Erectile dysfunction treatment

The first step is to rule out an underlying medical cause for the dysfunction, because many different physical health conditions can lead to this issue. Consequently, the first port of call for someone experiencing Erectile Dysfunction should be his GP, who will be able to run tests and, if relevant, refer him on to specialist treatment. In many cases, the Erectile Dysfunction is an early symptom of one of these conditions and, when the condition is treated, the dysfunction ceases.

In other cases, once all the potential physical causes have been ruled out, and the person affected has ceased behaviours that are likely to be causing or contributing to the problem, such as smoking or consuming alcohol to excess, it is likely that there is an underlying psychological issue that needs to be addressed.

Erectile Dysfunction that is psychological in origin may be diagnosed if the man still gets erections in certain circumstances, but not others. For example, if he can achieve an erection while masturbating, or sometimes wakes with an erection, but cannot sustain one during sexual activity, then a psychological cause is likely, as it seems clear that there is no underlying physical reason for the sexual dysfunction.

In the absence of a physical reason for Erectile Impotence, the condition is likely to be psychogenic in origin – in other words, related to feelings and psychological problems. While stress or other psychological issues can contribute to Erectile Dysfunction, the condition itself can cause or exacerbate stress, so the answer to the question of when to seek help is: “As soon as possible.”

Men with this issue often delay seeking treatment, or procrastinate for months or even years. They can feel ashamed or embarrassed about having this problem and worry that they may be seen as less of a man because of it. However, psychogenic Erectile Dysfunction is nothing to be ashamed of. It is a relatively common disorder, and in most cases, with appropriate treatment and support, it will get better. If you feel that you may have this issue, be assured that there are many ways to deal with it.

Sexual arousal in men is complex, involving interactions between hormones, emotions or feelings, and the physical architecture of the reproductive organs, including nerves, muscles, and blood vessels. When there is an issue with the brain and with the emotions the man is feeling, Erectile Dysfunction can be triggered or exacerbated.

Psychogenic Erectile Dysfunction tends to be more common in younger men with the condition, perhaps partly because of societal expectations – often fuelled by the extremely unrealistic scenes enacted in pornography, which today growing numbers of men are addicted to – that they should always be virile and “up for it.” These men can become extremely anxious when they feel unable to perform sexually as they would like, or as they have seen performed in pornography.

Psychological factors that can lead or contribute to Erectile Dysfunction include:

• Depression, anxiety, or other mental health conditions.
• Stress.
• Interpersonal problems in their romantic relationship that are causing stress or other issues.
• Low self-esteem.
• Fear of sexual intercourse (known as genophobia).
• An addiction to pornography.

Men who are taking medication to help with certain mental health disorders, including depression, can sometimes find that Erectile Dysfunction is an unwelcome side-effect of their medication, and can find themselves in a vicious circle whereby their depression deteriorates as a result of their Erectile Dysfunction, only for them to be prescribed with more medication that leads to this undesired outcome. Similarly, men whose problems with sexual performance are likely to be linked to smoking, excessive alcohol consumption, or other forms of substance abuse will find themselves torn between understanding that these behaviours are probably contributing to their sexual problems, while also being drawn to self-medication with these substances because of the negative feelings and thoughts they are experiencing.

A variety of medications and medical devices are available to treat Erectile Dysfunction. Because of the heavy burden of shame many men with this issue experience, due to cultural biases and prejudices, the market also offers a wide range of untried, untested, and often dangerous approaches. It is never a good idea to self-medicate for this condition, so any pharmaceuticals or devices employed should be used following a professional consultation with a doctor or other specialist in the field. Prescription medications, when provided by a responsible doctor, can provide short-term relief.

However, in the case of Erectile Dysfunction that springs from emotional or psychological factors, it will be necessary to address these for effective long-term management, for various reasons: firstly, even very safe medications can involve the risk of side effects, so in general if another treatment modality is available, it should be explored first; and secondly, unless the underlying causes of the condition are treated, medication will never provide more than short-term assistance. If a psychological source for your Erectile Dysfunction has been identified, then it is best to avoid any pharmaceutical support, as this may prevent you from tackling the root of the issue.

Psychological treatments for Erectile Dysfunction should be tailored to the individual in question, and can be multi-faceted.

For example, if the main underlying cause is anxiety, then an approach such as Cognitive Behavioural Therapy can treat the anxiety by providing you with the tools you need to recognise unhelpful behavioural patterns, and learn new, more helpful ones. As the anxiety gradually lessens, the Erectile Dysfunction should also gradually improve. Similarly, if the main issue appears to be self-esteem, the therapist will work with you to improve your self-esteem and, gradually, the issues with Erectile Dysfunction should also improve.

