Posts Tagged ‘men’
Erectile Dysfunction: Michael Castleman Talks to Women
Update note: I first posted this interview in June 2007. I have so many new readers now that I wanted to bring it to the forefront, because it’s such an important issue for both men and women. Often men feel they can’t talk about ED with their partners. Women tell me their men seem to emotionally disappear and avoid sexual activity and discussion. Michael Castleman helps all of us understand what’s going on. — Joan
In a previous post, I interviewed Michael Castleman, a sex educator, counselor and journalist specializing in men’s sexuality to answer some questions for men about erectile dysfunction. In this part of the interview, Castleman talks directly to women:
Q: What don’t women understand about erectile dysfunction (ED)?
MC: Like men, few women understand the difference between true ED and erection dissatisfaction. [See Erectile Dysfunction: Michael Castleman Talks to Men for explanation of the difference.] Women also don’t really appreciate how men FEEL when EDis or ED develop. It’s sort of like how women feel when they lose a breast to cancer. You’re still alive, but you feel diminished. A part of your body you took for granted isn’t there anymore, or in the case of men, doesn’t work like it used to. And this isn’t just any part of the body. It’s a body part that in a profound way DEFINES you as a man or woman. For women, loss of a breast raises issues like: Am I still attractive? Am I still sexual? Can I still please a man sexually? Men with ED and EDis wrestle with similar issues.
Beyond this, men have lived their whole lives pretty much taking their penises for granted: See a sexy woman, get hard. See porn, get hard. Think a sexual thought, get hard. Then all of a sudden–and in many men this happens pretty suddenly–they’re in a situation where they expect to have to rearrange their underwear to accommodate some swelling down there, and then….nothing. Nothing happens.
Many don’t understand what’s happening to them or why. But even those who do, me for example, feel surprised, upset, disappointed, depressed. Change is stressful. But when the changes concern the penis, well, men get seriously freaked out.
Now women often (and rightly) believe that men are too focused on the penis. That’s often true. It takes most young men years (sometimes decades) to leave penis-centric sex behind and understand the erotic value and pleasure of whole-body sensuality, a lovestyle more based on whole-body massage than on just sticking it in somewhere. Men who never get there, men who continue to view sex as penis-centered, when their penis stops behaving as they expect, they often think it’s the end of sex, that they’re over the sexual hill, that it’s all over. In my experience as a sex counselor and writer, few women appreciate how diminished men feel as they get used to EDis… if they ever adjust.
Q: Why can’t men express these concerns?
MC: Many reasons. In general, men tend to be less emotionally articulate than women. Men are socialized to be the “strong silent type,” to keep a “stiff upper lip,” to “grin and bear it.” In other words, to deny what they’re feeling and just go on. As a result, men get less practice than women discussing their emotions, and when they do, they’re less skilled than women. Now some women believe that men don’t HAVE emotions because they don’t discuss them. Wrong. Men feel things just as deeply as women. They just are less likely to discuss them, and if they do, they’re less likely to be able to really articulate how they feel.
The two genders have different natural histories of sex problems. With the exception of vaginal dryness, which is easily mitigated with lubricants, most women have most of their sex problems/issues when they’re young. Young women wrestle with the mixed messages that they should be sexy but not trampy, that they should want love/sex, but not want sex “too” much, not be “too” easy. But how easy is too easy? Young women also have issues with orgasm. Many don’t have them and have to learn how to release orgasms.
Meanwhile, few young men have sex problems–other than coaxing women in to bed. The young penis works just fine, thank you very much. Maybe the guy comes too soon (this is the #1 sex problem of young men), but only rarely do young men have problems with erection. Then they hit 45 or 50 and suddenly, the erections they took for granted their entire lives start to fail them. They freak. It’s almost unthinkable. Many Americans found themselves speechless after Sept. 11. It was so horrible, unimaginable. Men don’t discuss their ED or EDis in part because it’s unimaginable–then it happens and they’re speechless.
