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The setting
Most people find it difficult to talk about sex. Even on those rare occasions when we discuss it in company we do not speak about it in quite the same terms that we use to address other topics. Blue jokes and tales of sexual conquest are the standard fare of conversation amongst young adult males. With the benefit of hindsight most men realise that many of the tales they heard during their younger years were comparable to the unbelievable fantastic angling stories about the fish that got away.

We can all remember great rows or discussions that we had in the past with our friends but I am absolutely confident that most men will have no recollection of ever having had an adult conversation about sex. Those conversations are not recalled because they just don't happen.

There are many cultural, social, religious and other forces that have disabled us from speaking about sex in an adult way. And yet sex is everywhere. It sells cars, fuels our fantasies and stirs our loins. However, there is a major irony at work. Society is flooded with sexual imagery yet despite all the permissiveness of the modern world there are still remnants of taboo about sex. If we add a heavy dose of guilt to that powerful mixture we end up with a dizzying cocktail. Is it any wonder that people find it difficult to seek help when they have a sexual problem?

The central character
So you the reader now walk onto the stage against the backdrop I have just painted. You are the central character in the plot that is about to unfold. You have a sexual problem and you feel isolated, lonely, somewhat confused and frustrated. Your manhood is insulted because you just can't achieve a satisfactory erection. It's happened several times over the last few months and you are fearful it's just going to keep happening.

The first time it happened you were a little tired and both you and your partner were a little surprised. You were even a little embarrassed with each other and you both tried to sleep having shrugged off the incident with some banal attempt at a humorous remark.

As you struggled through work in the subsequent days the memory of that night was never far from your conscious thought. In fact you weren't really concentrating very well on your work. You decided that it would be a good idea to go out with your partner and have a good night out. A few stiff drinks will help to sort this out, you thought. And then it happened again. You managed to achieve some degree of erection with your partner but not as hard as usual. Instead of getting harder your penis just drooped and went soft again. No banal humour this time. In fact a few slightly waspish remarks were exchanged and you drew away from each other as you tried to sleep. Next morning you felt guilty and apologised for the hurtful comments.

Three months later the problem is worse. The easygoing relationship that used to exist with your partner is slightly more frayed. You haven't had a satisfactory erection for months and you have deliberately avoided actions and situations that might previously have led on to sex. Your partner is now becoming a little bewildered and doesn't quite understand what is happening.

Where do you start?
You are really isolated on the stage now. What do you do? You could try to talk to your partner and sit down as two adults in order to discuss the last few unhappy months. Maybe you could try to rediscover intimacy in your relationship. You might even agree to retrace the steps in your relationship back to the time you were first attracted to each other. Get back to sharing the things you used to enjoy doing with each other and rediscover the ingredients that led to your mutual attraction. It works for some people.

No. Things have gone too far. That last paragraph is all Mills and Boon nonsense and if you sat down to have an adult conversation the anger would rise very quickly and soon boil over. Maybe it would be better not to go there. That type of conversation could be very destructive and only make things worse.

So what do you do? You have lots of friends and now in your moment of need you realise that you can't really talk to them about your difficulty. Maybe they would get embarrassed. Maybe they wouldn't really be able to empathise with your situation. You are afraid that you would lose face before them. You realise that even though you have many friends there are always private areas that are off limits for discussion no matter how close your friendship is.

Getting professional help
You cannot talk to your partner about this and you cannot bring yourself to seek the help of your friends. Where will you go to seek help? There is help out there for you but maybe you cannot see that at the moment. What about going to see your GP? That would be a reasonable place to start seeking help. Or maybe you think that the GP is not really interested in this area or maybe your previous experience with that doctor was not great and you found the handling of the encounter a little bit insensitive. If that was the case then go and see another doctor. A doctor patient relationship is not a marriage. It's not as if you had to get a divorce before you can see another GP.

So you can't get up the courage to go to the GP and start talking about your problem. Have you considered the possibility that you are not the only one that ever had this problem? I don't say that insensitively. You are not alone. Many people suffer the distress and embarrassment that you are currently suffering. Many of these people have been helped enormously by their GPs. Some GPs even have a special interest in sexual problems and have developed considerable expertise in this area. Other GPs have formed very good professional relationships with counsellors and psychologists to whom they refer their patients should special expertise be required.

OK. So you agree with everything I have said but you still cannot bring yourself to go to your GP. Do you think you could ask your partner to go with you? Alternatively, would you be comfortable with the idea of your partner going to see the GP before you attend in order to break the ice for you. Have you thought about writing a confidential letter to your GP about the problem thereby taking the initiative yourself? Or maybe you decide to simply phone and make an appointment to see your doctor.

We needn't retrace your steps and discuss how you eventually came to see your GP. You are sitting in his waiting room. The secretary greeted you in a friendly manner. You pick up a copy of Men's Health from the magazine rack and are immediately drawn to an article on erection problems. The author states that erection problems are "top of the Richter scale of embarrassment for most men".

The doctor calls you into his office and you sit down. After initial hesitation you suddenly find yourself talking about your problem. The doctor doesn't get embarrassed. He doesn't cough uncomfortably and try to change the subject. The sky doesn't fall in. You don't hear the final trumpet call of the day of judgement. The consultation proceeds along and terminates with a plan and an appointment for you to return to the GP for review.

You leave the GPs surgery on a slight high. You are no longer a lonely actor on an empty stage. That first consultation was the first and most important step in solving your problem. You now have hope and your intense frustration has already begun to reduce. You know that your problem can be solved.

If you read back through this article you will notice that the principal character is clearly male but the sexual identity of his partner is not identified. All couples whether heterosexual or homosexual can have sexual difficulties.

Written by Dr Leonard Condren,
Medical Editor,


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