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, with studies showing 80-90% of men and their partners reporting satisfaction with the functional and aesthetic outcomes.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 affect libido or sensation.⁶ Regarding concerns about penile size, the EAU Guidelines acknowledge that men undergoing treatment for ED often worry about penile dimensions.⁷ It’s important to note that perceived penis size often has a greater impact on erectile function 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.