The role of the sexual partner in managing erectile dysfunction
Abstract
Erectile dysfunction (ED) has detrimental social and psychological effects on the quality of life of affected individuals and their sexual partners. When medical intervention is introduced to treat ED, physicians, nurses, and clinical educators should consider this disorder as a shared health problem for the men with ED and their sexual partners. New therapeutics such as phosphodiesterase-5 inhibitors improve erectile function in affected men, and the ultimate goal of medical intervention for ED should be achievement of a satisfactory sex life for couples engaged sexual relationships. Sexual partners of men with ED have an important role in its management and improvement in quality of sex life; therefore, they should be involved in assessment of, diagnosis, education, counselling, and choice of therapy. This sexual- partner-engaged approach might assist treatment and rehabilitation, helping the couples affected by ED to achieve a high-quality sex life.
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Difficulties to openly talk about sex and communicate about likes and dislikes may further increase negative sexual experiences.
“Difficulties to openly talk about sex and communicate about likes and dislikes may further increase the negative sexual experiences.54,56, 57, 58, 59, 60”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [54]
Female partners of men with ED more frequently report sexual problems as well as reduced quality of their sex life due to lower levels of intimacy and foreplay.
“Accordingly, evidence has shown that female partners of men with ED more frequently report sexual problems52 as well as reduced quality of their sex life due to lower levels of intimacy and foreplay.53,54”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [54]
Including the partner in ED treatment promotes treatment adherence, increases treatment success, and targets the partner's own psychological and sexual problems and distress.
“Statement #16: It is recommended to include the partner in ED treatment to promote treatment adherence, increase treatment success, and to target the partner's own psychological and sexual problems and distress (Level 2, Grade B).”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [54]
Positive involvement of the partner helps solve the problem and adhere to treatment.
“Both partners suffer from the problem, and it has been shown that positive involvement of the partner helps to solve the problem and adhere to treatment.49,52,54,99”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [54]
ED may cause partners to feel sexually unattractive, induce feelings of guilt and rejection, generate relational distress, and interfere with their own sexual function.
“Furthermore, sexual partners may need counselling too because the ED may cause them to feel sexually unattractive, induce feelings of guilt and rejection, generate relational distress, and interfere with their own sexual function.14,54,55”
From A Psychosocial Approach to Erectile Dysfunction: Position Statements from the European Society of Sexual Medicine (ESSM) (2021) · cites this paper as [54]
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“Here, partners’ needs have to be taken into account (Li et al., 2016).”
BackgroundInfluentialThe impact of menopause on sexual function in women and their spouses
Khalesi, Z. B., Jafarzadeh-Kenarsari, F., Donyaei‐Mobarrez, Y., & Abedinzade, M. (2020) · African Health Sciences · doi:10.4314/ahs.v20i4.56 · Cited by 36 · see citing works
Predictors of Patient and Partner Satisfaction Following Radical Prostatectomy
Guercio, C., & Mehta, A. (2017) · Sexual Medicine Reviews · doi:10.1016/j.sxmr.2017.08.005 · Cited by 34 · see citing works
“Partner involvement in the evaluation and treatment of ED results in increased adherence to ED rehabilitation and treatment, improved sexual function, and better relationship satisfaction for both the patient and the partner (8).”
BackgroundAnastasiadis, E., Ahmed, R., Khoja, A. K., & Yap, T. (2022) · Frontiers in Reproductive Health · doi:10.3389/frph.2022.944765 · Cited by 34 · see citing works
“Partners of ED patients are significantly impacted due to relationship difficulties and sexual dissatisfaction (12, 13).”
BackgroundPractical Approaches to Treat ED in PDE5i Nonresponders
Cai, Z., Song, X., Zhang, J., Yang, B., & Li, H. (2020) · Aging and Disease · doi:10.14336/ad.2019.1028 · Cited by 29 · see citing works
“Indeed, the high prevalence of ED has become a global health concern [3].”
BackgroundInfluentialThe Efficacy of Acupuncture on Patients with Erectile Dysfunction: A Review
Wang, H., Zhao, M., Zhang, J., Yan, B., Liu, S., Zhao, F., Guo, J., & Wang, F. (2022) · Evidence-based Complementary and Alternative Medicine · doi:10.1155/2022/4807271 · Cited by 21 · see citing works
“,erefore, the role of the female partners in the diagnosis and treatment of ED cannot be ignored [46].”
