Love Drugs:
Is a long lasting erection really a prescription for better sex?
by Ellen Rap
on behalf of
The Sinclair Institute
With the new erection drugs, lovemaking is once again a possibility for ED sufferers and their partners. But there’s much more to good sex than a firm, lasting erection.
All three drugs have been shown to work in the majority of users, restoring erectile ability in men who previously could not achieve – or maintain – an erection during lovemaking. With the new ED drugs, most men no longer have to worry about getting and keeping an erection. In fact, in rare instances, men using these drugs may even experience a condition known as priapism, a painful, abnormally prolonged erection, lasting four hours or more – and possibly causing permanent damage to the penis if untreated. You’ve probably seen the television ads for these drugs, warning users to seek immediate medical help if they experience a four-hour erection.
But priapism is a relatively rare side effect. And as the advertising for ED drugs emphasizes, most men who take these drugs can look forward to having a normal, healthy erection that lasts plenty long enough for intercourse. That’s good news. But is it enough to guarantee a fulfilling sexual experience? We would have to say no.
A long-standing and still-prevalent myth is that a strong erection is all that’s really needed for good sex – or, as the late sexologist Bernie Zilbergeld, Ph.D. described the myth in his book The New Male Sexuality, “Sex is centered on a hard penis and what’s done with it.” But in reality, mutually pleasurable lovemaking involves a lot more than a hard penis thrusting in a vagina. While the new erection drugs are undoubtedly a boon to ED sufferers and their partners, many couples have nonetheless found that a firm, lasting erection doesn’t necessarily result in a happy sex life or increased intimacy. Solving one problem - erectile dysfunction – can sometimes lead to other difficulties, like unsatisfying sex and relationship conflicts.
Difficulties like these can surface when a couple isn’t well prepared to make the transition to being sexually active again, say therapists. But problems can often be minimized if you and your partner have realistic expectations and respect each other’s needs and desires.
This article will cover some common “problem” scenarios that can occur when an erection drug is introduced into a relationship – along with expert advice on how couples can resolve or avoid common problems and concerns.
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1. Too much sex, not enough intimacy
For many men who have started taking an erection drug, the resulting erection is like having a new toy – a toy they want to share with their partner. But problems can occur when the man suddenly wants to have a lot of sex and the woman is physically or emotionally unprepared for this change in routine.
“Many women feel pressured when their partner wants to rush into lovemaking after a long abstinence,” says Stanley Althof, Ph.D., co-director of the Center for Marital and Sexual Health in Beechwood , Ohio and urology professor at Case Western Reserve University in Cleveland . “Sometimes the man doesn’t even tell his partner he took a pill, and then he comes home wanting to make love. It can be jarring for the woman, even if she’s missed having sex.”
What’s more, continues Althof, there are men who feel that “having this hard erection” will be thrill enough for their partner – but actually, it’s not enough. While most women enjoy vaginal penetration, other aspects of sexual connection as just as important: kissing, caressing, foreplay, and intimate, affectionate talk. In the rush to experience intercourse once again, some men might neglect these other intimacies. They shouldn’t.
Susan C. Vaughan, M.D., a psychiatrist and author of Viagra: A Guide to the Phenomenal Potency Promoting Drug (Pocket Books, 1998) advises: "I encourage couples to take it slowly and plan intimate time together before the man takes the drug. It's important for partners to get back in touch with feeling excited about each other and not just jump into intercourse right away." She suggests trying sensate-focus exercises, in which both partners are nude and take their time stroking and caressing each other, but without any genital touching. You can try these exercises or engage in other forms of sex play, like mutual masturbation and oral sex, until you both feel ready for intercourse.
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2. If sex hurts
Physical discomfort is a common issue for women resuming intercourse, particularly postmenopausal women, in whom vaginal shrinkage, dryness, and thinning of the vaginal walls are prevalent. “Penetration may be very difficult, as well as painful," says Virginia Sadock, M.D., clinical professor of psychiatry and director of the Human Sexuality Program at New York University Medical Center .