Here at the Private Therapy Clinic, our highly specialised therapists focus on giving people practical tools and exercises they can do at home so that they can become self-empowered in approaching their Erectile Dysfunction. Our therapists typically use psychotherapy to work with their client – and possibly their partner – to explore feelings, thoughts, and behaviours that may be impacting on Erectile Dysfunction, and to examine, learn, and practice new approaches.

A multi-faceted approach might combine aspects of diverse treatment modalities, including:

• Cognitive Behavioural Therapy (CBT) to identify, challenge, and replace negative thoughts with respect to sexual performance.
• Emotion-based Therapy, which explores the emotions underlying the problem thoughts and behaviours that are contributing to the Erectile Dysfunction
• Mindfulness and Relaxation techniques that can help to reduce stress and anxiety, by exploring approaches including deep breathing, meditation, and progressive muscle relaxation.
• Behavioural Experiments, whereby the client is encouraged to defocus on penetrative sex and orgasm and to explore engaging in new sexual activities that are less associated with anxiety.
• Developing open, positive channels of communication with partners regarding mutual sexual needs and concerns.
• Learning “Sensate Focus Exercises”, which are techniques especially designed to build trust in intimate relationships by focusing on non-genital touching and only gradually moving towards sexual intimacy.

If you smoke, consume copious amounts of alcohol, or engage in other forms of substance abuse, and these behaviours have not been satisfactorily addressed then, in parallel with therapies aimed at reducing anxiety and addressing other factors, it is advisable to also approach ways in which the substance abuse can be ceased, or at least reduced.

Yes, often it can. As Erectile Dysfunction can cause serious problems in relationships, some treatment modalities might also involve couples therapy, at which broader underlying tensions and issues in the relationship can be discussed, and potentially approaches for future therapy devised.

It is often advisable for couples to attend sessions with a sex therapist together. One of the most painful aspects of Erectile Dysfunction for many men – if not most – is feeling that they are unable to sexually satisfy their partner. The anxiety that this feeling understandably creates exacerbates their inability to achieve a sustainable erection, and they will bring this heightened anxiety to each interaction. They may benefit from reassurance that there many ways to satisfy a partner that do not involve penetrative intercourse, and encouraged to explore these new approaches at home. Many men find that, when they feel freer to engage in sexual play and put less pressure on themselves to have and sustain erections, their anxiety levels reduce dramatically, along with a significant reduction in their Erectile Dysfunction.

By getting couples involved in treatment – whether in couples therapy, sex therapy, or both – it may also be possible to observe and discuss behavioural dynamics that are contributing to the problem, and to devise strategies that may help to address them.

In men whose Erectile Dysfunction has a more complex aetiology, such as a fear of sex or a pornography addiction, any treatment modality needs to explore the origins of these issues, as well as developing strategies to manage them. In both of these cases, a combination of psychotherapy, which seeks to explore and understand why and how the person has these issues, and Cognitive Behavioural Therapy, which provides tools to manage unhelpful behaviours and to develop healthier ones, is typically indicated.

The treatment of Erectile Dysfunction may also include some management of expectations. Men of all ages can be reassured that occasional difficulties with getting and sustaining an erection are perfectly normal, while older men will often benefit from being reassured that some changes in sexual function are simply part of healthy aging, as sometimes men become anxious about symptoms that actually are caused by nothing more than the passage of time. While men (and women) certainly can enjoy a healthy sex life in older age, it is normal for men to experience a gradual reduction in sexual desire with the passage of time, and also a reduction in how quickly an erection is attained, how firm it is, and how long it lasts. A therapist can work with them to help them to accept the aspects of ageing that they find most challenging, while a sex therapist may be able to help with advice about alternative approaches to sex, and a healthy attitude towards sexuality at any age. With the increased medicalisation of sex, and the ubiquity of pornography, some older men can feel that they “should” be more sexually active than they actually want to be, and may need reassurance that there is nothing wrong with accepting a lower level of sexual desire, if they are comfortable with it.

Among younger men, many of whom frequently access pornography, some are self-referring to doctors in the belief that they are suffering from Erectile Dysfunction because they feel that they are not performing adequately. It is sometimes the case that there is actually nothing wrong with their sexual performance, but rather that they have developed unrealistic expectations relating to their pornography consumption. These men typically benefit from reassurance and a reality check – and where indicated, possibly some treatment to deal with addictive behaviours with respect to the consumption of pornography.

For most men with psychogenic Erectile Dysfunction, the prognosis is good and an appropriate therapeutic approach will see a significant improvement in their symptoms and in their general well-being.

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