BackgroundSexual function and sexual quality of life in men with genital warts: a cross-sectional study
Nia, M. H., Rahmanian, F., Ghahartars, M., & Janghorban, R. (2022) · Reproductive Health · doi:10.1186/s12978-022-01403-z · Cited by 21 · see citing works
Karlsen, R. V., Bidstrup, P. E., Giraldi, A. G. E., Hvarness, H., Bagi, P., Lauridsen, S. V., Albieri, V., Frederiksen, M., Krause, E. G., Due, U., et al. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2021.100350 · Cited by 18 · see citing works
“The strengths of this study include early recruitment of patients treated for PC with surgery only, and the inclusion of female partners, which has been shown to be an important factor for increasing use of and adherence to treatment for ED.(18,22,36) The intervention was manualized and based on a solid theoretical fr…”
MethodInfluentialA Preliminary Report on Quality of Life and Sexual Function in Brain Tumor Patients
Boccia, M. L., Anyanda, E., & Fonkem, E. (2021) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2021.01.171 · Cited by 17 · see citing works
Bilal, A., & Abbasi, N. U. H. (2021) · Sexual Medicine · doi:10.1016/j.esxm.2021.100464 · Cited by 17 · see citing works
de Souza, D. B., Silva, M. H. A. D., Costa, W., & Sampaio, F. B. (2018) · Asian Journal of Andrology · doi:10.4103/aja.aja_28_18 · Cited by 16 · see citing works
Kiserud, C. E., Dahl, A. A., & Fosså, S. D. (2017) · Recent results in cancer research/Recent Results in Cancer Research · doi:10.1007/978-3-319-64310-6_8 · Cited by 14 · see citing works
Global research trends in sexual health care: A bibliometric and visualized study
Fu, Y., Zhao, J., Zhang, W., Du, H., Cao, Z., & Chen, X. (2023) · Journal of Clinical Nursing · doi:10.1111/jocn.16915 · Cited by 12 · see citing works
Ma, J., Chen, Y., Si, Y., Qian, J., Wang, C., Jin, J., & He, Q. (2024) · Frontiers in Endocrinology · doi:10.3389/fendo.2024.1460033 · Cited by 11 · see citing works
Effect of estradiol on penile erection: a cross-sectional study
Xu, Z., Xu, X.-H., Pan, D., Liu, T., Yuan, M., Jiang, S., Guan, Y. S., & Zhao, S. (2019) · Translational Andrology and Urology · doi:10.21037/tau.2019.10.15 · Cited by 11 · see citing works
“ED has biological, psychological, and social effects on the quality of life of men and their sexual partners (4).”
BackgroundMaintenance of sexual activity following androgen deprivation in males
Duthie, C. J., Calich, H. J., Rapsey, C. M., & Wibowo, E. (2020) · Critical Reviews in Oncology/Hematology · doi:10.1016/j.critrevonc.2020.103064 · Cited by 11 · see citing works
Introducing sexual dysfunction in mental care
Gombert, M., Ballester, P., Segura, A., & Peiró, A. M. (2020) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2020.1849135 · Cited by 9 · see citing works
“role and should be involved throughout all therapeutic procedures, all the more so in situational SD where couple friction due to problems in handling mental health issues may cause conflict and anger and lead to low sexual desire [61,62].”
BackgroundSexual Health After Cancer Therapy
Higano, C. S., Zarowski, C., Wassersug, R. J., & Elliott, S. (2016) · Journal of Oncology Practice · doi:10.1200/jop.2016.011536 · Cited by 9 · see citing works
“An excellent review that underscores the role of the sexual partner in managing ED of any cause was recently published and is applicable to patients with cancer as well.(4) The review by Voznesensky et al(3) assumes that the goal of treatment of ED is the return of erectile function and ability to have coital sex.”
MethodAcupuncture for erectile dysfunction: Insights and future research directions
Simões, K., & Rodrigues, J. M. (2023) · Revista Internacional de Acupuntura · doi:10.1016/j.acu.2023.100269 · Cited by 6 · see citing works
Ghantous, I., Tlais, M., Khatib, A., Ghantous, G., Sahyoun, M., Hteit, A., Tarchichi, A., Maroun, G., Jaber, N., & Challita, A. (2025) · Cureus · doi:10.7759/cureus.95891 · Cited by 5 · see citing works
“Left untreated, ED can have adverse effects on the quality of life of both the men affected by ED and their female partners [3].”