Donnica Moore, M.D., founder and president of Sapphire Women's Health Group, an educational organization on women's health issues, observes that since the introduction of Viagra, "there has been an increase in older female patients being diagnosed with urinary tract infections." Also known as cystitis, the condition often occurs in women who have sex after a long hiatus, especially if the vagina isn’t sufficiently lubricated.
When ready to resume intercourse, it’s best to use an over-the-counter vaginal lubricant and to start off with slow, gentle thrusting. If penetration is still difficult because of vaginal shrinkage or thinning, the woman “may want to consider hormone replacement therapy (HRT), which is effective in treating vaginal symptoms of menopause,” says Sadock. Women who prefer not to undergo hormone replacement via pill because of concerns about possible health risks can talk to their doctor about receiving hormones in topical form, as a vaginal cream.
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3. “Is he turned on by me – or is it the drug?”
Some female partners of men taking erection drugs worry that their mate’s renewed potency has nothing to do with them: “He's responding to the drug, not to me.” This common complaint stems from an equally common misconception about erection drugs: The belief that these drugs not only facilitate erection (which they do), but also trigger sexual desire (which they do not).
"Both partners need to understand that in order for these drugs to work, the man has to feel some mental arousal in the first place,” says Althof. “Otherwise, his penis won’t get hard despite his taking the pill.”
What about those instances when a man actually is not turned on by his partner? After all, lack of sexual desire is a common problem – and it can become highlighted when an erection drug is brought into the relationship. "A man's lack of desire for his partner might not have been previously acknowledged because the previous focus was on his having ED, a physiological condition,” says Althof. "But if he starts taking an ED drug and still doesn't respond sexually, then there are clearly other issues in the relationship that need to be addressed."
Indeed, in any troubled relationship, the introduction of an erection drug can focus attention on conflicts that were previously swept under the rug. Dagmar O'Connor, Ph.D., a sex therapist and author of How to Make Love to the Same Person the Rest of Your Life and Still Love It!. (Virgin Publishing, 2003) recalls a male client who, at his wife's urging, started taking Viagra, but soon became resentful. "He said that he felt obligated to 'service' his partner, that he was being used. He stopped taking the drug."
"Couples who have significant marital problems would probably benefit from seeing a therapist before the husband starts on an erection drug,” advises Althof.
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4. Is that all there is?
The hype about erection drugs is that every man who takes one will have a rock-hard erection lasting for hours – but that is not necessarily the reality. Author and psychiatrist Vaughan, who interviewed Viagra users during clinical trials of the drug, reports that "some men said it didn't work the way they wanted it to. They got only a partial erection or lost their erection fairly quickly." In a minority of men, such as those who had nerve damage from prostate surgery, the drug did not work at all. (While Viagra, Levitra, and Cialis are safe and effective for most men, there is still a significant minority who don’t experience any benefit from these drugs or cannot take them for health reasons. For information on other options for treating erectile dysfunction, talk to a physician who specializes in ED.)
To avoid unrealistic expectations and possible disappointment, it is a good idea for a couple to educate themselves about an erection drug before the man starts taking it – including basic information about how the drug works and what sort of results they might expect.
And even if the drug does produce a hard, long-lasting erection, remember - that in itself is not a sexual panacea. As Vaughan sums it up, “There’s a lot more to good sex than mere erectile function.”
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GLOSSARY:
Erectile dysfunction : The chronic inability to get or maintain an erection satisfactory for sexual intercourse. In a majority of men with ED, the condition results from physical causes, usually involving damage to the blood vessels or nervous system.
Cystitis (also known as urinary tract infection, or UTI): An infection that happens anywhere along the urinary tract, including the bladder or urethra (the tube that empties urine from the bladder). Symptoms include painful urination and a frequent urge to urinate. If the infection goes untreated it can spread from bladder to the kidneys, so it is imperative that women with UTI symptoms abstain from intercourse (to avoid worsening the problem) and see a physician as soon as possible.
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