Erectile Dysfunction (ED) Q & A

What causes erection problems?

There are three kinds of ED: medical, psychological, and mixed. Sometimes they’re easy to distinguish, but sometimes it takes an expert to tell the difference. As a sex therapist, I deal mostly with psychological and mixed ED, but I’m experienced in working with men with all kinds.

How treatable is ED?

ED is one of the most treatable sexual conditions. Almost any man who is truly motivated can achieve better erections with currently available medical and/or psychological techniques, and treatments are improving all the time. There’s never been a better time to seek help.

How many sessions does ED treatment require?

Most men with ED can be treated in from 1 to 5 sessions. 

Do you prescribe medications like Viagra and Cialis for Erectile Dysfunction?

Yes -- usually in combination with brief counseling for ED-related issues. Short-term use of medication can often speed up ED treatment that used to take months.

What if I have ED but I’m single and don’t have a partner?

Approximately half of the men who consult me for ED treatment are single, so you’re in good company.  And many men with partners prefer to come in alone, which is fine.

What’s your approach to treatment for psychological ED?

Your body is built to prevent erections when you’re not feeling happy. Treatment simply requires figuring out why you’re unhappy, and what to do about it. Sometimes that can be accomplished in a single visit. Sometimes it’s more complicated.

Isn’t ED sometimes linked to deeper psychological problems?

Usually not. And even if there are other issues, it’s almost always best to treat the ED first.

Men with ED are acutely miserable. They need to feel better quickly before any other kind of treatment can take place.

What are the most common mistakes made by men with ED?

They become so preoccupied with their erections that they forget to enjoy sex. They masturbate compulsively, to reassure themselves they can still get hard. Or they start to avoid partner sex.

I notice you’re an MD as well as a sex therapist. Why is that important for a man with ED?

Very important. Erections involve the body and mind together, so it’s an advantage to be trained in both areas. 

As an MD, I assume total responsibility for the overall treatment, and I do a thorough search to rule out possible medical causes. I can also call in urologists and other specialists as needed.

I see you’re a psychiatrist as well. Why is that important for treatment of Erectile Dysfunction?

As you may know, there are two kinds of psychiatrists: the pill kind, and the counseling kind. I’m primarily a counseling psychiatrist, though I’m able to prescribe medication when needed.

Many men with ED also have other conditions such as social anxiety, OCD, or ADHD. And many people these days take psychiatric medications, many of which can affect sexual function. So it can be important to know about these things.

What can I expect from a first visit for ED? 

You can expect to gain a better understanding of exactly why you have ED, and to leave with a list of specific things you can do right away to start getting better erections.  

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