We have previously discussed the causes of male erectile dysfunction or impotence. This week we look at treatment of psychological impotence.{{more}}

As mentioned before, there are two main causes of impotence: psychological, and physical or organic. In the first case, we are dealing with factors that a tablet does not treat and includes factors such as relationship issues, alcoholism and other drugs of abuse, depression and anxiety and stress. I also mentioned that men in their 40s who suffer from impotence are affected more by these factors than the physical ones such as sugar, pressure, high cholesterol, heart disease, age, cancers and hormonal problems.

We also mentioned that it is infinitely easier to treat physical factors than psychological ones, because men do not go to see therapists; however, a lot of therapy can be done in the doctor’s office when these men come to see the doctor for their impotence. More and more men are coming forward and admitting that they are suffering from impotence. A common scenario that requires therapy is the young couple that has just gotten married and the husband cannot “rise to the occasion”. I also see young professional men in their 30s, stressed and overworked, suffering from impotence, these men also need psychotherapy, but instead get Viagra and OTC medications.

Psychotherapy is basically talking your problems over with a professional. These professionals have been trained to listen and be non-judgmental. They have also been trained not to take sides. They will want to speak with you and your partner and help you both to come to an amicable or mutually satisfying decision as to how to resolve your impotence. For example, a sex therapist or psychotherapist will be able to counsel the young professional in the above example about working hours and making time for sex. It sounds simple, but you’d be surprised at how many other issues will arise over the husband’s overworking. For example, the husband may be overworking because he has developed resentment over his wife’s lack of tact in criticizing him at home. She does not realize it and he is not much of a “talker”. Some men may have an affair with a “smallie” at the office or outside of work, even though he claims impotence with his wife. Still others will go and indulge in drinking with the “boys” only to go home too drunk to make love to the wife. If this happens regularly, then there are usually other issues apart from but including the drinking that needs addressing with a therapist. It’s amazing how often men claim impotence with “the wife” but makes love easily to the girlfriend. The older men will buy the OTC preparations and Viagra to use with the girlfriend, but not with his wife. Sex is a very sensitive and emotional issue and sexual dysfunctions manifest themselves in other ways apart from, but including, impotence. The problem is that couples do not seek help for sexual problems apart from, the use of supplements and medications, while the underlying problems remain unaddressed. The couple will have “sex” using the aids, but the relationship will still eventually disintegrate and end in divorce or separation.

Apart from the oldest of men and those with impotence following things such as surgery and heart disease, there is always an emotional component accompanying impotence. In addition, we are still very tabooed concerning sexual problems in our country. We do not like to talk about them except in closed environments, usually discussing them with people who are no more experienced or knowledgeable than us when it come to sex, so it becomes a case of the “blind leading the blind”. All men under 50 seeking help for impotence should be screened for psychological issues and relationship problems, as they should be screened for cardiovascular disease. The former involves a few questions and the latter a few tests; together this screening takes about 15 minutes and can save the man his relationship or life! Unfortunately, this is rarely done and the man or couple ends up taking medications or OTC preparations that treats the impotence and avoids the underlying problems. Many times when psychological problems are detected, men prefer to just “have a pill” than to deal with the issues. On the surface it appears easier and cheaper; it certainly takes less time than going to the doctor which involves initial counselling, then referral to a therapist. I deal with the issue midway. I prescribe the Viagra or other treatments based on the underlying cause and advise the patient to seek the help of a therapist. I inform them that the medication is just for temporary treatment for helping the impotence, but it is just like placing a “plaster on a sore”.

Next week we will discuss the medical treatment for physical impotence.

For comments or question contact:

Dr Rohan Deshong

Tel: (784) 456-2785

email: deshong@vincysurf.com