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Erectile Dysfunction Sex Therapy: How It Works

August 10, 2021

For men, erectile dysfunction is among the most common forms of sexual issues. Unlike some other roadblocks, erectile dysfunction leads to a physical inability to have sex. For women, physical sexual dysfunctions, like vaginal dryness that typically occurs as a result of low estrogen and aging, can be remedied through the use of lubrication.

Erectile dysfunction, meanwhile, may require a more complex treatment, and like any sexual dysfunction, it can be caused by a variety of issues. Diagnosing and treating ED can be challenging. Psychogenic erectile dysfunction is one of the more common forms of ED. Psychogenic factors involve the interplay between mental health and physiological response. Risk factors for developing ED that fall under the psychogenic umbrella include performance anxiety, depression, relationship strain, and psychosocial factors. 

Sexual dysfunction is a subject that no one wants in conversation, particularly with close friends and even your significant other. Your silence may be detrimental, however, as sexual health plays an important social and cognitive role in your well-being. Intimacy is proven to deepen bonds and further connection in an incredibly beneficial way.

When sexual dysfunction affects either partner, it's important to confront it rather than ignore it, say most experienced therapists. Confronting sexual dysfunction can be uncomfortable, but the outcomes can be an even better sex life and a closer bond with your partner. To get help with psychological erectile dysfunction, an individual may be referred to a sex therapist. A sex therapist is a therapist that specializes in treating sexual disorders, dysfunction, and other sexuality-related hurdles. 

Below is a deeper look at sex therapy, how it works, and additional information surrounding ED treatment. 

What is Sex Therapy?

Sex therapy is a therapy session in which sex is the overarching topic of concern. Sex therapy owes its beginnings to the mid 20th century where it was one of the only actual treatment options for men with erectile dysfunction. 

In the beginning, psychoanalytic therapy predominated the scope of sexual-based therapy. Sigmond Freud developed the psychoanalytic theory, which focuses on pivotal stages known as the psychosexual stages of development. Each stage represents a fixation on a part of the body. If the individual has an issue with a particular stage, it can lead to disorders associated with that stage. 

Freud's technique is largely considered antiquated, but the focus of sexual desire's effects on development opened the door for sex to be less taboo and observed more closely under a scientific scope. 

Sex therapy today is much different. The main goal of sex therapy is to give you the tools, resources, and space to voice your sexual concerns and seek guidance from an expert. Sex is still a largely taboo topic in public and is not always easily discussed. Sex therapy is meant to be that outlet and resource to help with your sex life through psychological intervention. 

What to Expect in a Sex Therapy Session

A sex therapy session can sound intimidating, but knowing what to expect before your first appointment is a great way to reduce the initial nerves about seeking sex therapy care. 

A sex therapy session very closely resembles what a typical therapy session might look like. In the first session, you should expect to discuss what issues you want to address through therapy, along with your goals and what you hope to achieve. This gives the therapist an idea of what success might mean for you and will allow them to work toward that goal. 

The therapist will typically ask you some questions regarding your circumstance to better understand where you are at versus where you want to be. If beneficial, it may be helpful to have your partner present in order to have conversations that may be tricky to navigate alone. 

After the therapist gathers some initial information, they may look for further introspection on your part to help determine an overarching cause of stress, anxiety, or lack of sexual function. The therapist may also give you exercises to help you with your given situation. For example, if the relationship is the crux of the problem, the therapist may give you activities to complete with your partner to rebuild communication.

Overall, a sex therapy session is nothing to be worried about. It involves a lot of talking, introspection, learning, and listening. Everything said in the session is confidential, and your privacy is protected by law. 

If your ED is psychological in nature, a sex therapy session may help you tremendously. 

How Can Sex Therapy Improve ED?

While sex therapy is largely conversational in manner, it can help with a range of causes of erectile dysfunction. Largely, anxiety and stress are the main components of psychological erectile dysfunction. These stresses could be from external sources like finances, relationships, or factors that revolve around sex, like performance anxiety or a broken line of communication during sex. 

For stress-induced instances of ED, a sex therapist may give the couple exercises to perform that help alleviate the pressure placed on the male.

The ultimate goal with sex therapy for psychogenic erectile dysfunction is to get the underlying stress and response to stress under control and give the patient the tools needed to cope effectively. 

Even if sex therapy doesn't help with your specific form of ED, it can be an effective way to come to terms with ED, the medical treatment, and how it impacts you. Many men face erectile dysfunction alone, and sex therapy is an opportunity to open up to another unbiased person to seek guidance for ways to navigate the challenges of dealing with ED. 

Psychological ED vs. Physiological ED

Psychological ED is not the only form of ED. In fact, only 10-20% of all ED cases have a psychogenic cause. Instead, the majority of ED causes are physiological. Physiological causes result in a physical inability to get an erection due to changes in the underlying biology and sexual response. 

In the sexual response cycle, a person encounters four stages. These stages include libido, arousal, orgasm, and resolution. Psychological ED is typically focused on the mental causation of libido and arousal interruptions; however, physiological ED can impact any part of the sexual response cycle.

Some common causes of physiological ED include vasculogenic, hormonal, neurogenic, and drug interactions. The biological process of obtaining an erection requires the vascular, hormonal, and nervous systems to work in synchrony. When any part of this fragile system is impacted, it can result in erectile dysfunction. 

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How is Physiological ED Treated?

Physiological ED can be treated in a number of different ways -- the physiological cause will determine what the best treatment option is for you. 

As an example, vasculogenic ED is caused by a decreased ability of the cardiovascular system to maintain or attain an erection. Vasculogenic ED can be caused by a low level of activity and poor diet, leading to cardiovascular disease and decreased cardiovascular efficiency. 

In addition to prescription, generic ED meds approved by the FDA, a physician may make positive lifestyle modifications a part of the treatment plan, too. 

Not all forms of physiological ED can benefit from the power of PDE5 inhibitors like Cialis®, Levitra®, and Viagra®. There are other treatment options available, and you should consult your healthcare provider for the best next steps for you and your ED if PDE5 is not working for you. They may suggest an assistive device like a penis pump or even surgery, depending on your specific case. 

Who Can Help With Non-Psychological ED?

While a psychologist typically facilitates sex therapy, most licensed physicians can help treat ED with medication-based solutions. Physicians undergo extensive education and are well versed on the functions of the body, and a licensed clinician can help navigate your ED and find the best treatment option for you. 

Rex MD is a telemedicine service that makes visits for ED quick and painless. With no appointment necessary, you can work directly with a U.S. licensed clinician to help you find the right ED treatment. If needed, the professional can prescribe and mail your prescription directly to your residence. 

The Takeaway

Sex therapy is a form of therapy that focuses on improving sexual issues that have a psychological or social aspect. For ED, sex therapy is a great treatment option for those that have anxiety or stress leading to ED, and it's especially helpful when combined with a prescription ED medication to help boost confidence and performance in the meantime. 

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