To many men, having reliable erections is a significant part of what defines them as men. If they have problems in the erection department, some fear that the women in their lives will view them as less than real men. So why talk about it? Why invite her to rub his nose in the fact that he’s less of a man?
Q: When should a couple seek counseling?
There’s no hard-and-fast rule on this. But when a problem festers, when you find yourselves having the same conflict over and over again, when there seems to be no way out, no resolution, basically, when you feel stuck, that’s when to consider counseling.
Now every sex problem is also a relationship problem and visa versa. If the main issue is power/control/decision making or conflict resolution, then a couples counselor is probably the place to start. But if they main problem is sexual–a desire difference, orgasm issues for the woman, erection issues for the man–then I’d start with a sex therapist.
Personally, I’m a fan of sex therapy. This is not self-serving because I am not a sex therapist. But studies show that two-thirds of couples who consult sex therapists report significant benefit within 6 months. That’s pretty good. Men with ED or EDis need to reframe their thinking about sex. They need to get away from porn-inspired sex and explore whole-body sensuality. This is often unfamiliar to men. They often fight it. So going back to a therapist week after week can help keep them on the path to self-discovery.
To find a sex therapist, visit the American Association of Sex Educators, Counselors, and Therapists (AASECT). Click the map of the U.S. and Canada, and get a list of all the AASECT-certified sex therapists in your state or province.
Q: What if the man won’t go?
The woman should go by herself. This is not as good as the couple going. But going solo gives the woman a place to vent. It may equip her with new coping skills that can help deal with the couple’s issues. And she may be referred to some written material, e.g. my book and others like it, that she can litter around the house and hope he picks up and checks out.
Michael Castleman, M.A., is the author of twelve books, including Great Sex: The Man’s Guide to the Secrets of Whole-Body Sensuality and Sexual Solutions: For Men and the Women Who Love Them. From 1991-95, he answered the sex questions submitted to the Playboy Advisor. Visit his website about sex after midlife, http://www.greatsexafter40.com/.
Personal View of Prostate Surgery and Sex
Neil, age 74, offers this startling information about sex after prostate cancer surgery. I’m grateful to Neil for his willingness to share his personal story:
A diagnosis of cancer is very frightening. For me the journey was scary enough without the myths and misinformation I was told about cancer of the prostate. I share my experience in the hope that this information will be of help to others.
Myth # 1: “After Age 55, Sex Doesn’t Matter That Much Anyway.”
I heard these words from a physician who specializes in the treatment of prostate cancer. A very nice person, considered extremely competent, he believed his words would be comforting. They weren’t!Sex does matter after 55. I promised the doctor that I would look him up on his 55th birthday and tell him to “cut that out.” He sheepishly smiled and said, “Oh my. I think I said something wrong.”
Myth # 2: “What You Have At The End Of A Year Is What You Get.”
Although many men are told that any rehab after prostate cancer treatment will peak in twelve months, every case is different. Some methods of prostate cancer treatment can result in serious damage to sexual performance. On the other hand, robotic surgery and nerve sparing have greatly improved sexual potential. Whatever the case, don’t give up! There are options for almost every case of sexual impairment.But I must warn about some of the product advertisements that flood the market about penile enhancement, instant erections, and so on. Some of these products can be harmful to a cancer survivor. Some are loaded with testosterone which can cause further growth of prostate cancer. Check with your physician before trying any of these medications.
At all times, keep your partner involved in the options you’re considering. They can be our most precious friends and supporters. They deserve to be part of the solution to our new life experiences.
What We Are Often Not Told:
The penis will be about an inch shorter after surgery. Because the urethra passes through the prostate, when the prostate is removed, that portion of the urethra is removed as well. Then, when the urethra is resectioned, the penis is drawn in towards the abdomen. Secure circumcised males seem able weather this storm but uncircumcised males have an additional problem. The surgery leaves more foreskin than before. This additional tissue traps urine and produces odor. Baby Wipes do a very fine job of solving this problem. They are easy to carry and save a lot of embarrassment.
