Originally created 07/21/98

Can this marriage be saved



"James was impotent on our honeymoon 20 years ago, and we've struggled with this problem, off and on, ever since," says Wendy, 45, a schoolteacher and the mother of a 16-year-old daughter. "All this time, I've rationalized the fact that our sex life has been a continuous disappointment because in so many other ways our marriage was rich," she continues. She and James both adore their daughter and are involved with their families, church and community activities and share a passion for gardening and theater.

Sex, she notes, was never as important to James as it was to her. When they were dating, they would have long discussions about their shared interests, but sex was rarely a part of it. And it was James, not Wendy, who insisted they wait to have sex until they married.

"At best, we've made love barely once a month," she says.

More often than not, James found it impossible to sustain an erection. Making love became such an ordeal, fraught with anxiety and anguish, that James began to avoid her entirely, Wendy claims, staying up to read long after she had gone to bed. They saw two marriage counselors over the years, both of whom assured them that if they worked on other problems in their marriage -- Wendy's tendency to be angry and critical, James' tendency to be sarcastic and pompous -- the sexual problem would take care of itself. "It never did," she says.

What forced Wendy, who was raised in a strict Catholic home, out of her lethargic state was the reappearance of her old college boyfriend, Tim. "Tim has been writing and calling me since we met at a college reunion a few months ago," she says. "I can't believe I'm saying this, but I'm actually thinking of having an affair. I don't want to leave my husband, but I don't want to live without sex, either."

James, 55, an industrial designer who is at least 60 pounds overweight, believes the real problem is simply that he is not a sensual person. "Even as a teen-ager, sex was never a priority in my life," he explains. "And clearly my medical condition -- I've had high blood pressure and diabetes for years -- doesn't help." But James doesn't understand why Wendy is making such a big deal about sex now. "Wendy fell in love with the most important part of me, my intellect," he says.

Discovering options

"Although James and Wendy clearly love each other, a great deal of pain, anger, defensiveness, hurt and fear rages on both sides," says Suki Hanfling, director of the Human Sexuality Clinic at McLean Hospital in Belmont, Mass.

They are divided on the importance of sex in a good marriage. Wendy believes it's vital -- though for years she rationalized her desires and needs to preserve her marriage. James believes it's of scant importance. Before they can move closer together, they have to better understand the reasons for impotency in the first place.

Ignorance about sexual issues and problems is one of the main causes of sexual dysfunction, and impotence is no exception. Experts believe that as many as 20 million men will, at some point, experience impotence. In years past, it was believed that psychological problems -- marital discord, depression, anger and other emotional factors -- were largely responsible. While these factors clearly contribute to the problem, today it's recognized that the vast majority of impotency cases -- urologists now say 80 percent -- are organic in nature. That is, they have a direct medical cause, be it high cholesterol; hypertension, which affects blood flow, as well as the medications used to treat it; diabetes; the natural aging process, which brings a drop in levels of testosterone (the hormone responsible for triggering sexual desire); a host of other medications, including sleeping pills and tranquilizers; and, in a small percentage of cases, prostate cancer. Still, studies have shown that fewer than 5 percent of sufferers ever seek treatment.

Most men, like James, are too ashamed to talk about it. Others assume it is a normal part of the aging process, which is not true. Needless to say, their reluctance dramatically increases the problem and further erodes intimacy.

If impotency threatens to destroy your relationship, keep the following points in mind:

-- Force yourself to look at the problem realistically. Impotence is much more common than most people realize. Both Wendy and James were under the impression that everyone else was having problem-free sex all the time.

-- Don't be afraid to discuss the problem with others. Experts stress that impotence is a couple's problem. Not talking about your mutual concerns may well cause conflict in other areas of your relationship.

Wendy alternated between blaming herself and blaming James, picking fights -- often right before bed -- that saved him from the humiliation of attempting sexual intercourse and then failing.

Consider the emotional baggage from your past that may be making your problem worse. Wendy had come to believe that there was something innately sinful about enjoying sex. Like countless women, she spent years rationalizing away her sexual appetite and burying her desires out of guilt and fear of losing a marriage that "was 95 percent terrific."

James, on the other hand, hid his feelings of inadequacy behind a wall of words, aware of his physical interests and achievements to compensate for his self-consciousness about his body. His self-image needed a good deal of polishing.

Investigate new treatment options. A qualified sex therapist or physician who specializes in erectile dysfunction can demystify the problem, explain the many options available and help you choose what works best for you.

Because he has to give himself insulin injections daily, James wasn't comfortable with the idea of another injection for impotence (marketed under the brand name Caverject), although this option works for many men. One he is considering: the vacuum pump, which is placed over the penis and attached to a hand pump, can help men achieve an erection for about 30 minutes.

On the horizon: a plunger-like device, which places a drug directly into the urethral opening, triggering a 60-minute erection within minutes. Called the MUSE, this system has proved particularly effective for diabetics, 60 percent of whom experience erectile problems.

For more information, talk with one of the many impotence support groups nationwide (check your Yellow Pages), Impotence Anonymous and I-Anon (for wives), the Impotence World Institute at (800) 669-1603.

By the editors of Ladies' Home Journal