Why Does My Partner Lose His Erection?

Erectile dysfunction (ED), defined as the persistent inability to attain and maintain an erection sufficient for satisfactory sexual performance, is a common condition that can significantly impact relationships.¹ According to the 2025 EAU Guidelines, ED may be associated with modifiable risk factors including lifestyle choices or medication side effects, as well as underlying conditions such as diabetes, cardiovascular problems, or psychological factors.² The first step in addressing your partner’s erectile issues involves identifying these potential causes through proper medical evaluation. When conservative treatments like lifestyle modifications and oral medications (PDE5 inhibitors) are unsuccessful, penile implants represent an effective solution for restoring erectile function.³ The EAU Guidelines recognize two main types of penile implants: malleable (semi-rigid) and inflatable prostheses.⁴ Malleable implants provide permanent rigidity with the advantage of simple use, while inflatable devices offer a more natural appearance in both flaccid and erect states, though they require greater manual dexterity to operate. Patient satisfaction rates with penile implants are notably high: according to the EAU Guidelines, 92-100% of patients and 91-95% of partners are satisfied with appropriate counselling.⁵ The guidelines emphasize that proper counseling before implantation is essential, as it helps establish realistic expectations regarding the postoperative experience. Partners should understand that while the implant restores the mechanical ability for intercourse, it does not change libido, although some men notice changes in penile sensation after surgery.⁶ Regarding concerns about penile size, the EAU Guidelines note that how a man sees his own penis size can affect his sexual function and quality of life.⁷ It’s important to note that perceived penis size seems to predict erectile function more than actual measurements, and dissatisfaction with size can contribute to performance anxiety.⁸ The guidelines specifically mention that patients undergoing prostate cancer treatment should be counseled about potential changes including penile size reduction alongside erectile dysfunction.⁹ Complications from penile implants are relatively rare when performed by experienced surgeons, with infection rates of 1-3% for primary implantations.¹⁰ Mechanical reliability has improved significantly with modern devices, with 5-year survival rates exceeding 90%.¹¹ The guidelines strongly recommend implanting a penile prosthesis if other treatments fail or based on patient preference, emphasizing that patients should be fully informed about both benefits and potential complications associated with the procedure.¹² Finally, the EAU Guidelines highlight the importance of psychological support and couple-focused approaches.¹³ Cognitive Behavioral Therapy combined with medical treatment can maximize outcomes, addressing both the physical and emotional aspects of erectile dysfunction.¹⁴ Open communication between partners about expectations and concerns is essential for successful adaptation to any ED treatment, including penile implants.