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TAKING A PILL to regain lost erectile function is an incredible development in the history of drug intervention. But the pill itself cannot obliterate the other problems a couple experiencing ED may have. In fact, in certain circumstances, it may even add to the existing issues with which the pair has had to cope.

One of my greatest concerns as a physician is that the new treatment for ED gives people an unrealistic expectation about their ability to immediately cure their emotional relationships along with their physical ones.

Nothing could be further from the truth.

It is no secret that men and women react differently to sex— before, during, and after it takes place. The availability of a new quick, painless treatment for ED can have one impact on men and quite another on women. Consider the comments I’ve heard in my office:

From a thirty-three-year-old man under tremendous work-related stress: “The pill is the best thing lhal could have happened to me.”

The comments of his partner, a twenty-nine-year-old lawyer who was equally busy: “Right now we can have the sex we want when time allows for it—which isn’t very often.”

From a fifty-two-year-old man whose extra poundage and drinking made ED a constant companion: “In one way I feel great because I can have sex again. But in another I feel awful, because I can’t hide behind my weight anymore.”

His fifty-four-year-old wife had a different view of the situation: “For the last five years his primary relationship has been with food. Now everything has changed and, frankly, I’m not happy about it. It sort of puts the focus on me now.”

A forty-six-year-old man, on the verge of a divorce after eight years of marriage, told me: “Ever since I found out that a drug could help me, I’ve wondered how to use it. Our marriage was based, to a large degree, on sex. For two years we’ve been trying to find other ways to communicate. We never did. Having the means to have sex again is wonderful—but I have to ask myself, what kind of relationship did we have in the first place?”

His forty-three-year-old wife concurred: “He’s right. It was a big reality check to see how little we had in common. Yes—I’d like to have sex with him again. But where do we go from there?”

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This highlights the importance of the gay community as an alternative or supplemental family. Bill said he had been fairly cynical about the gay community at first. ‘I thought the whole scene was really superficial and forced. I used to keep pretty much to my small group of friends. When one of my close friends developed AIDS I was deeply upset. I wanted to do anything I could to help, so I got into some volunteer work. Over the past year I have seen the supportiveness and the strength of the community trying to cope with so many young people dying.’

Any person coming out invariably throws the family into crisis. Loving parents often want to be supportive but don’t know how. They will need accurate information and support too so that they can genuinely help their child.

It helps to try to get in touch with why you are having trouble dealing with your child’s choice. Have you never been able to talk about emotional things? Graham is thirty-four and told his mother only three years ago. ‘She said, “For God’s sake don’t mention a word of this to your father. You know how conservative he is.” I had no intention of telling Dad because we had never talked about anything more deep and meaningful than the stock market results. Pick any other subject and we would get into an argument about it.’

Strong objections based on religious beliefs can be hard to shake. The old trinity of guilt, shame and fear are pretty powerful emotions. The discomfort they cause forces you to reassess your own sexuality and for some parents this can be an intensely confronting experience, especially if it brings up aspects of their own past that might have been forgotten or suppressed, like adolescent experimenting.

Some parents say they feel like failures … ‘Where did I go wrong?’ … and there may well be a concern about how their own friends, colleagues and relatives might react. Hopefully their child’s need for support will be more important at the time.

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Many people say their first time was when they were drunk at a party or a dance. This happens so often because your usual inhibitions disappear. The best of intentions can be blown away in a matter of minutes by the influence of drugs and alcohol. All the self-talk and assertiveness in the world is not going to protect you if you drink so much alcohol, or do so many drugs, that your judgment goes out the window. The old story of waking up to a stranger in bed next to you who doesn’t look a bit like the person you thought you brought home can be a jarring reminder of the tricks alcohol can play on a brain.

It is very easy to be coerced into intercourse before you are ready if you don’t have a lot of self-confidence and if you are not willing to stick up for your rights. Some of the methods of coercion are more sophisticated than others. It’s hard to believe that old lines like, ‘I’ll tell everyone you’re frigid’ or ‘What’s wrong with you? All your friends do it!’ or “Why not, are you gay or something?’ can work, but they have stood the test of time. Parents would do well to prepare their children with a healthy dose of cynicism and a few clever retorts.

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‘He knelt down beside her and only then could she make out his face in the moonlight. His breath was warm against her neck and the sweet smell of jasmine hung in the air like perfume. He sighed softly and stroked his cheek down her temple.

She could feel the warmth of his body as it neared and a chill down her spine turned into a quiver. This was the moment she had dreamt of since she first saw him walk into her life in that little cafe down the street from the University. Now as she lay close to him listening to his breathing get faster and faster, she remembered the way he laughed when he spilt his cappuccino down the front of his shirt. As his fingers lowly but expertly unbuttoned her shirt to reveal her now heaving breasts, her apprehension gave way to his gentle yet confident lips. First-time fears melted as her body trembled with moist expectation. His hand traced a tingling trail of ecstasy across her thighs and she gasped as they surrendered to each other’s passion …’

Now if you believe this romance novel version of the first experience of intercourse, your own first experience might leave you with a few lingering doubts and a fair share of disappointment. For many people this might as well be a story from another planet.

