I have treated many men over the years who have suffered from (ED). A small number were simply in need of : they put pressure on themselves to perform under trying circumstances, or they expected too much given their age. Others were diagnosed by urologists as having an organic problem: a blockage of blood flow or an interfering disease such as diabetes. And some were rooted in relationship issues such as control struggles or a lack of physical . Prior to the availability of ED medications such as Viagra, most of these men were treated with behavioral individual or couple’s that included take-home exercises. The primary objective was to help reduce the client’s self-focus and performance , and to help him to refocus on the pleasure of intercourse. While the discovery of ED has been a relationship-saver for millions of couples, many men—and their partners—refuse to use these drugs. The following are 5 reasons men (and their partners) avoid taking advantage of these medications. These reasons may be employed consciously or unconsciously.

1. Shame and : Given the long-standing correlation between a man’s penis and his it is no wonder many men are too embarrassed to admit to themselves and others that they have an erection problem. Even when told medication may end their suffering the mere need for, and use of it bothers many men. Unfortunately, this attitude only brings increased failure and shame.

2. Negative Side Effects: This can be a legitimate excuse given that some of these medications cause aggravating sinus issues, headaches, heartburn, and vision problems. Those with heart problems will need to consult their cardiologists for options. Nevertheless, many men balk at even the slightest side effect to avoid having with their partners.

3. Lack of Effectiveness: Some men claim that the medications do not work for them. However, I have found that many of these individuals failed to take the medications as directed by physicians. For example, most ED drugs require a man to take them at least an hour before attempting intercourse. But many men lose track of time or are too impatient to wait the required time before having sex; some unconsciously sabotage their success.

4. and Retaliation: One way a man can retaliate against his partner if he is angry or upset is to convey the message that he is no longer interested in, or turned on by the partner. Oftentimes these men are and refuse to connect their anger, impotency, and refusal to improve their sexual functioning, even if the clinician points it out. The anger and desire for enables these individuals to misuse the medications or to avoid a medical evaluation.

5. Lack of Sexual Attraction: These medications are not meant to increase a man’s sexual desire—some libido and attraction for the partner is usually needed for the drugs to be effective. Many men will not admit that they lack attraction for their mates and continue to keep their lack of functioning a mystery. Non-symptomatic partners often enable the problem by discouraging the use of ED drugs. Many of these individuals claim, despite the scientific evidence, that if their partners need to take drugs to achieve an erection, they are not sexually attracted to them. “It just isn’t natural. If he really finds me attractive he wouldn’t need the help of a chemical,” a wife said.

I am sure there are more reasons men and their partners avoid using ED medications, but I will defer to my readers to bring them up and discuss. One thing most sex therapists are certain of: “Use it or lose it.”