL DRUGS

Prescription drugs and alcohol often have side effects that impair sexual functioning. It is important to evaluate the effect of these drugs on each person's capacity and desire for sex.

PSYCHOLOGICAL HEALTH ISSUES

FLUCTUATIONS IN SEXUAL DESIRE

Sex therapists document that low sexual desire is the number one complaint that brings couples into treatment. Many professionals believe that is you do not have sexual thoughts, fantasies or urges more than two times a month, there may be a problem. This yardstick is certainly arbitrary, but when either or both partners avoid sexual activity on a regular basis, something is amiss.

Women reach their orgasmic prime in their forties and fifties. It is not unusual for a mid-to-post menopausal woman to experience an increase in sexual interest as she ages. Simultaneously, men begin to experience cardiac and prostate disease, which can cause impotence. At a life period when many women are most interested in making love, their partners begin to lose their ability to perform.

When a woman experiences a lack of interest in sexual activity, there is usually a good medical or psychological reason. If you are not orgasmic, find out why. Discuss this problem with your physician and consider your treatment options.

DEPRESSION

Depression frequently accompanies sexual dysfunction in both women and men. In the general population, depression appears to more commonly affect females and older adults. It is important to have this problem evaluated if it is severe. If any individual experiences more than two of the following symptoms, he/she should consult a physician: suicidal feelings, impaired concentration, low energy, lack of interest in usual pleasurable activities (includes sex), sleep disturbance, and significant weight loss or gain.