Figuring out how to discuss erectile dysfunction with your partner can be more difficult than the actual condition itself. Although changes in attitude have occurred over the years, it is still difficult for a man to admit to impotence. The impact to his self-esteem is often real and substantial, even in cases when he knows the cause is purely organic and outside his control. But failure to communicate honestly and frankly with one's partner can only make a bad situation worse. It can produce a vicious cycle of both the patient and the partner believing they are unattractive or no longer desired.
Even if the partner discovers that a physical cause underlies the ED, shutting one out from the treatment process injures intimacy. One naturally wants to help and not being part of the process, which inevitably follows or accompanies lack of communication, frustrates that desire.
The consequences to both parties is a deepening of the problem. The only solution is to have the courage and wisdom to be open about the problem. Taking a partner into your confidence eases the difficulty in a number of ways. The most obvious is that it removes any doubt about some possible sources of the problem. Partners who believe they're no longer desired can grow anxious and may seek to terminate the relationship. At minimum, anger and resentment are the most frequent outcomes. Open discussion can head that off before it festers into a larger problem.
In the case when the underlying cause is a disease, it's natural for some men to want to 'be tough', to want to avoid burdening their partner with 'their problem'. But ED is the problem of both parties, even when it affects the patient most directly.
The condition can be the result of more subtle influences, such as anxiety over work, depression from a negative view of one's future or other psychological state. Having a frank talk with the wife, girlfriend or gay lover can keep the problem from being amplified.
Start by getting the best possible medical diagnosis. Ask probing questions about the available treatments, including their potential risks and benefits. Armed with the facts, be willing to share all that information and seek advice from your partner. Having the perspective of a trusted person, one with whom you share intimate moments, can help make erectile dysfunction a relatively minor issue.