Zhang, X., Zhu, Z., & Tang, G. (2024) · International Journal of Impotence Research · doi:10.1038/s41443-024-00855-0 · Cited by 5 · see citing works
“It should be noted that it is recommended that ED be evaluated using the IIEF-5 questionnaire.”
Importance of Addressing the Psychosocial Impact of Penile Cancer on Patients and Their Families
Paster, I. C., & Chipollini, J. J. (2022) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2022.151286 · Cited by 5 · see citing works
Gao, J., Zhang, Y., Li, H., Gao, P., & Zhang, X. (2020) · BioMed Research International · doi:10.1155/2020/2302348 · Cited by 5 · see citing works
“ED has biological, psychological, and social effects on the patients and their sexual partners [6].”
BackgroundInfluentialZhang, J., Han, T., Cai, Z., Wang, Y., Shang, X., Yang, B., & Li, H. (2020) · American Journal of Men s Health · doi:10.1177/1557988320975529 · Cited by 5 · see citing works
“Sexual dysfunction, including erectile dysfunction and PE, may be related to the female sexual partner; thus, the shared decision-making by the physician, the patient himself, and his sexual partner is critical for better treatment and prognosis (Burnett et al., 2018; Li et al., 2016).”
BackgroundErectile Dysfunction Symptoms in Polydrug Dependents Seeking Treatment
Clemente, J., Diehl, A., Santana, P. R. O. H., da Silva, C. J., Pillon, S. C., & Mari, J. D. J. (2017) · Substance Use & Misuse · doi:10.1080/10826084.2017.1290114 · Cited by 5 · see citing works
Fu, F., Duthie, C. J., Wibowo, E., Wassersug, R. J., & Walker, L. M. (2022) · Sexual Medicine · doi:10.1016/j.esxm.2022.100559 · Cited by 4 · see citing works
“ED may distress not just patients but their sexual partners, contributing to relational strain and reducing the quality of life for both.(6)”
BackgroundQuintana, G. R., Ponce, F. P., Escudero‐Pastén, J., Santibáñez-Palma, J. F., Aguayo-Zuñiga, C. P., Carrasco‐Portiño, M., Cid-Aguayo, M., González, M., Baeza, P. I., Jarpa-Schäcker, R., et al. (2024) · Sexual Medicine · doi:10.1093/sexmed/qfae084 · Cited by 6 · see citing works
Gerbild, H. N., Josefsson, K. A., Larsen, C. M., & Laursen, B. S. (2021) · Scandinavian Journal of Caring Sciences · doi:10.1111/scs.13021 · Cited by 4 · see citing works
Brock, G. B., Hellstrom, W. J. G., Giraldi, A. G. E., & Honig, S. C. (2025) · Sexual Medicine · doi:10.1093/sexmed/qfaf021 · Cited by 3 · see citing works
“12 These adverse effects include decreased intimacy, reduced sexual desire, and relationship dissatisfaction.”
Mollaioli, D., Sansone, A., Jannini, T. B., Hoai, B. N., Nguyen, T. C., Pham, Q. M., Ciocca, G., & Jannini, E. A. (2025) · The Aging Male · doi:10.1080/13685538.2025.2509006 · Cited by 3 · see citing works
“On the one hand, the presence of a supporting partner is helpful in the management of any chronic disease [21], and even more in the diagnostic and treatment process of ED in chronic diseases [22–24].”
InfluentialNeenan, C., & Chatzi, A. V. (2025) · Journal of Advanced Nursing · doi:10.1111/jan.16703 · Cited by 3 · see citing works
“Being successful in this could lead to the development of support groups, patient information literature and referral pathways to address these barriers (Li, Gao, and Wang 2016).”
Lartey, M., Frimpong–Manso, S., Amoah, S. O., Boamah, D., & Mohammed, A. A. R. (2023) · Nutrition and Health · doi:10.1177/02601060221109985 · Cited by 3 · see citing works
“ED has led to breakdown of families due to the lack of intimacy among sexual partners (Li et al., 2016).”
