Treatment of erection problems and erectile dysfunction
The effectiveness of sex therapy compared to other treatment methodologies
Whytie studied a group of 45 men who had been diagnosed as having erectile dysfunction whose origin was predominantly psychogenic. Of these 25 men and their partners received a vacuum constriction device and psychotherapy, while the other 20 men and their partners received psychotherapy only.
This is an interesting experiment which offers some indication into the degree to which physical problems can be overcome by dealing with the relationship issues that so often lie at the root of erectile dysfunction.
Whytie discovered that in the first group 21 couples out of 25 reported improvement in the man’s erectile dysfunction after receiving both psychotherapy and vacuum constriction device treatment. However, in the second group, only 12 couples out of the 20 reported an improvement after psychotherapy. This improvement was brief, though, because after three weeks of treatment there were no differences between the groups.
What could explain this? A meta analysis of the literature about the value of psychotherapy compared to drugs, injection, and vacuum devices in the treatment of erectile dysfunction offers some explanation of what is going on here. The reality is that despite the psychological interventions being widely used as the treatment of choice for erectile dysfunction, there are very few studies that have investigated whether or not it is actually effective.
In general, one of the most unexpected conclusions was that group therapy is an effective way of treating erectile dysfunction. This doesn’t surprise me because group therapy offers a kind of reinforcement of self-esteem. This is an understanding that one is not unique or indeed alone in one’s experience of sexual dysfunction, and an affirmation of the fact that this is a normal part of human experience.
The effectiveness of sex therapy is based on the assumption about a treatment program. That is, one which combines education, information, counseling, and exercises to try at home to improve intimacy and physical response to stimulation will have an effect on every aspect of a man’s psychological and physiological being.
Effectiveness of group therapy for erectile dysfunction – video
So although group therapy appears to be a superior option it seems to me that any treatment which involves approaching the man as an individual within a relationship is more likely to be effective.
When one studies the results of a meta-analysis, there is no correlation between the effectiveness of therapy and the severity of his erectile dysfunction, the type of relationship he is in, or the age at which he developed the condition.
Where the therapist seeks to educate a man about the condition from which he is suffering, it appears the research demonstrates no statistically significant changes between pre-and post treatment.
More compelling is a study which compared the effectiveness of systematic desensitization and routine group therapy. The conclusion was that there was no difference in the effectiveness and persistence of treatment outcomes.
In both cases, the same skill would be required, in other words the ability to establish a relationship with the client, to accurately “read” the man, to assess with discrimination the nature and quality of the relationship in which the sexual dysfunction had developed, and the capacity of the therapist to resolve issues such as performance anxiety.
Since we know that other factors such as the harmony of the relationship and any power struggle within it are major elements of erectile dysfunction, these always need to be addressed during therapy.
When Melnik investigated the effectiveness of group psychotherapy and Viagra, he found significant differences between the effectiveness of group therapy alone and group therapy combined with Viagra. The IIEF was significantly greater in the group who received both treatments three months after the conclusion of therapy, and the dropout rate was also significantly lower. This clearly suggests that if the focus is purely on the administration of Viagra or similar pharmaceutical compounds, psychological factors that are involved in the development of the erection problem are neglected and reduce the efficacy of treatment..
Use of Viagra can highlight of the sexual issues which include a lack of sexual desire and sometimes delayed or premature ejaculation, which are both sometimes associated with erectile dysfunction. (More information is available here.) Clearly there is evidence that the administration of Viagra alone, without any attention to the psychological issues that may be playing a part, is not an adequate approach to the treatment of erectile dysfunction.
Evidence which supports this conclusion is the fact that there was a significant difference in the level of persistence of erectile dysfunction between the group who received Viagra and therapy compared to the group who received Viagra alone. It seems that in some couples the sexual dysfunction may simply represent a kind of neurotic way of expressing deep relationship conflicts such as lack of communication or power struggle. It follows that the administration of Viagra is not likely to address those issues, let alone solve them.
Some studies have been conducted on the efficiency of sex therapy and intracavernosal injection. Rather more men were satisfied when they received both intracavernosal injection and sex therapy then when they simply received intracavernosal injection alone. One of things that certainly makes this treatment more effective is when men receive adequate counseling. And, also, from the doctor who is administering the treatment initially, and also from a counselor or therapist. the roe of the therapist here may be to mediate between partner and the man.
Sometimes this is important because the woman may find the injection methodology disturbing; at other times it is the man who finds it disturbing.
Although Viagra has revolutionized the way reptile dysfunction is treated, and there’s no question that it is essential to ensure that all psychological and behavioral aspects of the relationship between the man and his partner that may have contributed to the development of erectile dysfunction also require attention.
The integration of sexual psychotherapy and other psychological techniques into a doctor’s practice clearly has the potential to improve the effectiveness of erectile dysfunction treatment. A balanced approach is very necessary in this field.
To summarize, there’s plenty of evidence, although it’s not strong, that group psychotherapy can improve erectile dysfunction. We’ve already seen that focused sex psychotherapy in a group together with Viagra is more likely to be successful down the administration of Viagra or psychotherapy alone.
Some serious investigation is required here in the form of randomized controlled trials to establish whether or not psychological and conventions are routinely required in the treatment of erectile dysfunction. In particular, the issue that needs investigating is whether or not there are differences in effectiveness between different forms of psychological intervention.