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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4471
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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How do I get my husband to see a doctor about his erectile

Customer Question

How do I get my husband to see a doctor about his erectile dysfunction? And is the excuse of use it or lose it true?
Submitted: 9 months ago.
Category: Mental Health
Expert:  Dr. Z replied 9 months ago.

Dr. Z :

Hello

Dr. Z :

I believe I can help you with your concerns about your husband

Dr. Z :

I am so sorry that your husband has been exhibiting symptoms of Erectile Dysfunction (ED), I can imagine how distressing this must be for him and for you

Dr. Z :

Most men are embarrassed by this condition, so that is one why he may not want to go and see a medical doctor. Also because of the prostate cancer issue you mentioned to me, he may also be scared as well if this is a serious condition

Dr. Z :

May I ask, what reasons does he give for not going to a medical doctor about this?

Customer:

He said that he just couldn't deal with it right now. I have been having health issues with numerous things, one is vaginal atrophy. Which had interrupted our sex life on and off. I have gotten to point that it is no longer painful. He is giving me the excuse of use it or lose it and is at least partially blaming me. He has always had a high sex drive and I find it difficult to believe him when he is also saying that he just doesn't really want it anymore.

Dr. Z :

It is possible that his causes for ED may be caused by a psychological reason, like frustration and depression, but it is important to go to a Urologist to rule out any organic causes first. Here a few organic causes for ED that can cause this.

Dr. Z :

Diabetes to be ruled out by getting fasting and post-prandial blood sugar and also Hb1AC. Diabetes can not only lead to erection failure but also it can lead to lack of sensation and stimulation which often precedes erection.

Dr. Z :

Blood pressure needs to be checked on 3 consecutive days in 3 different positions (standing, sitting upright and lying down) to rule out hypertension (increased blood pressure).

Dr. Z :

Blood vessels in the penile region need to be evaluated for presence of patent pathway for the blood to pass onto the penis because often what happens is that due to narrowing of these blood vessels or clogging of them by atherosclerotic plaque the blood cannot flow through their lumen properly thereby leading to poor pooling of blood in the penile region thereby leading to lack of erection. This can be tested by use of penile doppler ultrasonography which he can seek from a urologist.

Dr. Z :

Prostrate needs to be physically examined by the urologist and investigated for it's enlargement or any other organic pathology this can be a cause for erection problem.

Dr. Z :

If he uses alcohol and smokes then he needs to curb these since they are highly associated with erection problem.

Dr. Z :

Please see the link below for more information on various organic/ physical causes that lead to ED.

Dr. Z :

Now if these are all ruled out, then his cause most likely is psychological and I would suggest going to a sex therapist to help bring back the intimacy in your lives.

Customer:

He doesn't smoke, but I do. Could that be a factor? He is a minimal drinker. He used to be on high blood pressure medicine, but has not needed it in over a year. He absolutely refuses to go to a counselor of any kind. He said that if we needed that then to him it is over. I already knew the type of problems that could cause the condition. What I need help with right now is how to convince him to go to the doctor.

Dr. Z :

No you smoking is most likely not a factor at all. Well he blames you for this which is most likely a self-defense type mechanism to protect his fragile ego. You can make a compromise with him that you will go to a doctor to see if you can sexual intercourse more pleasurable again in spite of your medical issues if he agrees to go to a doctor for his issues. At least you both may be able to get some information for yourselves

Dr. Z :

While I know it is no longer painful having sexual intercourse with him, he may still be blaming you for the interruption unfortunately

Customer:

I have already been working with a doctor for 2 years and my problem is under control. I tried to tell him that I would go with him and that didn't change his mind. I don't know what else I can do to get him to go. He did have me get him cialis but he won't use it.

Dr. Z :

Really? I think that he may have a medical problem like I mentioned above, but I am leaning to this being a psychological issue because of his resentment and resistance. Have you considered seeing a therapist on your own? Many times the spouse who is resistant will see this and then will notice a change in your behavior from the therapy and will be curious about what goes on during the sessions and will ask to join

Dr. Z :

This is one option. The other is giving him an ultimatum and saying that you will not be physically intimate with him unless he sees a doctor about his issues. This is more demanding and may harbor more resistance, but it is usually effective

Customer:

I saw a therapist about 11 years ago and all it did was make things worse. He said that I should be able to talk to him and not need anyone else's advice. He told me last night that he is fine not having sex and that if I needed that I should either seek out other avenues or leave him. We have been together for 26 years and I'm still very deeply in love with him. We've had our problems but never anything to do with intimacy. I feel like I'm losing him, my marriage, and my mind.

