East Toronto Therapy

Treating Erectile Dysfunction

In my last post, I discussed the causes of erectile dysfunction. This post will look at the treatment options available.

As mentioned in the last entry, erectile dysfunction may be caused by physical, psychological, and/or social factors. Even in the case of a physical cause, psychological and social factors may maintain the erectile dysfunction (for example, anxiety about whether the problem will happen again or lack of trust or intimacy in the relationship). This interaction of multiple causal factors means that treatment for erectile dysfunction may not be as simple as a pill.

Viagra and other similar drugs for erectile dysfunction act by increasing blood flow to the penis to allow an erection. These medications may work on erectile dysfunction due to any cause. In the case of erectile dysfunction due to psychological factors, the medication may override those factors and provide the man with the confidence he needs to break the cycle of anxiety (where anxiety leads to poor erections, leading to more anxiety, leading to poor erections). However, sometimes the psychological factors will override the medication, resulting in the maintenance of erectile dysfunction. Medication also cannot treat any relationship problems that may have existed before the erectile dysfunction, or that may have developed as a result of the sexual difficulty

In my practice as an individual, couple, and sex therapist, I often work with couples that have sexual difficulties. In some cases, couples have started avoiding sex as a way of avoiding disappointment or rejection. Sometimes these couples even start avoiding non-sexual touching, for fear that it will lead to sex or will be perceived as a bid for sex (an activity that has become fraught with frustration and anxiety). For these couples, it is unlikely that medication alone will result in a return to a satisfying sex life. If you haven’t really touched your partner beyond a peck on the lips in the past year, how would you even go about starting to have sex again even if you can achieve an erection? This is where sex therapy can be helpful.

Sex therapy can help reduce anxiety in a man with erectile dysfunction. It can also address relationship conflict and increase emotional intimacy within a couple. It is important to note, too, that while medication works to allow erections, it does not increase desire. If you do not desire your partner, the medication will not help with this. Sex therapy can treat low desire.

A good first step in treating erectile dysfunction is to see your doctor. As mentioned in the previous post, some cases of erectile dysfunction are caused by physical problems such as vascular disease. For this reason, it is important to see a doctor to rule out any medical problems that need to be addressed apart from the erectile dysfunction. It may be, too, that medication is all you need. However, if you know that you experience a lot of anxiety about sex, there is conflict or lack of intimacy in your relationship, or you and your partner have avoided being physical due to the erectile dysfunction, sex therapy can address these concerns and help you return to a satisfying sex life. For those men who are unable to use medication for erectile dysfunction, sex therapy can help the man and his partner adjust to additional treatment options (such as a pump or injections) and can help the couple expand their sexual repertoire to make sex pleasurable again.