Erectile dysfunction (ED) is more than a matter of lifestyle for men.
It is, indeed, a couple’s problem – not just (one of) the man’s problem. It is oftentimes the determining factor of when sex stops in a relationship, and can cause significant ripple effects throughout the family unit – even leading to marital demise and destabilizing parent-child and extended family relationships.
If you and/or your partner is experiencing ED, there are several courses of actions you can take to remedy it. Here’s the full picture on ED prevalence, symptoms, and which treatment may be best for your situation:
Erectile dysfunction is extremely common
The prevalence of mild- to moderate-ED is estimated to be more than 50%, and increases by 10% a decade over the age of 40 – i.e., 40% of men aged 40, 50% men aged 50, 60% of men aged 60 tend to experience symptoms of erectile dysfunction.
Your health care provider can help you figure out what’s going on
The first thing a man with persistent ED should do is make an appointment for a complete history and physical exam. This will help determine the underlying cause – and more importantly, make sure nothing more significant is brewing.
Here’s what you and your health care provider might rule out at your physical:
High blood pressure. Left untreated, it’s the leading cause of erectile dysfunction. Unfortunately, high blood pressure often has no symptoms until it has significantly progressed.
Other potential causes include (but are not limited to):
- Side effects of prescription medication (including blood pressure meds and antidepressants)
- Chronic use of recreational substances (including drinking and smoking)
- Sleep disorders
- Conditions that block blood flow (e.g., diabetes, atherosclerosis)
- Depression and/or anxiety
- Mental and emotional stress
When you schedule your appointment for a medical exam, talk to your health care provider to discuss your next steps, based on your unique situation.
Psst: Here’s how ED pills work
The most common PD5-Inhibitors (Cialis, Viagra, Levitra etc.) work by relaxing smooth muscle in the blood vessel. This allows for enhanced blood flow and sufficient engorgement, producing a sufficiently firm erection for vaginal penetration.
Are ED pills always necessary?
No. Many times, if there is not an underlying physical condition, the man can have good erections again without medication (i.e., with sex therapy).
ED pills will physiologically enhance any man who takes them. However, these pills are not magic. They obviously have a role in managing erectile dysfunction; however, understanding the couple’s sexual script is equally, if not more, important.
“ED pills obviously have a role in managing erectile dysfunction; however, understanding the couple’s sexual script is equally, if not more, important.”
What does sex therapy for ED look like?
Sex therapy attempts to understand the couple’s relationship dynamics and sexual script both as a couple and individually. The assessment usually requires four visits.
In the first session, the couple presents their shared understanding of what the problem is and what they think is causing it.
Then, each member of the relationship is seen for an individual session to get an unfiltered explanation of the problem without the individual feeling the pressure to give acceptable answers but an honest assessment of the situation.
By the fourth session, the therapist summarizes what he has identified as the primary problem and if sex therapy is the right course of action.
So is sex therapy always the best choice for ED (and other sex-related concerns)?
Not necessarily. Sometimes, during the course of sex therapy treatment, the therapist learns that the problem is more than just a sex-specific problem, and the couple would benefit more from traditional couples therapy.
Sometimes, it becomes apparent that one or both of the couples may have a significant mood disorder, which would require psychiatric care first. If one of the members is a trauma survivor (especially sexual trauma), then individual therapy may be necessary.
Depending on the severity of the mood disorder sometimes individual therapy or psychopharmacology is necessary.
When might sex therapy be the best option?
Sex therapy is recommended for sex-specific problems, such as basic sex education regarding the mechanics of sex.
Another common example is when one or both members of the couple have a sexual script filled with cognitive distortions, which the process of sex therapy can help correct.
Sex therapy or ED meds – which one is right for me and/or my partner?
That depends on your unique situation and symptoms.
I sometimes will prescribe ED medication; other times, restoring sexual confidence and function is sufficient to remedy the problem.
However, in some instances – especially if a problem has become entrenched – the couple may benefit from a short course of sex therapy. In other words, if a problem that has been present for enough time that it has caused a rift in the relationship, the client(s) may benefit from sex therapy.