Treatment is a short-term form of counseling, generally involving five to 20 sessions. (If a man drops out of therapy after only one or two sessions, successful treatment of ED is unlikely.) During the sessions, the counselor will give the patient "assignments" to do at home, such as practicing sexual communication skills, reading books about sexuality, and touching exercises that are designed to take away the pressure to perform during sex.
Not only does sex therapy work best when a man's sexual partner gets involved with the treatment; the therapy also helps a man's partner cope with the problem. When a partner gets involved with therapy, men resolve stress-related erectile dysfunction 50 to 70 percent of the time. When a man goes through counseling alone, the success rate is lower.
Even when erectile dysfunction has a clear physical cause, psychological problems sometimes contribute to erectile failure. Several sessions of sexual counseling can help a man who is going to receive medical or surgical treatment for erectile dysfunction. A counselor can guide a couple as they decide on a particular treatment, or the counselor can help the couple improve their sexual communication and lovemaking skills. A man who is single may benefit from counseling on how to talk to a new partner about penile injections or a vacuum constriction device.
Testosterone replacement therapy
The male hormone testosterone is produced by the testicles and is responsible for the proper development of male sexual characteristics. It is also important for maintaining muscle bulk, red blood cells, bone growth, sense of well-being, and sexual function. Though inadequate testosterone production is not a common cause of erectile dysfunction, some men with low testosterone might see increased sexual functioning from testosterone replacement therapy.
As a man ages, the amount of testosterone in his body gradually declines, starting after age 30. Other causes of testosterone deficiency include injury or infection to the testicles, chemotherapy or radiation treatment for cancer, genetic abnormalities, hemochromatosis (too much iron), pituitary gland dysfunction, medications including prostate drugs and steroids, AIDS, stress, and alcoholism. Testosterone deficiency can cause decreased sex drive, decreased sense of well-being, depression, concentration and memory difficulties, and erectile dysfunction.
Testosterone levels fluctuate in the body throughout the day, and a doctor may test the amount of the hormone in your blood several times to diagnose low testosterone. If your testosterone levels are low, your doctor may prescribe one of several different types of testosterone replacement: intramuscular injections, testosterone patches, or testosterone gels. Because oral hormones may lead to liver abnormalities, no pills exist in the United States that provide adequate levels of testosterone replacement.
Though testosterone replacement therapy is generally safe, it is associated with several conditions including acne, oily skin, mild fluid retention, stimulation of prostate tissue and increased urination, breast enlargement, worsening of sleep apnea, and decreased testicular size. Some laboratory side effects of testosterone replacement therapy include changes in blood cholesterol, increased red cell count, and a decrease in sperm count (which can produce infertility, especially in younger men).
Since testosterone may stimulate prostate growth, the hormone can also accelerate the growth of prostate cancer. It is important for all men considering testosterone replacement therapy to undergo screening for prostate cancer before starting treatment. Further, men with breast cancer should not take testosterone replacement therapy.
Alternative treatments
Some men with erectile dysfunction choose to treat their condition with alternative medicines or techniques. These alternative treatments, which include nutritional supplements, herbal remedies, and acupuncture, fall outside standard western medical practice; many have not been evaluated for effectiveness in clinical trials. It is important to consult a physician about erectile dysfunction to determine the cause and receive appropriate treatment for the condition. Men considering alternative treatments should seek the advice of a healthcare provider.
Popular nutritional supplements to treat erectile dysfunction include bioflavonoids, zinc, vitamin C, vitamin E, and flaxseed meal. Supplemental doses of the amino acid arginine have helped some men with ED, according to research. Some people claim that herbal remedies such as Asian ginseng and Ginkgo biloba help improve sexual functioning. You should consult a doctor before taking any herbal supplement to weigh the risks and potential benefits of herbal remedies.
Although some ED patients have shown improvement from low levels of the hormone dehydroepiandrosterone (DHEA), experts have expressed concerns about the drug's long-term safety.
Acupuncture, a technique that involves sticking very fine needles into specific points on the body, is believed by some to stimulate the body's ability to resist or overcome illnesses and conditions. Acupuncture has helped some men with erectile dysfunction.<
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