Comprehensive Treatment of Male Psychogenic Erectile Dysfunction by Sex Therapy ADN Psychotropic Drugs (Without Pde5 Inh.)

Abstract

The aim of this presentation is to explain the curative treatment of male psychogenic erectile dysfunction (ED) by sex therapy and psychotropic drugs (without PDE5 inh). This reduces the PDE5 dependency and non-responsiveness later on. Psychogenic ED is very common in conservative Muslim society like Pakistan where masturbation and sex education is a taboo. Masturbation is religiously inhibited. 415 patients of erectile dysfunction were treated at Nasim Fertility Center Lahore, ISD and FSD during Oct. 2015 to Oct. 2016. In these patients 67% are bellow 40 years age and 84% had the symptoms of less erection or no erection and less ejaculatory time (duration of the symptoms varies from few months to many years) and had predominantly psychogenic erectile dysfunction without any organic cause. This is almost the reverse ratio to European and American studies. Diagnostic work up included, detailed sexual and medical history, and relevant lab investigation. Psychological factors that predispose, precipitate and maintain psychogenic erectile dysfunction are treated by psychosexual therapy (sex Therapy), which integrates cognitive behavioral interventions, system/couple interventions and sometimes-psychoanalytic interventions. Performance anxiety or acute stress in psychogenic ED is treated by SSRI, benzodiazepines, supported by yohimbine and testosterone and some time by I/C injection. This pharmacological intervention facilitates early recovery. Aphrodisiac food and regular physical activity is advised.