In the real world, things are usually very different. If you ask people to describe their reactions to their first experience of intercourse … their technical ‘loss of virginity’ … you discover a range of emotions from fear, guilt, regret and disappointment to relief, elation, and pride. These reactions may well determine how you feel about sex for many years to come.

One woman in her sixties told me, ‘I think the honeymoon for us was grossly oversold. I remember it as the worst week of my entire life. I kept wondering what on earth I had let myself in for. I didn’t even know there was a thing called an erection! That was quite an unpleasant shock I can tell you. The only sex education I had at home was when my mother shyly handed me a book and said, “If you have any questions, ask your aunt.” My husband and I went along to a church-organised “Married Love” course. To go along, you had to either produce a marriage certificate or a signed affidavit from a clergyman that you were booked to be married within the next six weeks. If you wanted to know about contraception, they sent you along to a doctor they recommended but you weren’t allowed to make an appointment until three weeks before the wedding date. A few friends of mine at the time were sexually active, but they didn’t know anything about contraception. If they accidentally fell pregnant they just got married in a hurry … it didn’t seem to matter whether they wanted to spend the rest of their lives with each other or not. Or else they got shipped off to relatives in the country until they had the baby and had it adopted out. It was never openly discussed.’

There is little doubt that the partner you choose and the circumstances make a big difference to the experience. ‘I was a virgin until I was twenty-eight,’ said Susan. ‘I had had lots of boyfriends. I got on really well with all of them, I was even engaged once, but I never felt any sexual attraction for any of them. For a while I thought I must be a lesbian, but I wasn’t aware of any attraction to other women. Well, one day I met John and all that changed. We had a fantastic physical and emotional attraction right from the start and he’s the one I married.’

While some people describe their first intercourse as a pleasant experience, there are many who say the first time is downright unpleasant. Beth recalls, ‘I couldn’t believe how painful it was. I had no idea that it might hurt. I knew very little about sex at all and so I was incredibly nervous. I suppose that made matters worse. Because the first time was so painful it took me months and months before I could relax. I reckon it took years before I could say I really enjoyed it.’

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Puberty is a time of physical and emotional turmoil as both boys and girls face the dilemmas of their changing bodies, and a growing sexual awareness. It is a time of evolving a concept of ourselves in relation to others.

The time bomb of puberty is set to explode at a preordained age, releasing a surge of hormones that have effects on every part of our being: our thoughts, our appearance, our emotions. Although it can be frustrating for late bloomers, the timing of that change is different for each person and there is nothing that will speed it up.

While nature is working its wonders it is also playing some pretty mean practical jokes, things that make you suspect a Creator with a sense of humor. Why else would your nose and your feet grow first? Why else at the most self-conscious time in your life would you break out in pustular lumps all over your face? Why else would so many developing boys grow breasts which disappear just as mysteriously as they arrive? This is a phenomenon called ‘gynecomastia’. You can often pick the boys with gynecomastia … they’re the ones wearing big sloppy sweaters on the beach in the middle of summer. If only they knew they weren’t changing into girls and that the swelling would go away there wouldn’t need to be so much anguish.

Getting used to a changing body is part of the excitement of growing up … I can remember being really excited when I realized I had grown tall enough for my feet to touch the floor when I was sitting on the bus … but it is also a source of embarrassment, fear and confusion. The biggest question is, Am I normal?’ If an adolescent can be reassured that what they’re going through is normal, a large part of the battle will be won.

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Teaching our children about sex is as important to their wellbeing as teaching them about good food, road safety or protecting their environment. But no one says it’s always going to be easy.

It’s not possible to write a script for every situation, but here are some useful guidelines that will help you to talk to children about sex.

There are certain times in a child’s life when you can pretty easily predict that they are going to want to know more. If you tell a three year old that there is a new baby brother or sister growing in Mum’s tummy, they’re sure to want to know how it got there. If parents are separated and a new partner comes on the scene, questions will be asked. Sooner or later, they’re going to want to know what a condom is.

If you can foresee that things like these are going to come up, you can prepare a bit of a spiel that covers the basics.

Thankfully the days of babies arriving in the cabbage patch or being dropped off by a low-flying stork are long gone. Children cope with the truth remarkably well, provided we use words they can understand and we are prepared to take the time to explain anything they don’t follow. A friend in her forties is the youngest of four siblings. She recalls that, when she was about six, a neighbor became pregnant. She had no idea what pregnancy was, only that the lady next door was getting fat in the strangest way. Curiosity got the better of her so she asked her mother about it. ‘It’s a growth,’ she was told. ‘Don’t worry, the doctor will take it out.’ She was worried sick for months, wondering if the woman was going to die.

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