psychological erectile dysfunction

ED of Psychogenic Nature and Its Treatment with Viagra

Friday 19th of January 2018

In 10-20% of all cases of ED (erectile dysfunction), the problem is due to various psychological factors, such as stress or sexual trauma. How to cope with such an unpleasant disorder? Will Viagra help in the case of psychological erection problems?

Contents

  • 1 Definition of Psychogenic (Psychological) ED
  • 2 Prevalence of Psychogenic ED
  • 3 Causes of Psychogenic ED
  • 4 Symptoms of the Condition
  • 5 How to Treat Psychogenic ED?
  • 6 Treatment of Psychological ED with Viagra

Definition of Psychogenic (Psychological) ED

Psychogenic (psychological) erectile dysfunction is a permanent inability to get or maintain a penile erection satisfactory for a normal sexual intercourse, mainly or solely because of psychogenic or interpersonal factors. This diagnosis is not used if the origin of the disorder is uncertain or unknown. Men who have a combination of physiological (organic) and psychological factors are considered to be those who have a mixed organic-psychological ED.

According to a study by R. C. Rosen (2001), psychological erectile dysfunction often exists along with other sexual malfunctions, especially with an inhibited sexual desire (ISD) and severe mental disorders such as depression.

Read about Classification & Management of psychological erectile dysfunction published by Rosen.

Prevalence of Psychogenic ED

Psychogenic ED can occur at any age, but young men suffer from it several times more often than older patients. In men aged 45-55, anxiety and depression can be a major cause of impotence, as shown by the study of H. Sugimori et al. (2005), but this study cannot be extrapolated to all cases, since it concerned Japanese men. Nevertheless, at this age, organic factors begin to predominate. In men over 65, these factors cause ED in approximately 90% of cases, while psychogenic dysfunction is rare.

Causes of Psychogenic ED

The most widespread causes of psychogenic ED include:

  1. Stress. Stress can be caused by a poor material condition, lack of work, workplace issues, financial pressure, marital problems, among other factors. Some people are more prone to psycho-emotional stress than others.
  2. Fear of sexual failure. A typical mechanism for the development of this disorder is as follows. A random, often situationally conditioned sexual failure in the form of deterioration of an erection or its disappearance raises man’s doubts in his own sexual strength. Fear of possible failure leads to suppression of sexual arousal and loss of erection. Because of self-suggestion, a man begins to think that he is unable to perform sexual intercourse. This problem is typical for people having hypochondriacal traits and those suffering from anxiety.
  3. Situational factors. These factors include the lack of conditions for complete intimacy, the fear of contracting a sexually transmitted disease, a powerful external irritant (sudden knocking, screaming), fear of being caught unawares, etc.
  4. Interpersonal problems. They imply worsening of interpersonal relationships, frequent conflicts, negative emotions, misunderstanding and cooling of relations between partners. These can also be differences in sexual preferences and partner’s ridicule.
  5. Indifference. According to WebMD, this problem can arise as a result of ageing and the gradual loss of interest in sex and the opposite sex. Sometimes it arises because of partners’ having problems in their relationship.
  6. Feeling of guilt. A man can think that he does not satisfy his partner. Consequently, this suppresses the natural mechanisms of erection.
  7. Depression. This is a fairly common cause of erectile dysfunction. It causes other negative consequences for health and can be the cause of ED even if a man feels comfortable in an intimate situation with a partner. Moreover, medicines that are used to combat depression can cause problems with erection. Scientists A. Makhlouf et al. (2007) believe that the interaction between these states is undervalued. Psychiatrists are reluctant to ask patients about ED, and urologists rarely assess the presence of depression in men with ED.

Symptoms of the Condition

Symptoms of psychogenic erectile dysfunction usually manifest themselves suddenly. Patients are prone to decreased libido and have a good spontaneous or self-stimulated penile erection (H. Nguyen et al., 2017). Also, psychogenic ED is usually characterized by the restoration of a normal erection after the elimination of an external problem. Unlike psychogenic impotence, with the organic one, the symptoms appear gradually, the spontaneous erection worsens, though the decrease in libido is not observed.

Psychogenic ED is manifested in many forms.

For example:

  • a weak erection that does not allow a man to have sexual intercourse;
  • a fairly strong erection, which however quickly disappears when a man attempts to have sexual intercourse;
  • the appearance of an erection in situations that provoke sexual arousal, if a man excludes the possibility of sexual intimacy;
  • a normal erection that can be achieved only under certain conditions.

How to Treat Psychogenic ED?

Treatment of psychogenic erectile problems should be comprehensive and should include a combination of psychological and drug therapy. A specific treatment plan should be chosen by the physician in collaboration with the patient. If a person suffers from depression, antidepressants can relieve symptoms including ED. But it should be borne in mind that some drugs of this group, on the contrary, can exacerbate ED, as we have indicated above.

PDE5 inhibitors like Viagra remain mainstay in the treatment of psychogenic ED. Studies (e.g., I. Kalaitzidou et al., 2014) have shown that the treatment with PDE5 inhibitors helps both improve erection and reduce stress levels.

Treatment of Psychological ED with Viagra

Generic Viagra is an excellent medication for the treatment of ED, which helps in cases of psychogenic, organic and mixed nature of the disease. It is available in the genuine form and in the form of generics, such as Canadian Viagra. Due to the inhibition of the enzyme PDE5 in penile tissues, Viagra provides vascular relaxation and rapid erection achievement in the presence of sexual arousal.

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The powerful effect of Viagra often becomes a means of psychological protection for a man. He understands that he has nothing to fear, as the drug will help him anyway. The drug becomes like go-to remedy for a male. The use of Viagra or its generics should continue until the restoration of natural psychological protection (A. Perekhov, 2011). But sometimes a strong fear of a possible sexual failure can reduce the effect of the drug.

Therefore, scientists believe that in case of severe pure psychogenic ED, psychotherapy should be conducted.

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