For Arab Men, Treatment of Sexual Dysfunction is Mired by Myth and Shame

“I got married at 30, to a man who had previously been married and had children. During the engagement period, I got the sense that he wasn’t physically attracted to me; not once did he try to steal a kiss while no one was looking. At the time, I convinced myself that this was due to his honourable nature, but within three weeks of our marriage, I was surprised to find out he was sexually dysfunctional.”

Samar*, aged 33, recounts her experience of marriage to her former husband to Raseef22. Presently divorced and living in Cairo, in an apartment next to her parents’, she recalls: “After a period of marriage, I began to struggle with the issue. Why had this man decided to get involved with someone, knowing well that he couldn’t perform the requirements of a husband? When I would bring the matter up with him, he would simply say, ‘that’s just how it is’.”

"Why had this man decided to get involved with someone, knowing well that he couldn’t perform the requirements of a husband?"

When Samar eventually confronted him about the issue, after the few times they did manage to have intercourse, his response was that this is normal. Eleven months later, he left her, while she was pregnant. When she asked him to reconsider his decision, he refused, insulting her and complained to her parents. During their marriage, she would often see him popping various pills, but did not know whether these were medication or performance enhancers.

In the Arab world, a small minority of men will resort to medical solutions for their sexual problems. Others resort to ‘attarin—perfume and spice sellers who provide traditional brews and tonics—or non prescription performance enhancers. Others prefer to sweep the issue under the rug, pretending it doesn’t exist.

Though accurate statistics are mostly lacking, many have come forth claiming an epidemic of sexual dysfunction in Egypt. In view of this, solutions have ranged from the scientific to the criminally ludicrous. Yet, on the ground, shame and myth continue to govern the conversation—or lack thereof—surrounding sexual dysfunction.

Tamer Darwish, 30, owns a shop for spices, perfumes, and other traditional goods in the Giza area in Greater Cairo. He says that such traditional concoctions can help with sexual dysfunction; however, they deal with the symptoms of the problem, and not the cause. “The treatments include ointments and other substances, such as ginseng, pollen seeds, royal jelly, palm fronds, and others,” Darwish notes.

In present times, he receives an average of two or three customers seeking such treatments every month; far less than the previous numbers. He attributes this to a number of factors, most prominently that his clients no longer purchase treatments from popular or crowded locations, due to potential embarrassment, as the customers and shop-owners are all acquaintances. Thus, Darwish says they prefer visiting the larger stores.

Moreover, pharmaceutical companies have undermined the popularity of these traditional brews due to their products immediate efficacy. Darwish further notes that some ‘attarin use unsavory means to attract clients, such as lacing their substances with pharmaceuticals. However, in some cases, the dominance of pharmaceuticals has come with its own set of unsavory consequences.

Kamal, 32, works in furniture production. Kamal says his history of drug abuse began with Tramadol, a highly popular drug in Egypt, due to its low prices. Later, Kamal would also turn to pharmaceuticals to attempt to address his sexual dysfunction. Tempted by a pill-peddler, who promised him quick and tangible results, Kamal purchased some nondescript performance enhancers. Yet, after the third use, the effect began to wear off, but by then Kamal was already addicted. With time, his teeth deteriorated, and his dysfunction became chronic. A friend advised him to treat his condition with hashish, but this only led him further down the rabbit hole.

Eventually, Kamal became addicted to heroin, consuming about 500 milligrams weekly. He attempted to seek treatment, but relapsed several times before he was able to quit, with the help of Narcotics Anonymous support group. At no point throughout this journey did Kamal consider visiting a medical specialist, convinced that he could resolve the issue on his own.

According to Gamal Farweiz, a psychiatric consultant at Egypt’s military hospitals, the main cause behind people’s avoidance of medical solutions is the wish to avoid the label of illness, as it is perceived as a burden. Moreover, this is aggravated by popular belief in myths and sorcery, whereby some might explain sexual dysfunction as having been caused by a vex placed on them, and hence search for solutions from religious figures or witch doctors.

Further, Farweiz affirms that sexual dysfunction is primarily caused by psychological issues due to stress, fatigue, and other daily issues. Conversely, these issues may also cause premature ejaculation.

A man’s worth is often tied to his ability to perform sexually.

Walaa Nabil, a psychiatric and behavioral specialist, says that in Middle Eastern society, a man’s worth is often tied to his ability to perform. Thus, sexual dysfunction, or even illness, signify a lack of manhood. She further notes that this is a thorny issue that is only ever discussed behind closed doors, and is associated with a great deal of shame.

Sawsan Fayed, a professor of psychology at the National Center for Social and Criminological Research in Egypt, affirms this, saying that men who suffer from sexual dysfunction generally seek to rectify the condition clandestinely. This may result in cumulative stress, resulting in aggression toward their partners, and even violence at times.

In this environment of overwhelming misinformation and harmful cultural ideals, men are left either reluctant to seek proper help, or unable to find the right outlets. What begins as a relatively simple and common issue takes on new dimensions in view of the prevailing values, transmuting a personal inconvenience into a social quandary.