The Development of ED Part 2
Exacerbating factors are conditions that follow the onset of the ED and increase the likelihood that isolated occasions of erection difficulty generalize into a persistent period of ED. These are typically the individual’s and the partner’s response to the lack of an erection at times it is expected. Performance anxiety is the most common response on the part of the man that causes an exacerbation of normal fluctuations in erectile response. This is commonly seen in men who are predisposed to performance anxiety due to an underlying personality trait, unrealistic expectations of their own sexual response or feelings of sexual inadequacy. Even one occasion of less than optimal erectile response can quickly mushroom into persistent ED because performance anxiety then interferes in subsequent sexual situations.
The partner’s response to the onset of an erection problem is also crucial. If the partner responds in a relaxed and supportive fashion, the man is less likely to develop performance anxiety. Occasional lapses in erections are overlooked and the couple is able to continue to enjoy the sexual relationship. However, if the partner reacts negatively to the onset of an erection problem, the man will be at greater risk of escalating frequency of ED. Most often the origin of the partner’s overreaction is her or his own fear of the meaning of the sexual problem. Most partners, at first, worry that the cause of the lapsed erection is the man’s lack of attraction or affection for them. If she or he is already feeling insecure about herself or himself or the relationship, this may manifest as anxiety and/or anger at the man, which may then exacerbate his anxiety and the ED.