BackgroundThe relationship between social support and erectile dysfunction in middle-aged and older males
Hu, D., Zhang, Y., Zhang, Y., Liu, Y., & Han, J. D. J. (2024) · Frontiers in Public Health · doi:10.3389/fpubh.2024.1332561 · Cited by 3 · see citing works
“Previous study demonstrated a strong association between couple’s relationship deterioration and ED (23).”
A Bibliometric Analysis of the Scientific Research on Erectile Dysfunction
Alzharani, A. A. Y., Alshami, A. M., Khan, M. A., Siddique, N., & Abualait, T. (2024) · Sexuality and Disability · doi:10.1007/s11195-024-09849-8 · Cited by 2 · see citing works
“ED exerts significant biological, psychological, and social repercussions on individuals’ quality of life (QOL) and their sexual partners [13].”
Addressing erectile dysfunction in prostate cancer survivors after radical prostatectomy
Dahl, A., Nilsson, R., Axcrona, K., & Fosså, S. (2016) · Expert Review of Quality of Life in Cancer Care · doi:10.1080/23809000.2016.1236660 · Cited by 1 · see citing works
“There is a considerable correlation between male ED and female sexual dysfunction, which also can be related to female cardiovascular diseases, menopausal and post-menopausal problems, as well as depression [101].”
BackgroundSafaei, M., Maasoumi, R., Mahdavi, S. A., & Ghadirian, L. (2023) · International Journal of Medical Toxicology and Forensic Medicine · doi:10.32598/ijmtfm.v13i1.39138 · Cited by 2 · see citing works
Should experts in male sexual health learn about female sexual function?
Parish, S. J., & Shindel, A. W. (2024) · The Journal of Sexual Medicine · doi:10.1093/jsxmed/qdae050 · Cited by 2 · see citing works
Cai, Z., & Li, H. (2020) · Andrologia · doi:10.1111/and.13880 · Cited by 1 · see citing works
“It can lead to disharmony in partner relations, emotional disorders and even social insecurity (Li et al., 2016; Rajkumar & Kumaran, 2015; Yang et al., 2019).”
BackgroundPharmacological evaluation of a new nanoformulation in the erectile tissue of rabbits and humans
Paz, I. A., Filho, P. M. D. S., Leitão, A. S., Pessoa, T. O., Santiago, R. O., de Oliveira, N. O., Longhinotti, E., Sousa, E. H. S., Lopes, L. G. D. F., Santos, . F., et al. (2024) · European Journal of Pharmacology · doi:10.1016/j.ejphar.2024.177071 · Cited by 1 · see citing works
Yu, J., & Liang, P. (2024) · Translational Andrology and Urology · doi:10.21037/tau-24-378 · Cited by 1 · see citing works
“ED not only undermines the psychosomatic health of the patient but also significantly disrupts family stability and marital harmony (4).”
Abdi, D., Misgana, T., Asefa, A., Bete, T., Temesgen, A., Zewudie, A., Asefa, H., Tilahun, S., & Dereje, J. (2025) · Biomedical Sciences · doi:10.11648/j.bs.20251101.11 · Cited by 1 · see citing works
Azimi, S., Javadivala, Z., Izadi, M., Ghilani, N., & Allahverdipour, H. (2025) · SAGE Open · doi:10.1177/21582440251357056 · Cited by 1 · see citing works
“As a result, these negative thoughts can unconsciously affect their sexual relations and general communication with their spouses (H. Li et al., 2016; DiMeo, 2006).”
Garrett, D. (2021) · Perspectives in nursing management and care for older adults · doi:10.1007/978-3-030-40075-0_6 · Cited by 1 · see citing works
Função sexual de mulheres com infertilidade
Salomão, P. B. (2017) · doi:10.11606/d.17.2017.tde-10012017-101301 · Cited by 1 · see citing works
Sexual Dysfunction in the New Father: Sexual Intimacy Issues
Misri, S. K. (2017) · Springer eBooks · doi:10.1007/978-3-319-68249-5_7
Thompson, K. E., & Kaufman, M. R. (2019) · The Journal of Sexual Medicine · doi:10.1016/j.jsxm.2019.05.001
Prótesis penianas: descripción de una serie de implantes con y sin dilatación de cuerpos cavernosos
Daniela Fleck, L., Marconi, M., Mercado‐Campero, A., Hidalgo, J. P., Marchant, F., & Palma-Ceppi, C. (2019) · Revista Internacional de Andrología · doi:10.1016/j.androl.2019.07.002
Seesawang, J., & Thongtaeng, P. (2022) · Journal of Health Research · doi:10.56808/2586-940x.1003
“The duty of husbands to have sex with their partner is also regarded as vitally important to their partners' mental health [35].”
