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GORDON F. GREEN, CDR, MC, USNR
Do you have any of the following conditions?
What are the advantages and disadvantages of each of these treatment options?
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Psychogenic impotence is relatively uncommon. It is characterized objectively by the presence of good nocturnal and morning erections and negative findings from all other tests. During the interview, a history of highly variable erections that can be totally absent one day but virtually normal the next suggests a psychogenic cause. Virtually 100% of men with severe depression have erectile dysfunction (ED). Sildenafil (Viagra) works well for psychogenic ED; other treatment modalities are also effective because the tissues, nerves, hormone levels, and vasculature are normal. The authors usually recommend a full psychological evaluation in these patients so that the underlying etiology can be identified and treated appropriately rather than just treating the symptom of ED. Therefore, the authors defer treatment of the patient's ED until he has begun psychological testing and therapy for the underlying problem.
Received September 30, 2003; de novo received December 21, 2003; revision received March 10, 2004; accepted March 17, 2004.
If low testosterone is the only cause of a man's erectile dysfunction, it can be treated with testosterone replacement therapy.
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"For men getting a high dose of radiation in a shorter amount of time than is typical -- meaning getting higher doses per day for fewer days -- a loss of sexual function is the chronic side effect that concerns most," noted study co-author Dr. Eric Horwitz, a clinical director in the department of radiation oncology at Fox Chase Medical Center in Philadelphia.
Reading books about sexuality.
All men at one time or another will experience ED. Only if the problem becomes persistent -- occurs more than 50% of the time, or becomes a source of distress for you or your partner should you be concerned and consider seeking medical advice and treatment. For men whose erectile dysfunction is caused by psychological problems, therapy may be needed.
- Headaches and flushing ( may sham 1 in 10 people or more);
"We do need more research," she added. "I'm sure it can be a pharmacological tool that may one day be able to help patients who cannot take Viagra."
Are condoms a good choice?
Treatments (with the exception of testosterone supplementation, where effective) work on a temporary basis: they enable an erection to be attained and maintained long enough for intercourse, but do not permanently improve the underlying condition.
The ability to achieve and sustain erections require:
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