Dr. Z :

Well this is not your fault at all, this is his issues, but since he is refusing to seek help and he cannot be forced then your options are limited. Another option is to have a close friend, someone he looks up to, talk to him about these issues and help him see that going to a doctor is a good preventive medicine for this and that a medical problem is no one's fault.

Dr. Z :

Also I would like to recommend this book because I think he has psychological issues that he is repressing and this book has great techniques on how to interact with someone who is in denial like this

Dr. Z :

Would he be open to self-help therapy that you both can do together?

Dr. Z :

Or is he against all forms of therapy?

Customer:

I've thought about having someone else talk to him. He is private to an extreme and would only resent me more for talking about this with someone else. He can be very stubborn and unreasonable with a lot things and I don't want it to get to that point with this issue.

Dr. Z :

Here are a few techniques that I use with resistant patients with similar issues to help them see all options and be more objective about things too

Customer:

He is against all forms of therapy. Our son is suffering with severe depression right now and I'm currently trying to set up to have him evaluated again. He has seen a number of therapists and it hasn't helped. My husband has told me that he can't help with this because he doesn't really believe that it will help. And yes, I have so much going on right now in my life that I feel like I'm at my breaking point. I have always been strong, but I am not sure how to deal with any of this.

Dr. Z :

I am so sorry, that your son is going through this severe depression, I can imagine it hurts you to see him this way. Your husband is definitely not making your life easier and is actually not be very supportive of your or your son by his attitude towards therapy. At one point you may have to decide that you are better off just taking care of yourself and not being in a hostile environment that hurts you more and adds to your stress.

Dr. Z :

If he is not motivated to change and is so set on not going to a doctor or therapist, then there is not much anyone can do unfortunately

Dr. Z :

Usually the logic and objective exercises help for him to see the bigger picture, but he may be against those too

Customer:

I don't feel that leaving is an option. I love him and I know that it would make things worse for our son. I can't even tell him everything that is going on with our son because I know how he'd react. Like my son telling me last February that he was confused and was thinking about a sex change. I don't even know how to deal with that. Are the logic and objective exercises in the links you gave me?

Dr. Z :

Yes they are in the links I gave you and if your husband is willing, you can work with him on those, but that may be a long shot. I understand that leaving may not be an option, but I do not see things changing unless he changes his attitude about therapy and communicating more effectively with you too

Dr. Z :

This is also a really good book to help communicate better with him and to interact with him. It contains a lot of the same logic/objective principles too

Customer:

I know, I just don't know how to keep bringing this up without it causing more problems or him thinking that I'm nagging and not understanding.

Dr. Z :

Bringing it up will be hard and no matter how you do it, it may cause problems, this is why he must be open to this type of therapy for thinking objectively

Dr. Z :

Still you can use the exercises for yourself to improve your situation and your internal issues too that your husband is causing you

Customer:

I have tried buying new lingerie, to be more playful, to talk and do more things with him that he likes, all to reconnect. It hasn't gotten me anywhere. I'm feeling unloved, undesirable, and unattractive and have told him that too because he thought that everything I was doing was because I was having an affair or just ended one and wanted him again. At least that is what he told me last night.

Customer:

I have never and would never have an affair. I don't know how to get that through to him either.

Dr. Z :

He is fixed on this idea of you having an affair to blame you for his ED and other internal issues, this is called deflection and rationalization. I do not think you will be able to change his behavior by yourself, I think only Cognitive Behavioral Therapy (CBT) will do that for him, but he is unwilling to get help

Dr. Z :

His belief may be so strong that it caused a delusion of this affair as well

Customer:

I've told him that I rarely even leave the house and when I do he knows where I am and can get me on my cell. He said that that didn't convince him. That I could be having an affair anyway. I even told him that I wouldn't be so worried about him, our sex life, or our marriage if that was going on. So the botXXXXX XXXXXne is that I'm just going to have to live with this, since he won't see a therapist. His parents are both gone now or they would be trying to help as they did before. I tried talking to his sister and he accused me of trying to cause a rift in his family and turn them against me. Everything I've tried has been out of love but he doesn't see it that way. He'd be furious if he knew I was doing this. I'm rarely alone and have virtually no privacy, yet I have never felt so alone before in my life. If that makes any sense.

