Once the preliminary investigations of the patient have been done and all the sexual issues have been discussed, only then the psychological treatment can be started.
In majority of the cases where the sexual disturbance is short term, non-fixated and there is no consistent organic deficit, the patient may not need more than a few communicative discussions.
It is very commonly observed that the public media either produces or deteriorates one of the most important problems in sexual capacity and makes it very unreal. It is essential to interrogate the attitude of the patient towards his own sexuality.
Clarifications of his own assumptions and failure fears are a must and he should be explained about the human erection physiology. It has been observed that it proves to be helpful when the patient is given rational explanation about the biochemical connections in increased sympathetic tone and failure fear as well as the problem of functional erectile.
The patient and his partner should be able to scrutinize their relationship through this kind of counseling. Along with the erectile dysfunction therapy, betterment in the communication among the partners should also be the motive of psychological counseling.
Sexual therapeutic methods have displaced the earlier psychodynamic therapies in the last few years. Various other forms of treatment like family therapy, couple therapy or behavioral therapy are the basis of sexual therapy. According to Masters and Johnson, a very essential part of sexual therapy is overcoming the fear of failure. For this, the couple is normally asked to stay away from copulation for a certain time period so that the fear of failure can be stopped.
A major objective of sexual therapy is to create a tension free and fear free environment and encourage sexual practice that is non-coital. This kind of environment helps in drastic betterment in the ability to communicate and develop a better relation between the partners.
The chances of improvement are much higher if both the partners are involved in the therapeutic procedure. The diagnosis is not very favorable in cases where the disturbances have been there for a long time, or there are other problems in the relationship with the partner or where there is significant libido loss.
The success rate of sexual therapy when used as an incidental therapeutic intervention in psychogenic erectile dysfunction for a sufficient time period, is nearly 90%. The reasons for such brilliant results in majority of the cases are usually attributed to partner’s involvement.
One of the reasons why this therapy is not so compliant is the long time duration for which it continues and the numerous sittings it takes. Practical problems in this therapy are due to extensive time required and unavailability of sexual therapists that are well trained.
Psychologically oriented therapy is not only useful for psychogenic problems, it must also be talked about with the patient in cases where his erectile dysfunction has an organic origin. There is a very rare chance that there is only one cause of erectile dysfunction even in patients with intense organic finding and especially when there is rare absence of longstanding, psychogenic parts.
The patients who are suffering from erectile dysfunction of psychogenic origin are likely to get better with added organically oriented treatment. According to the new studies, this type of combined treatment is very effective, usually in conjugation with oral medications like Viagra, cialis and levitra.