The “Missionary” position usually is no longer successful after prostate surgery. Because the prostate stabilizes the penis and prevents it from receding into the abdominal cavity, removal of the prostate decreases penile stability. The angle of the vagina, coupled with a shortened penis with no internal stability means vaginal intercourse may not work. However, “Doggie Style” and “Woman on Top” work just fine.
I welcome feedback about the experience of others regarding sex and prostate surgery!
9/22/2009: Neil added these comments about how his urologist saved his life.
Doug, 80: “8 penises on his hands”
Doug, a reader from the Philippines, wrote a comment that was so interesting and helpful that I’m excerpting it here so you won’t miss what he said. Doug wrote,
I am 80 years young and have had ED (erectile dysfunction) all of my life. It has taken me a whole lifetime to come to the point of seeing sex but the tip of the relational iceberg.
Yes, I also know that we men are our penises and our penises are the man. This is a mental hang-up that we need to change.
Doug addresses a reader in an earlier post who wrote that her husband can no longer have erections and has given up on sex and communication. Doug says to this reader,
Until your husband can change the way that he sees his masculinity, he’ll never really feel good about himself. He has eight penises on his hands and the best penis in his mouth. And that up close and personal penis can and does give my wife wonderful, body-shaking orgasms, one right after the other, that most penile intercourse cannot come close.
And best of all, my ego isn’t lying on the ground of mental failure. It works for me and it can work for your hubby.
Doug, you’ve been most helpful to our readers here, and I thank you for sharing your perspective. Would you please contact me personally so I can invite you to be in my next book?
He thinks he can’t please her without an erection, so why bother?
An important question was posted as a comment to my blog interview with Michael Castleman who answered my questions about erectile dysfunction. Here’s what a reader asked:
I’ve been in a loving relationship for over two years, its been great. Until now, its taken a complete turnaround. His thinking is because he can’t get an erection he’s a failure in pleasing me. No matter what I say, his comment is “why bother”. I have been completely satisfied with our love making up until now, I am completely confused. Our love and intimacy made our relationship what it was, now what? What do I do?
This question moved me and I asked Michael Castleman if he would answer this reader He promptly replied:
I feel for you. When men develop erection difficulties and withdraw from lovemaking, they often seem completely shut down and unreachable, and no amount of reassurance seems to help.
Of course, such reactions are not unique to men. Imagine that you suddenly gained 100 pounds and no matter how hard you dieted and exercised, you could not lose an ounce. Now imagine that your lover said: “It’s all right. It doesn’t matter. I still love you, and want to make love with you.” Would you believe him? Would you want to have sex?
To most men, sex means erection, and the notion of sex without erection makes a much sense as baseball without bats. But men CAN enjoy sex–and have great sex–without erections. Erection is NOT NECESSARY for male orgasm. Vigorous fondling of the penis by hand, mouth, or sex toy can produce orgasms every bit as intense and satisfying as the ones he used to have with erections. And erection is not necessary for female pleasure or orgasm either. In fact, only 25% of women are reliably orgasmic during vaginal intercourse because the old in-out doesn’t provide much clitoral stimulation. Many women prefer a man with a talented tongue and fingers to a guy who just sticks it in.
Of course, it’s a major adjustment for men to decouple sex from erection. Given how adamantly your man has been saying “why bother?” I think your best bet would be to try to coax him into joining you in consulting a sex therapist. To find one near you, visit the American Association of Sex Educators, Counselors, and Therapists or the Society for Sex Therapy and Research.
If he refuses to go, then I urge you to go by yourself. The therapist can help you cope, and make suggestions you might try at home with him. And the fact that you’re going may show him how important the sensual side of your relationship is to you, and eventually he may relent and join you. Good luck!
Michael Castleman, M.A., is “one of the nation’s top health writers” (Library Journal). He has specialized in health, medicine, and sexuality for 36 years. He is the author of Great Sex: A Man’s Guide to the Secrets of Whole-Body Sensuality. From 1991-95, he answered the sex questions submitted to the Playboy Advisor. Visit his Web site about sex after midlife, GreatSexAfter40.com.