According to the American Journal of Natural Medicine, more than 90 percent of men over the age of 50 suffer impotence as a result of an organic physiological cause. Physical causes should always be explored first by patients suffering this illness. In many cases, however, stress, anxiety at work or at home, relationship problems, performance anxiety, unresolved gender orientation issues, worry, depression or even simple boredom can underlie psychogenic male sexual impotence. Pure psychological dysfunction usually occurs quite suddenly and often with little or no warning. Physical erectile dysfunction, on the other hand, can develop over years as a gradually escalating problem.
Physical Treatments
The first line of treatment is to treat for an underlying physical cause, even if psychological factors may be the culprit. Treatments may include natural or homeopathic remedies like herbal treatments, nutritional (vitamin) supplements, acupuncture, diet, exercise, quitting tobacco or recreational drugs and lifestyle changes.
Medically supervised interventions can include simple medications like Viagra, Cialis and Levitra, trans-urethral therapy or hormone therapy. Stronger interventions like vacuum pumps, penile implants, injections and surgical treatments are not indicated for psychogenic (psychological) impotence.
Psychological Treatment
Psychological counseling is usually the preferred line of treatment if psychological factors are the only causes of the condition. Counselors will attempt to reassure the patient and build confidence using relational and behavioral therapies. Counseling may involve teaching the subject to give and receive affection. The sexual partner is an essential partner in supporting the therapeutic process. Issues such as the wife's lost of interest in sex or other basic spousal conflicts can interfere with erectile function. Relationship work is critical in setting the stage for satisfying sexual relations. The brain not only brings about an erection, but it can also prevent one by blocking the reflex that causes an erection. Psychogenic impotence of this sort can have a cascading effect by feeding on fear of failure to perform and subsequent guilt and depression triggered by such failure.
The Importance of Information in Psychogenic Impotence
Aging is often a crucial factor in erectile dysfunction, but age itself is not an inevitable cause. Men may remain sexually active into their 80s and 90s if they remain healthy, happy and in a close relationship with their partner. The emotional impact of aging can have an important effect on self-esteem as well as the relationship between partners. Providing information in counseling can help partners cope with the challenges of aging and anticipate problems before they lead to emotional and sexual dysfunction.
Many medications used to treat age-related conditions also cause erectile dysfunction and loss of libido. Blood pressure and anti-depression medications are particularly common culprits. Patients who know about such side effects going into treatment can anticipate the effect and, with the help of their physician, treat the condition before it causes stress and psychological harm to them.
Sex Therapy
Many therapists recommend some form of sex therapy for individuals suffering from impotence, whether caused by physical or psychological factors. Several recent studies have questioned the value of this method because they found that a majority of men resisted or outright refused to participate due to embarrassment or unwillingness to share such on such an intimate level in the presence of a therapist. As full participation by the spouse is critical, both must be willing to fully take part in the process.
It is possible to offer other kinds of interpersonal, supportive or behavioral therapies during the process of agreeing on a treatment strategy. A great deal of informational work can be done in helping the couple understand how normal aging impacts sexuality and adapt to those changes. Simple techniques like using more direct stimulation or stress reduction techniques can help. Aging may also trigger deep-seated emotional issues or trauma that have set up the patient for sexual problems. Identifying these underlying problems can help the therapist and patient together create a successful sex therapy treatment strategy.
Tags: erectile dysfunction, psychological factors, behavioral therapies, line treatment, treatment strategy