Erectile dysfunction affects a great many men, especially over the age of 40. It can damage self-esteem as well as relationships. What are the treatments for this very frustrating problem?
If the erectile problem is mainly physical, drugs such as VigRx Plus, hormones or devices may be the answer. If it has psychological aspects, sex therapy and counselling may help.
If the erectile problem can’t be traced to a definite reason the man may be offered therapy with VigRx Plus, devices and counselling, regardless of its cause.
For some men, mechanical devices or drugs can restore enough confidence to sustain erections without them after a while. Since drugs and devices won’t overcome intimacy problems, sex therapy is often also suggested.
Mechanical erection-producing devices:
Penile prostheses of various kinds can restore erectile capacity without disturbing libido, ejaculation or orgasm, although they don’t enlarge the penis beyond its natural size. There are devices that actually do enlarge the penis, such as penis extenders.
Perhaps the most well-known penis extender is the SizeGenetics device. It is uncertain whether enlarging your penis with something like SizeGenetics can help overcome erectile dysfunction.
Vacuum devices (such as Penomet), placed on the flaccid penis, increase blood flow via a side arm that withdraws air and creates a vacuum into which blood flows.
The basic model contains a soft plastic tube that fits over the penis and a handheld pump. A rubber band is wrapped around the bottom of the penis to stop blood flowing out. The cylinder is removed during intercourse and the blood drawn into the penis keeps it erect.
“A man can get a good enough erection for penetration, but it’s not rock hard,” says one University of Toronto expert. “Some love the vacuum devices and others hate them. However, it takes practice to use them deftly.” They are rather cumbersome and may dim sensation, detracting somewhat from their popularity.
Permanent penile implants come in inflatable or non-inflatable models that are semi-rigid and can be bent down to seem more natural when not in use. The more complex the mechanical device the more likely it is to break down or malfunction.
Inflatable models – inflated for sex then deflated afterwards are the most popular and operate more like the real thing. One model is composed of two inflatable tubes put into the shaft of the penis with a fluid reservoir in the abdomen and a pump in the scrotum. Squeezing the pump moves fluid into the penis.
Penile implants are a last resort as surgical insertion destroys some erectile tissue. Candidates must be in good health, have a high sex drive, good penile sensitivity and a desirous sex partner.
It is imperative that the couple be assessed for suitability and well informed about the benefits and risks. The risks include infection – requiting removal – swelling and pain.
Sex therapy can also help. Sex therapists are trained professionals such as physicians, social workers, psychologists, nurses and psychiatrists skilled in the art of helping people work through the guilt, hang-ups, worries, anger, sexual myths and misconceptions that bedevil our sex lives.
Sex therapy is particularly useful for dysfunctions that involve performance fears, relationship conflicts and spectatoring (observing oneself and one’s responses rather than participating in the event).
A non-directed “sensate focus,” in which the goal is sensuous pleasure rather than intercourse, often helps couples overcome conflicts around mismatched sexual desire or a lack of “connectedness.” The couple learns to approach sexual intimacy as mutual pleasuring rather than as intercourse or orgasm.
By concentrating on sensual play – neither partner being pressured or expected to become aroused – sensate locus exercises can often override performance anxieties and communication hurdles.
As neither partner expects to become sexually aroused, the couple learns to relax and playfully explore what gives the other pleasure. Each shows the other what kinds of touching he or she enjoys, where the most erotic places are, communicating verbally or by directing the partner’s hand. The exercises work equally well for gay, lesbian or straight couples.
The PLISSIT model of sex therapy, developed about 20 years ago, is based on the premise that many people benefit from the simplest of counselling – even just being permitted to talk about their erectile, desire or other problems. Reassurance, support and information are often enough to reverse a sex problem without intensive psychotherapy.
The acronym PLISSIT refers to four basic stages:
* Permission Giving (P) – permitting people to talk about their sex troubles, fantasies, fears or wishes;
* Limited Information (LI) – often used together with permission giving – providing some basic information (perhaps about erotic zones and genital anatomy) but no specific advice;
* Specific Suggestions (SS) – given for specific sex problems for instance telling someone with premature ejaculation what might slow things down or suggesting that someone with performance anxiety might try sensate focus exercises;
* Intensive Therapy (IT) – required by the relatively few with deeply-rooted psychological sex problems.
The first steps of permission giving and limited information are often enough to resolve a sex problem. Many of us occasionally get the feeling that what we are doing sexually is perverted, deviant or wrong.
All we may need is reassurance or someone to say, “If you are comfortable with it, carry on.” Once a sex problem has been pinpointed, its solution may be obvious to those versed in human sexual behavior.
Please note: A sex therapist should never ask you:
* to take off your clothes, unless for a medical examination;
* to engage in any type of sexual activity with or without your partner in the therapist’s presence.