BackgroundObsessive‐compulsive disorder and men's health. Part 2: Treatment and related sexual dysfunction
Conti, D., Pellegrini, L., Riaz, M., Mpavaenda, D., Sim, A., & Fineberg, N. A. (2023) · Trends in Urology & Men s Health · doi:10.1002/tre.908
Abdellatif, A. E., Abdelbary, A. M., Ragheb, A. M., Moussa, A. S., Naguib, M., Elmarakbi, A. A., & Elbatanouny, A. M. (2025) · Arab Journal of Urology · doi:10.1080/20905998.2025.2526978
“The incidence rates of ED among men are distributed as follows: between 14.3% and 70% for those aged ≥60 years, 6.7% to 48% for individuals aged ≥70 years, and 38% for men who are ≥80 years old [12].”
InfluentialBehavioral Interventions for Health Behaviors in Primary Care
Jackson, K., Montgomery, M., Daniel, R. M., Botello, R., Mixco, G., Mosley, T., Porter, D., Sekula, M. K. K., Swanson, J., Roberman, S., et al. (2026) · Springer eBooks · doi:10.1007/978-3-032-09558-9_9 · Cited by 1 · see citing works
Stigma and Relationship and Sexual Life in People with Severe Mental Disorders: A Systematic Review
Díaz-Pérez, G., Grandón, P., Fernández, D., & Navarrete‐Valladares, C. (2026) · Community Mental Health Journal · doi:10.1007/s10597-026-01644-3
Awareness of Urologists Regarding Partner Education Following Penile Prosthesis Implantation
Eren, A. E., Arslan, B., İnal, M. R., Aksaray, E. E., Boğa, M., & İslamoğlu, E. (2026) · Endouroloji Bulteni · doi:10.54233/endourolbull-1770797
Ramlee, N. H., Sidi, H., Woon, L. S., & Jaafar, N. R. N. (2026) · Malaysian Journal of Medicine and Health Sciences · doi:10.47836/mjmhs.22.s4.9
Brock, G. B., Yafi, F. A., Hellstrom, W. J. G., Nelson, C. J., Ralph, D. J., Honig, S. C., Hackett, G. I., Rubin, R., Pearlman, A. M., Ward, S., et al. (2026) · The Journal of Sexual Medicine · doi:10.1093/jsxmed/qdag251
- Authors
- Li, H., Gao, T., & Wang, R.
- Affiliations
- Chinese Academy of Medical Sciences & Peking Union Medical College (CN)
- University of Alberta (CA)
- The University of Texas Health Science Center at Houston (US)
- Corresponding author
- Li, Hongjun
- Venue
- Nature Reviews Urology
- Published
- 2016-02-02
- Volume
- 13
- Issue
- 3
- Pages
- 168-177
- ISSN
- 1759-4812 (ISSN-L)
- 1759-4820
- OpenAlex
- W2264291267
- Cited by
- 65
- References
- 82
- Citations by year
- 2026: 5 · 2025: 7 · 2024: 8 · 2023: 6 · 2022: 6 · 2021: 10 · 2020: 7 · 2019: 3 · 2018: 3 · 2017: 7 · 2016: 3
- FWCI
- 0.76
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.springer.com/tdm (tdm)
- Locations
- Nature Reviews Urology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Sexual function and dysfunction studies
- Health Sciences › Medicine › Urology › Urological Disorders and Treatments
- Social Sciences › Sociology and Political Science › Marriage and Sexual Relationships
- Keywords
- erectile dysfunction, sexual partners, phosphodiesterase-5 inhibitors, sexual health counselling, patient education, quality of life
- MeSH terms
- Communication, Female, Humans, Erectile Dysfunction, Male, Quality of Life, Sexual Partners, Disease Management
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