Erectile dysfunction (impotence): symptoms and treatment

Erectile dysfunction is one of the sexual problems that most worries men. It usually occurs for different causes, although performance anxiety is one of the psychological origins that can cause it and that turns this problem into a vicious cycle from which it is difficult to get out.

Erectile dysfunction can cause consequences in different spheres of a person's life: self esteem issues, relational difficulties, etc.

Erectile dysfunction, why does it occur?

Any alteration of the mechanisms involved in erection can cause erectile dysfunction. From the outset, it is very important to know if there is any alteration at an organic level (as is the example of the neurological problems or vascular).

Once any affectation of organic origin has been ruled out, it is when we can examine the problems of psychological origin, being performance anxiety again the protagonist of this dysfunction.

Causes: performance anxiety

Performance anxiety is an alert state that appears in response to the set of thoughts that connect with previous unsatisfactory results and augur a new failure.

The battery of messages related to "Will I make it?", "What if it goes wrong again?" or "what could change this time?", leads the individual to a mental state governed by over-analysis; the demand and fear join forces to find a channel of expression.

Putting one's own capacity in doubt, added to the enormous lack of knowledge (what is causing the problem) generates a feeling of frustration that, again, fuels thoughts related to the alert.

How can psychotherapy help us?

From Psychotherapy, the different areas that can trigger stress and anxiety in the life of the patient are worked on (life experiences, current work and family situation, relationship, etc.), as well as more specific aspects related to performance anxiety.

The obligation to deliver results, excessive altruism, and self-observation are three key themes of performance anxiety. In order to improve the ability to self control, therapy focuses on detecting automatic thoughts that trigger alertness. In the line of what has been commented, these types of thoughts respond to:

• The need to give a very consistent and long-lasting erectile response.
• The control of the satisfaction of the couple more than of their own and joint eroticism.
• Continuous observation of the penis and its functioning.

Talking about these types of concerns offers the patient a channel of expression that will increase emotional self-awareness. This, added to the creation of alternative thoughts, it will diminish the voice of self-demand and facilitate the work of self-empathy. Likewise, building a discourse with all the elements that remain in the "backstage" of the problem (taboos), will facilitate understanding and rapprochement within the couple.

Guidelines and tips to follow

An important point is to provide the patient with guidelines that reduce the level of nervousness and pressure in sexual experiences.

More concretely, one of the indications that is sometimes offered in sex therapy is to "prohibit intercourse" throughout the first sexual encounters, thus getting the concerns that previously we mentioned (the results 10, the satisfaction of the couple and the physiological response itself) cease to be a source of anxiety.

There are many myths in relation to the genitalization of sexual relations or the belief that they are only complete if penetration and orgasm are achieved. It is true that the genitalia are a very important part of the human body, but reducing sexuality to the genitality is to limit the experience, especially if we consider that the whole of our body is sexed. The skin is a sexual organ, and as such, it must be taken into account in our intimate relationships.

Penetration is just one more practice within the multiple possibilities we have to satisfy ourselves. There can be very pleasant sexual relations without intercourse. This connection again with pleasure is another of the objectives within Psychotherapy.

What happens if the person does not ask for help?

First of all, it is important to differentiate between an isolated manifestation or an established problem.

When it comes to a dysfunction that recurs over time, serious problems appear such as impaired self-esteem, avoidance of sexual relations and conflicts at the level of the couple. In reference to this last point, the belief that "you are more and more distant" and "you don't want me anymore" attributes the origin of the problem to wrong causes and ends up becoming a reason for discussion and estrangement.

From couples therapy it is essential to work on communicating the fears and needs of each member, thus achieving an atmosphere of love and mutual care... A problem that was previously experienced from loneliness, is now being lived from hand.

And premature ejaculation, why does it occur?

Premature ejaculation is the most common sexual problem among the male population. This lack of control can be due to many different causes. In fact, the origin is inaccurate. What we do know is that it depends on psychological factors and, many times, on beliefs related to men and sexuality (cultural aspects).

Among the factors that contribute to the existence of this dysfunction we find predisposing factors (for example, family history, circumstances that accompanied the first sexual relations and poor learning), the precipitants (among which the low sexual frequency, the demanding partner and performance anxiety), and maintainers (where performance anxiety, lack of psychosexual skills and the couple conflicts), without forgetting all those biological aspects that could exist in each case.

• Related article: "Premature Ejaculation and Psychology”