Dr. Z :

It does, you feel emotionally alone and isolated even though there are people around, this is a sign of depression and stress. I am so sorry that you are dealing with this. You can try reading that book "Im not Sick" and it may help you, but ultimately I think he will never seek help unless forced to. I think you will either have to live with this behavior, which I do not recommend, or you will have to leave him, even for just a trial separation to show him that you are serious that his behavior is a serious issue and he needs help because right now he has no insight on his behavior.

Customer:

Sometimes I wish I could just leave. I have no job because of my health problems and have not worked enough in the last 10 years to get social security disability. I'm sorry for turning this around and making it about me, but I feel trapped. I don't feel like there is anything I can do right for him or my son. I have nowhere and nobody to turn to. He has always been my best friend and now I feel like I don't even have that anymore.

Dr. Z :

Its okay, we can talk about anything. I know that you feel very trapped and I am so sorry. There are support groups that may be able to help you. I would like to give you this hotline that may be able to get you some referrals and resources that you can use.

Dr. Z :

For your son, you can use these books filled with techniques to help him

Dr. Z :

Are you still there?

Customer:

Sorry for the delay, on top of everything else I just got a call from my mother and a knot she has on the back of her leg came back as really bad cancer. They are doing surgery in the morning. Thank you for the links I will try to get both of them to look at them. As far as I go, at this point I'm so overwhelmed, devastated, and truly hurt that I don't think anything will help me. I think unfortunately that there isn't going to be a happy ending for me no matter what I do. Thank you for your time.

Dr. Z :

I am so sorry, I hope that there is a happy ending for you and that your husband sees that he needs treatment to help himself and you as well. I wish you and your entire family all my best and I hope that everything works out well for you. These techniques are very effective and can work, when given the chance. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime.

Customer:

Thank you for trying to help.

Dr. Z :

Is there anything else I can assist you with today?

Customer:

I just told him that I wasn't up to going to my women's meeting tonight because I can't go 10 minutes without crying. He said that I needed to give it rest and stop making such a big deal about it. That I'm just making it worse. I told him that it wasn't just that, that is was our son and now the news that I got from my mother. He couldn't even say sorry. Am I making a bigger deal about his problem than I should? I'm trying not to but I'm not a man. I feel like the fact the he can't make love to me and doesn't seem to care is a big deal.

Dr. Z :

No you are not exaggerating these issues at all. I think your concerns are legitimate and all these issues are combining and overwhelming you. Eventually you this will lead you to the breaking point I am afraid because your husband is not being supportive at all for you and making things worse.

Customer:

I'm already at my breaking point and I have nowhere to go from here.

Dr. Z :

I know, I am so sorry. Try the books and see if they help you, but I am afraid that without therapy your husband's non caring behavior will continue with you

Customer:

I know that it will because he doesn't believe that there is anything wrong with him that he needs help for, in his eyes I've always been the problem. When he can't find anything legitimate to blame things on with me, he blames my smoking. My son will be home soon now and I will have to listen to him talk about his problems, not knowing what to say or how to help other than getting an evaluation set up which I'm already doing. I hope that doesn't sound awful or insensitive, I care very much about helping him. I just don't think I can take anymore right now.

Dr. Z :

It is not insensitive, I think you are just very tired and exhausted. I hope the techniques help and that your son can get a good evaluation for himself and his wellbeing.

Customer:

Thank you for listening.

Dr. Z :

Anytime, I am always happy to help and listen to you. If you have any other questions or just want to chat, I am always here for you

Customer:

Thank you

Dr. Z :

You are most welcome :)

Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 4471
Experience: Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
Dr. Z and other Mental Health Specialists are ready to help you
Expert:  Dr. Z replied 9 months ago.
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Customer: replied 9 months ago.

I'm sorry to bother you again, but the situation with my son has become even worse and I need help. He has not only created a bad situation for himself, but could have caused a huge problem for me now as well.

Expert:  Dr. Z replied 9 months ago.
You are not bothering me at all, I am so sorry to hear about your son, please tell me what is going on with your son, so that I can better help you.
Customer: replied 9 months ago.

