Beyond the Bedroom: How Sex Therapy Can Help Men Overcome Erectile Dysfunction
Published in NCCA Newsletter, Spring 2023
Sexual health and well-being can be vital to a person’s quality of life. However, issues can arise that inhibit the ability to perform in the bedroom when the time for sexual performance arrives. We know one such area that affects men is erectile dysfunction (ED). Individuals with ED have a constant inability to get an erection or the inability to maintain the erection to perform sexual intercourse (American Psychiatric Association, 2013). ED usually affects older men, but unfortunately, it is common and can affect men of any age group. For instance, between one and 10 percent of men between 40-49 years of age have ED, for men between ages 60-69 there is an increase between 20 and 40 percent, and men over 70 have a 50 to 100 percent chance of suffering with ED (Williams et al., 2021).
Notwithstanding the age factor, other health issues can also result in ED. Certain health conditions, medications, mental health issues, and lifestyle choices can affect the development of ED (National Institute of Diabetes and Digestive and Kidney Diseases, 2017). For example, diabetes mellitus is a health condition contributing to the development of ED (Defeudis et al., 2021).
Also, mental health issues, such as depression and anxiety, as well as the medication treatment for these mental health issues, can contribute to the development of ED (Hentzen et al., 2022). Additionally, lifestyle choices such as obesity and smoking are also potential contributors to the development of ED (Lowy & Ramanathan, 2022). This short list is just a glimpse of the different contributors to the development of ED.
While urologists might attempt treatment for these individuals, sex therapists can also provide helpful contributions, particularly if the ED results from certain mental health issues where a physical issue is not the culprit. A question that is useful to determine if mental health issues are a likely reason for ED is, “Are you able to masturbate without the presence of your partner?” If the answer is yes, then ED is most likely caused by stress or anxiety found in the relationship. When this is the case, oftentimes the individual may have a variety of negative thoughts, which can contribute to negative behaviors. The individual might think, “I’m worthless because I can’t get an erection to please my partner.” This thought may lead to the behavior of withdrawing from his partner emotionally and physically, thus disturbing the intimacy within the relationship. The lack of intimacy may cause sexually debilitating anxiety. A sex therapist can help put these negative thoughts at ease, which should enhance his relationship, thus increasing his sexual performance.
Sensate focus is another great technique to help reduce ED. Sensate focus is used to help relieve anxiety and tension. It involves minimizing or eliminating the notion that one must have an orgasm for it to qualify as sexual intercourse. Weiner and Avery-Clark (2014) describe sensate focus as exploring each other’s bodies in a non-demanding manner without intent to create a sexual response, but to create relaxation for the individual or their partner. When our bodies and minds are at ease, there is a better chance that sexual intercourse can happen. Our minds are like muscles, and we must train our bodies to build muscles. Likewise, we must train our minds to react to certain situations. Sensate focus can help individuals re-train their minds safely so that they can achieve the end goal of sexual intercourse or sexual intimacy.
Erectile dysfunction can have many causes, physical, mental, or often both. While physicians provide necessary treatment for ED’s underlying physiological problems, sex therapists employ proven therapies to provide relief from psychosocial issues contributing to ED. Physicians and sex therapists together provide positive outcomes for individuals struggling to achieve their desires for sexual intercourse and sexual intimacy.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders. Author.
Defeudis, G., Mazzilli, R., Tenuta, M., Rossini, G., Zamponi, V., Olana, S., Faggiano, A., Pozzilli, P., Isidori, A., & Gianfrilli, D. (2021). Erectile dysfunction and diabetes: A melting pot of circumstances and treatments. Diabetes Metabolism Research and Reviews, 38(2), 1-25. https://doi.org/10.1002/dmrr.3494
Hentzen, C., Musco, S., Amarenco, G., Del Giulio, P., & Panicker, J. N. (2022). Approach and management to patients with neurological disorders reporting sexual dysfunction. The Lancet Neurology, 21(6), 551-562.https://www.doi.org/10.1016/S1474-4422(22)00036-9
Lowy, M., & Ramanathan, V. (2022). Erectile dysfunction: causes, assessment, and management options. Australian Prescriber, 45(5), 159-161. https://www.doi.org/10.18773/austprescr.2022.051
National Institute of Diabetes and Digestive and Kidney Diseases. (2017, July). Definition facts for erectile dysfunction. https://www.niddk.nih.gov/health-information/urologic-diseases/erectile-dysfunction/definition-facts#common
Weiner, L., & Avery-Clark, C. (2014). Sensate focus: clarifying the Masters and Johnson’s model. Sexual and Relationship Therapy, 29(3), 307-319. https://www.dx.doi.org/10.1080/14681994.2014.892920
Williams, P., McBain, H., Amirova, A., Newman, S., & Mulligan, K. (2021). Men’s beliefs about treatment for erectile dysfunction–what influences treatment use? A systematic review. Internal Journal of Impotence Research, (33), 16-42. https://doi.org/10.1038/s41443-020-0249-1