Psychogenic erectile dysfunction (PED) is differentiated from other erectile dysfunction because patients exhibit psychosocial inhibitions to sex, rather than organic inhibitions from medical conditions. Though oral treatments, injections and suppositories meet with some success, men who combine these with sexual therapy have the fullest recovery.
Treatments promise more intimacy for men with PED
Oral Treatment
Pills help nearly one third of patients
Tadalefil, vardenafil and sildanefil are available as prescription pills, targeting enzymes in penile tissue. When these enzymes (PDE5s) are blocked, aroused men find it easier to achieve erection. Most pills last for only four hours and they cannot be used with nitrate medication. According to Banner and Anderson's 2007 work in Vol. 4 of the Journal of Sexual Medicine, 29 percent of men responded to this method alone.
Intracavernosal Injection Treatment
Injections improve confidence
Self-injection of Prostoglandin E1 is a more invasive, but more physiologically successful, treatment. The trained patient uses a syringe to inject his penis with the serum, producing erection within minutes. Unlike other methods, men do not have to feel aroused for injections to work. Patients often use injections for enhancing confidence before transitioning to other methods. According to Devici et al in the Journal of Urology for May 2008, self-injecting patients were 100 percent successful at achieving erections.
Suppository Treatment
Your doctor can introduce you to MUSE
MUSE suppositories deliver the same chemicals as injection, an alternative for patients uncomfortable with syringes. After urinating, the patient slips a pellet into his urethral opening with an applicator, achieving erection within 10 minutes. Side effects include pain, burning and partner discomfort. According to Nathan and Gorman (2005), 43 percent of PED patients respond to MUSE.
Sexual Therapy Treatment
Therapy can teach intimacy
Guided sexual therapy confronts patients' psychological barriers to erection, probing into relationship satisfaction, sexual history and fantasy. Authors suggest therapy is as effective as oral treatment.
Homeopathic Treatment
Acupuncture helps with some PED
Although urban lore suggests homeopathic extracts are successful at curing PED, clinical trials show they are no more effective than sugar-pill placebos (Resource 1). But a study in October 2003 by Engelhardt et al in the International Journal of Impotency Research suggests focused acupuncture produces erections in 20 percent of patients (Resource 2).
Integrated Treatment
Integrated treatment improves desire and performance
By and large, the most effective method of treating PED is through an integrated approach (IA) including psychosexual therapy and PDE5 blockers; around 66 percent of patients resume normal sex lives. Though injection produces erections more often, IA improves both arousal and performance and can lead to full recovery.
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