Psychogenic erectile dysfunction and methods of its treatment

Elements of psychogenic erectile dysfunction( ED) are somehow present in any form of erectile dysfunction in men, since the very fact of sexual failure causes a most powerful stressful condition.

Table 1 - Differential diagnosis of organic and psychogenic forms of erectile dysfunction.

Methods of treatment of psychogenic dysfunction

Psychotherapy

The main method of treatment of psychogenic forms of erectile dysfunction are methods of sexual therapy. One of the main tasks of therapy is to help a man cope with the fear of sexual failure. Discussion of the problem is recommended to be carried out together with the partner. At this stage of treatment, the psychotherapist identifies and eliminates the main cause of psychogenic ED.

Often psychological disorders occur against the background of one failure, which develops into a syndrome of anxious anticipation of sexual failure. These disorders are well treatable by psychotherapy and often do not require other forms of treatment.

Medical treatment

• PDE-5 inhibitors

In psychogenic disorders of erectile dysfunction, any therapy aimed at achieving an erection, including taking PDE-5 inhibitors, is effective, since the very type of erect penis has a powerful therapeutic effect.

The following drugs are used for treatment:

• Sildenafil citrate( Viagra).
• Tadalafil( Cialis).
• Vardenafil( Levitra).
• Udenafil( Ziden).

The majority of the leading specialists in the treatment of erectile dysfunction recognize the same clinical efficacy of this class of drugs, although the distinctive features of each of them( more about drugs to increase potency).

• Antidepressants

In most cases, psychogenic dysfunction is caused by prolonged depression. The appointment in this case of common antidepressants does not improve the sexual function, and moreover, can worsen it. Long-term use of antidepressants is not recommended in connection with the possibility of development of hypogonadism.

Trazodone is a selective serotonin reuptake inhibitor, it also blocks 5-HT2A receptors and moderately suppresses serotonin reuptake.

Trazodone can be used as a separate treatment, or in combination with other drugs for the treatment of erectile dysfunction( in particular, PDE-5 inhibitors and androgens).

Trazodone in a dose of 150-200 mg per day , divided into 2-3 doses, is well tolerated and effective in men with erectile dysfunction of psychogenic nature. With a decrease in libido, both for patients suffering from depression and for patients without depressive disorders, a dose of 50 mg per day is sufficient.

Prevalence of psychogenic ED

According to medical research, 20-25% of cases of erectile dysfunction are caused by psychological disorders. When examining and interviewing men with ED, it was found that the most common causes of psychogenic erectile dysfunction were experiences and stress about work, personal problems( family problems, middle age crisis, etc.).It turns out that avoidance of erectile dysfunction would be much easier if you contact your specialist beforehand with your problems.

Attending physician

• Primary treatment: psychotherapist - if the diagnosis of psychogenic ED is confirmed, the urologist - if the etiology of ED is not yet determined.
• Possible secondary treatment: neurologist, andrologist.

Used Sources:

1. S.Yu. Kalinchenko, I.A.Tyuzikov "Practical Andrology."
2. Other sources.

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