I took him for the evaluation with the psychiatrist yesterday. The doctor treated him from the time he walked in as if he was just a drug seeker. I'm not happy about that since my son made it clear that he wanted evaluated and sent to a therapist that could help him with his problems. My son got the impression that he was not going to help and in desperation he lied to him and told him that he had been taking vicodin (that I had been giving him) to help with pain from a broken tooth. He thought that hearing this would make the doctor see that he needed help now. I want to stress that I have not and would not give him my vicodin. I counted them when I got home and it does not appear that any are missing. The doctor told him he would have to let our doctor know this was going on and that he could not give him an evaluation or help him under these circumstances. I have legitimate health problems and cannot go without my medication. Although I have downplayed the seriousness of the situation he has created for me, I really am scared and do not know what to do. On top of that, my son had another really bad breakdown last night and I fear he is even closer to a nervous breakdown or worse than before. Once again we all feel let down by people in this profession as far as my son goes. The only good thing that came out of it is my husband has now seen how bad off our son is and just what I have been dealing with and is on board completely as far as needing to get our son help. I know my son is not going to feel any better until he knows that I will not be in any trouble, and I am highly concerned about this too.

Expert:  Dr. Z replied 9 months ago.
I am so sorry to hear about this. It definitely sounds like your son's psychiatrist that evaluated him, was not very well qualified and did not appear apt to help him unfortunately. Most likely you will not get in trouble for what he said, especially if he recants too. Your doctor knows your situation and knows that you need the medication, so you should be fine there. Well I do remember when we talked about your son the last time we chatted and he was open to therapy and treatment, so that is a positive aspect and it is unfortunate that this psychiatrist may have turned him off of that. So I would suggest going to a Psychologist, someone with Ph.D. or Psy.D. by their name, as these mental health professionals are best to do evaluations, and if he wants a thorough evaluation with objective evidence, then he would need an Assessment Psychologist or one that specializes in Testing and Evaluation. If you like I can find a few in your area, I would just need your zip code. These types of psychologists will give the best kind of evaluation for your son to narrow down his diagnosis appropriately and then your son can approach psychological/therapy treatment from there.

If a psychiatrist will not help at this time, I do recommend that your son needs medication, so he can go to general practitioner and ask for an antidepressant. I would recommend escitalopram at 10-20mg because this is a very effective SSRI antidepressant that works fast and has less side effects too.


I think this would be the best approach for your son at this time. I am so sorry that you are having these issues with mental health professionals currently, but I agree that your son needs to get a good firm diagnosis from objective evidence through the use of psychological assessments, then he can approach treatment which should include therapy and medication. I hope this helps you and gives you guidance. If you have any other questions or concerns please feel free to contact me at anytime
Customer: replied 9 months ago.

Our zip code is 26062. We did see a physician, not our normal one, but at the same office on Oct. 4. He recommended viibryd and my son told him that he would rather try to deal with this through therapy first, then if necessary he would consider medication. He almost had a nervous breakdown last night. My mother even came over to try to help because we were so scared that he may hurt himself. He said he wouldn't only because he knew what that would do to the family, especially me. He seems to be doing a little better today, but I have seen that these breakdowns are becoming more and more common. I would appreciate any help you can give me in finding someone that can help him. Don't forget what he said to me about the sex change issue too. I really feel that he has felt so bad for so long that he is just searching for any change that would help him feel better and that he doesn't really mean that. However, I know it cannot be ignored either. He also just let me know this morning that the psychiatrist he saw yesterday wanted to get a drug test and he just left because the doctor told him he couldn't or wouldn't help him right now. Should I offer for him to do this, and would that help the situation?

Expert:  Dr. Z replied 9 months ago.
I think the Viibryd is a very good medication and I understand that your son wants to deal with this through therapy first, but therapy is a gradual approach and does take time to be effective, while the medication will give him temporary relief. Also the medication can be weaned off later as his therapy becomes more ingrained and as he becomes more mentally stable and stronger. I think with his sex change issue, he should talk to a therapist before making any decisions, so that he is given time to think about it and make the best decision for him, not make a decision as a response to his depression. Well this psychiatrist seems very unethical and judgmental, so i am not sure if your son would get a lot of help from this psychiatrist unfortunately. You can try to do to the drug test and then get prescribed ant-depressant medications, but other than that I see no value in this psychiatrist in helping your son. I definitely would not trust this psychiatrist to use therapy with your son.

So I only found one assessment psychologist in your area that will use objective assessments to give a firm diagnosis for your son. Now you can also choose to go to this psychologist for therapy, but this psychologist will give the best evaluation for your son that is very thorough.

http://therapists.psychologytoday.com/rms/prof_detail.php?profid=112518&sid=1381852931.9103_7766&zipcode=26062&zipdist=20&spec=303&tr=ResultsRow&trow=1&ttot=13

I hope this helps you and your son. If you have any questions or concerns, please feel free to contact me at anytime.

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