Erectile dysfunction psychotherapy

Because of the absence of clinically proven safe and effective pharmacotherapy for erectile dysfunction, psychotherapy was until recently the core treatment for most patients, except for a few cases where a surgically correctable cause could be identified. The results of psychotherapy have been disappointing (155), and often times, the goal of psychotherapy was to help men accept their sexual dysfunction rather than to correct it. The widespread belief that erection failure is primarily of psychological origin, and hence the acceptance of psychotherapy as the primary treatment, continued until the early 1980s. 

For patients with psychogenic erectile dysfunction, psychotherapy may be used as monotherapy, or as an adjunct to specific treatments for the disorder. To enhance the relevance of psychotherapy, both the patient and his partner should be included in the counseling sessions. Also, treatment should be individualized and should address those immediate factors that may be causing performance anxiety or depression, rather than the remote, deep-seated reasons for psychological disorders. The effectiveness of psychotherapy is generally low, and long-term psychotherapy is often necessary. 

Specific treatments for erectile dysfunction include medical devices, pharmacologic treatments, psychotherapy, and surgery. 

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