Medical Explainer

What Shubh Mangal Saavdhan gets wrong about erectile dysfunction

Erectile dysfunction may be caused by psychological factors like stress but also physiological factors like bad cardiovascular health.

The movie Shubh Mangal Saavdhan is about a real and common couple’s problem – erectile dysfunction. But, as a couples counselor, I do not know if I should celebrate the movie or not. The story offers a dated perspective of the problem and no realistic solutions. In fact, it cannot even bring itself to name the impairment.

Here are four important facts that Shubh Mangal Saavdhan gets wrong or minimises.

First, erectile dysfunction, defined as a consistent inability to achieve or maintain a penile erection sufficient for satisfactory sexual intercourse, occurs in as many as 50-70% men between the ages of 40 and 79. The rate among men under 40 years is lower but not insignificant at between 3% and 9%. So men, like the movie’s protagonist Mudit, are hardly an exception.

Second, Shubh Mangal Saavdhan makes it seem like erectile dysfunction is caused by mysterious and mostly psychological factors. This is a dated and inaccurate assumption. In addition to important psychological causes like stress, erectile dysfunction has a large physiological component, which should not be ignored. Erectile dysfunction has been shown to predict cardiovascular diseases – it is even considered to be an early sign and a reason to get tested for such diseases. Doctors, therefore, recommend that men with erectile dysfunction go to a general physician or a specialist and get examined for cardiovascular diseases and other risks.

Third, the movie seems to imply, that if you have erectile dysfunction, you and your partner are doomed to a life of sexual frustration and celibacy, until there is a spontaneous resolution of the problem. But erectile dysfunction is actually treatable. There are pharmaceutical options that you can and should explore with your physician. Studies have also shown that improving physical health – by increasing one’s level of physical activity, for instance – can also help resolve erectile dysfunction. Any attempt to increase one’s level of physical activity, however, should be cleared by a doctor.

Finally, dynamics between couples can contribute to causing and maintaining erectile dysfunction. Often, erectile dysfunction is a symptom of a bigger relationship problems like conflict and lack of intimacy. Once erectile dysfunction occurs, it reciprocally and negatively impacts both partners. In one endearing scene, the movie’s female lead Sugandha tries to up the level of sexual excitement in the relationship by imitating a scene from a porn film. This is something the movie gets right. ED can contribute to feelings of anxiety, failure, low self-esteem and a lowering of sexual confidence and sexual satisfaction, often, in both partners. Couples also tend to reduce the frequency of their sexual activities, which further reduces their feelings of intimacy in the relationship. So, talking honestly to one’s partner about what is going on, seeking out trusted friends and family members, especially those that may have gone through something similar and seeking couples counseling are all valid solutions.

What can you do?

Men with erectile dysfunction and their partners can expand their sexual repertoire in the relationship. This is not novel advice, but it bears repeating – sex involves more than just penetration. Developing a curious and playful attitude towards sex helps reduce the feelings of disappointment, pressure and failure that get associated with intercourse. For instance, touching each other – not as prelude to intercourse but just because – is a good place to start. It can be the beginning of developing a flexible and expansive couples’ style for intimacy. Exploring oral sex is another avenue for expanding one’s sexual repertoire and can be immensely satisfying.

Experiencing ED can be an isolating experience which can eat away at partners’ confidence, self-esteem and hope for the relationship. It is important to read about and understand ED to identify appropriate solutions.

Partners of men with ED can remind themselves that “it is not about me”. It is important for partners to know that men’s ability to achieve or sustain an erection is not a direct function of their level of attractiveness or adequacy. Worries like “am I not sexy enough?”, “am I not good enough?” or “what am I doing wrong?” although common, only adds pressure and is unpleasant for both partners, and the resolution of erectile dysfunction much less likely.

The writer has a PhD in Couples and Family Therapy and practices as a couples therapist in Mumbai.

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