In a world where male sexual performance seems to be the yardstick (excuse the pun) for measuring success, it is easy to see why men suffering with ED might feel a sense of worthlessness. This might help explain the popularity of male enhancement products and the explosive sales growth of this industry. For example, Gamma Pharmaceuticals alone has enjoyed steady sales growth of their Male Enhancement products over the past five years with sales exceeding $4.0 billion in 2011. Not to be overlooked is the parade of advertising in the media for the sale of sexual arousal enhancement products. In this highly sexually charged climate, it is easy to see why men suffering with ED can give way to deep depression.
ED and depression: A growing problem
Data for the National Institutes of Health says that approximately 5% of 40-year-old men and between 15% and 25% of 65-year-old men experience ED on a long-term basis. This number is expected to grow as more men undergo treatment for prostate cancer. This, no doubt, is a contributing factor to the soaring use of antidepressants in this country, although the CDC (Centers for Disease Control and Prevention) found that women overall were 2.5 times more likely to take antidepressants than men. According to IMS Health, a leading provider of information, services and technology for the healthcare industry, sales of antidepressants in the United States alone surpassed $11 billion in 2010. What has also contributed to the increased use of antidepressants is the fact that more and more general practitioners are prescribing antidepressants, a domain previously dominated by psychiatrists.
One ironic twist in ED-related depression is the fact that many of the popular antidepressants on the market (Zoloft, Lexapro, Paxil, and Prozac), can produce “sexual side effects” (ED). If your ED condition is related to prostate cancer surgery, you may want to think twice about treating your depression with drugs if you hope to ever resume normal sexual function. (Caution: If you are currently taking an antidepressant, do not discontinue use without consulting your physician.)
Facing down depression
If you suffer with ED-related depression, one thing that you might want to consider is having meaningful dialogue with your mate about the problem. Sometimes a man’s expectation of his sexual performance is greater than a women’s. Sexual fulfillment for women involves more than the physical act itself. This might help to explain why some men, despite being well endowed, are unable to sexually gratify their mates. Keeping this in mind can help put the problem of ED in the proper perspective—from a women’s view. To help in this matter I consulted Ruth Houston, a leading expert in marital infidelity, to get her view on ED and how it might contribute to marital infidelity. After all, one popular cause for concern among men with ED is fear that their mate might leave them. Commenting on this issue, Ruth Houston had this to say:
“Sexual indiscretion with women is not always linked to the poor sexual performance of their mates. There are number of factors to consider when analyzing the problem of female infidelity and sex accounts for a small percentage of the cases. Women who are in a close and loving relationship are not likely to become unfaithful because their mate developed a ‘sexual handicap.’”
How can meaningful dialogue between husband and wife help relieve ED-related depression? Here is what Ruth Houston had to say on the matter:
“Healthy, meaningful dialogue is how sincere couples address any challenges in the relationship; whether it’s finances, a problem child, buying a home or in this case, ED. I think men underestimate the extent to which a wife will go to preserve and protect the dignity of their husband, even if it means making serious emotional sacrifices. We see this in cases where husbands are injured in war and are unable to resume normal sexual relations and yet both mates enjoy a warm and caring relationship. If on the other hand close, intimate and honest communication is lacking in a marriage, tackling the subject of ED may be to be a real test to the relationship.
”A loving and caring wife will first of all be happy that she didn’t lose her mate to cancer. The last thing on her mind will be his ability to achieve an erection. Her focus at this time will be helping him through the healing process and returning to a normal routine. Perhaps at that time she might be mentally and emotionally ready to discuss any challenges that ED may pose to sexual intimacy.”
Another factor to consider following prostate surgery is a condition called “post-op depression.” This condition was first observed among heart surgery patients but now doctors are finding that post-op depression can occur after any type of surgery. So, it is only natural that a patient might experience some form of depression following a radical prostatectomy. With this in mind, here are a few suggestions that might help:
Find the cause
There are a number of factors that can trigger depression following surgery, these include: pain and physical discomfort, anxiety over mortality issues, being confined to bed, surgical complications or financial concerns. Finding and addressing a cause that might be fueling the depression will help in working toward alleviating those concerns. This is one area where open and honest dialogue with your mate, close family member or friend is essential.
Is it drug related?
Some medications intended to treat pain, inflammation or infection may produce changes in mood as a potential side effect. If this is the case, your doctor may be able to switch the medication or taper the dosage to help relieve the side effects.
Negative, pessimistic thinking is a breeding ground for depression. Positive thinking, on the other hand, can have a healing effect on the spirit. A leading source on human behavior and health has this to say on depression, “A joyful heart is good medicine, but a crushed spirit dries up the bones.”—Proverbs 17:22. Setting specific short term goals during the healing process will help focus the mind on those activities and will promote a more positive outlook of the future.
Don’t isolate yourself
Surrounding yourself with the loving support of close friends and family will prove to be a natural antidote to depression. Their warm and encouraging conversation as well as assistance with household chores and shopping will reduce your stress and anxiety. Caution here is also necessary as you don’t want to overwhelm yourself with well-meaning friends and family you might bombard you with questions so choose wisely.
Resume your routine
As soon as you are physically and mentally able, get back to your normal routine even if you are not able to go back to work immediately. The physical and mental activity will help relieve depression by shifting your attention away from the trauma of surgery and any related quality-of-life issues.
More joy in giving
Even with a nerve-sparing radical prostatectomy, the procedure can result in decreased penile sensation as well as ED. These two factors alone can trigger depression, especially if you enjoyed active and pleasurable sex relations. While there are a number of products on the market that help address these two issues, they are not cures. The challenge here is to find new ways to heighten your sexual enjoyment without focusing solely on your needs. One of the best ways to do this is by focusing on the emotional and sexual needs of your mate. This will help you to become a more compassionate and affectionate lover and will bring you the joy of seeing your mate respond more passionately to your advances. While this might take considerable effort on your part, as it will with some men, it can take your relationship to new heights of sexual intimacy and emotional expression, if you put forth the effort.
Mr. Collins, a cancer survivor, has first-hand experience with surgical prostate cancer treatment, more specifically, laparoscopic radical prostatectomy. A former publisher of the New York edition of Doctor of Dentistry magazine, Henry has completed certificate courses in anatomy, medical terminology, physiology and pathophysiology. He is currently writing a book on prostate cancer and is an advocate of early PSA screening. He can be reached at: firstname.lastname@example.org.