How are erection problems treated in sex therapy?

Erectile dysfunction is one of the sexual dysfunctions that affects most men. Fortunately, however, it can be treated effectively by both medicine and sex therapy based on the results of psychology and emotional regulation methods.

In this article you will find a summary of how erectile dysfunction is treated with psychosexual therapy, As well as the factors that can cause this problem.

    What is erectile dysfunction?

    Also known as ‘impotence’, erectile dysfunction is the inability to maintain a full erection during sexual activity. It is, along with premature ejaculation, the most common sexual dysfunction in men.

    Dyserection it can be produced or facilitated by a large number of organic alterations; basically, all those which directly or indirectly affect the physiological process linked to sexual arousal and the triggering of the changes that this produces in the male genitals. This includes injuries from bumps, burns or cuts, as well as diseases that damage the nerve cells involved in an erection, as well as those that impair the production of certain hormones.

    In practice, however, and if we look at the statistics, the pathologies with easily identifiable organic causes with which erectile dysfunction is most associated are cardiovascular disease and benign prostatic hyperplasia. In other words, two phenomena that directly influence the functioning of the genitals (it should be remembered that erection occurs when the cavernous bodies are filled with blood) and their surrounding areas.

    On the other hand, as we went along, erectile dysfunction it is a problem that is statistically closely related to age; it affects around 7% of men under 40, 22% of those 40 and one in two of those 70.

    However, it would be simplistic to assume that erectile dysfunction is essentially a medical problem. The main causes are often psychological, and even in cases of organic disease, emotional disturbances often overlap with the symptoms of the latter. That is why, when therapy is offered to men with erection problems, in the early stages, great importance is placed on determining the cause (s) of what is happening to you, from here on out. , offer personalized cognitive, emotional and behavioral solutions. the processes likely to play a role in the appearance of this phenomenon are neglected.

    between psychological aspects that can cause or promote the onset and maintenance of erectile dysfunction it is necessary to emphasize the following:

    • depression
    • Anxiety during sex
    • Intrusive thoughts about erection failure
    • Insecurity with own nudity and sexuality
    • Conflicting relational dynamics with the last sexual partners

    How is erectile dysfunction treated in sex therapy?

    These are the main areas of intervention in patients with erectile dysfunction, although they are always used or not depending on the specific needs of each person.

    1. Psychoeducation and sex education

    Something as simple as report on problems related to sexuality, emotional management and healthy habits that needs to be followed to prevent sexual dysfunction is very helpful in combating erectile dysfunction, especially in cases where it mainly occurs due to fears and belief in myths circulating about sex.

    2. Imaging exercises in therapy

    Imagery is based on performing imaginative exercises, having previously practiced so that these mental images and their associated sensations are very vivid, very similar to the real world. They allow you to control emotions during key actions, in this case focused on sexuality and sexual arousal. In this way, it is possible to practice managing anxiety and other emotions in a “controlled environment” in which it is easier to start making progress from the first relatively simple challenges.

    This way, he loses fear of the kind of experiences associated with erection. In addition, the patient is trained in the ability to let go of worrying about whether an erection is in progress or not (these fears often hamper the process) and instead focus on satisfaction.

    3. Neurofeedback

    Neurofeedback it is used in a wide variety of problems caused in whole or in part by poor anxiety regulation. It consists in bringing the patient to a certain mental state at the same time that he receives information on his nervous activity in real time, thanks to a series of sensors applied to his skin. He thus learns to encourage those psychological operations which bring him closer to a certain objective, and to discard the rest.

    4. Improve self-esteem through cognitive restructuring

    Low self-esteem is closely linked to sexual dysfunctions, both as a cause and as a consequence. Therefore, it is common to work in therapy to help the person have a more appropriate level of self-esteem.

    It involves a wide variety of techniques and strategies, but one of the most important is cognitive restructuring, which is to get the patient to question dysfunctional beliefs that they hold onto and that have caused them problems, By replacing them with others that allow you to have a more constructive mindset and not to fall over and over into avoidance of experiences.

    5. make a challenge calendar

    Between therapy sessions, patients are required to perform a number of tasks in their private life. These objectives to be reached throughout the week are distributed temporarily and designed according to an ascending difficulty curve and adapting to the person’s level of progress; having short-term goals (days or hours in sight) makes the patient feel more motivated to keep improving.

    Bibliographical references:

    • Althof, SE and Wieder, M. (2004). Psychotherapy of erectile dysfunction: more relevant than ever. Endocrine, 23 (2-3): pages 131-134.
    • Anna Kessler Sam Sollie Ben Challacombe Karen Briggs Mieke Van Hemelrijck (2019). The global prevalence of erectile dysfunction: a review. BJU International, 124 (4): pp. 587-599.
    • Avasthi, A .; Grover, S .; Rao, TSS (2017). Clinical practice guidelines for the treatment of sexual dysfunction. Indian Journal of Psychiatry, 59 (1): pages 91-115.
    • Kendirci, M .; Nowfar, S .; Hellstrom, WJ (2005). The impact of vascular risk factors on erectile function. Drugs Today (Barc), 41 (1): pages 65-74.
    • Shamloul, R .; Bella, AJ (2014). Dyserection. Editorial Biota.

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