I work with the Center of Pelvic Restorative Disease at Methodist Hospital. This is a virtual center and encompasses about twelve physicians and staff. I am the intimacy and sex counselor for the center, which deals with any problems in men or women from the waist down. I work with gynecologists, urologists, oncologists, internists, urologists, gastroenterologists, as well as plastic surgeons. The Center cares for men and women every day who have problems with their genitals, bowels, bladders-you name it.

Patients with genital problems are emotionally challenging. This is partly because the patient and their partner have suffered a long time prior to the problem. The marriage is strained, and this makes any problem more difficult to resolve. Men come in with erectile dysfunction, premature ejaculations, prostate cancer, bladder cancer, Peyronie's disease, and low libido. Men are more vulnerable emotionally when their penis does not work than a woman is if she has vaginal problems. There are many reasons for this. The number one reason is the emphasis the man puts on his penis to declare his total manhood. Women value their vagina, but women are more complicated sexually; we have back-ups, such as our clitoris and breasts.

When I am counseling a couple who is struggling with erectile dysfunction or premature ejaculation, I can see the woman has no idea how deep this is hurting her man. She has no idea how ashamed he may feel, or how it makes him less confident in himself as a man. She may even tell him, “You're a Rhode's Scholar for goodness sake; I didn't marry you for your penis.” He doesn't respond to that and most likely that comment makes him feel worse. When a woman gets married, she should understand she is marrying the man, his family, and his penis. A man looks at his penis as an individual, and I will bet you money your husband has a name for his penis. The best way to a man's heart may be his stomach, but men are willing to starve if you love his penis. Women don't really understand this. In fact, some of the cruelest things I have heard a woman say are when the man cannot get an erection. Sometimes she is angry at herself, feeling that she is not sexy or attractive enough. However, most of the time, she blames him. Once a man feels bad about himself, no medicine is going to help him stay erect. This erodes marriages, and it can kill the way a man feels about his wife.

When a man falls in love with a woman and wants to marry her, many times he will tell her, “Don't ever change.” He means to say, “You love me right now, you love my penis, if you continue and stay like this I will do anything to make you happy.” The kids come, the bills come, women are stressed, but they still love their husband. However, they forget about the other member-the penis. They begin cajoling the husband that all he wants is sex. The more women cajole, the less sex they have, and the man begins feeling less about himself. Soon, no one has sex, no one touches each other, and the marriage disintegrates. It isn't about who is at fault; it happens because we don't understand each other. Women think it's superficial to only want sex; men think its cruel and rejecting when women don't want sex.

What works best is if women understand up front what value a man places on his penis, how it affects his thoughts of his ability to be a man and take care of his woman. Men should understand that women like the penis, but they like the man more. They want more than an erect penis. They want a partner, someone who helps with the kids, chores, and makes them feel loved. Women: when and if your man ever has a problem with his penis (and most likely he will at some time in his life), I encourage you to take it seriously. For one thing, it defines how healthy he is because an erect penis is all about blood flow. Secondly, it helps define his emotional health. Yelling at him or making light of his issue is cruel and insensitive. Work with him to help overcome his problem. Sometimes, men who don't feel appreciated in regards to their ability to take care of their woman may turn to alcohol or food to numb their feelings. A problem with the penis is complicated by obesity and alcoholism. You can see how an issue that wasn't insurmountable becomes that way when it is misunderstood. If your husband has problems in this area, find a quiet time and talk to him. Reassure him that you love him and will work with him. He will view this as you loving both him and his penis, and his outcome will be much better.