Erectile dysfunction (impotence): what is it and what is its treatment?

One of the most common sexological disorders in men. We explain its causes.

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

Erectile dysfunction can have consequences in different spheres of the person's life: self-esteem problems, relational difficulties, etc.

Erectile dysfunction, why does it occur?

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

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 a state of alertness that appears as a 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 I change this time?", leads the individual to a state of mind governed by over-analysis; demand and fear ally to find a channel of expression.

Doubting one's own capacity added to the enormous lack of knowledge (what is causing the problem) generates a feeling of frustration that, again, feeds the thoughts related to alertness.

How can Psychotherapy help us?

Psychotherapy works on the different areas that can trigger stress and anxiety in the patient's life (life experiences, current work and family situation, relationship, etc.), as well as more specific aspects related to performance anxiety. (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. With the aim of improving the capacity for self-control, the therapy focuses on the detection of automatic thoughts that trigger the state of alertness. Along the lines of the above, 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 partner rather than of the eroticism of oneself and of the partner as a whole.
• The 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, coupled with the creation of alternative thoughts, will diminish the voice of self-demand and facilitate the work of self-empathy, 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 advice to follow

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

More specifically, one of the indications that is sometimes offered in sexual therapy consists of "prohibiting sexual intercourse". throughout the first sexual encounters, thus ensuring that the concerns mentioned above (the results, the satisfaction of the partner and the physiological response itself) cease to be a source of anxiety.

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

Penetration is just one more practice among the multiple possibilities we have to satisfy ourselves.. There can be very pleasurable sexual relations without intercourse. This reconnection with pleasure is another goal of 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 is a dysfunction that is repeated over time, serious problems appear such as the affectation of self-esteem, the avoidance of sexual relations and conflicts at the couple level. In reference to this last point, the belief that "you are becoming more and more distant" and "you no longer desire me", attributes the origin of the problem to wrong causes and ends up becoming a reason for discussion and estrangement.

In couples therapy it is essential to work on the communication of the fears and needs of each partner, thus achieving an atmosphere of love and mutual attention... A problem that was previously experienced from loneliness, is now experienced hand in hand.

Why does premature ejaculation occur?

Premature ejaculation is the most common sexual problem among the male population.. This lack of control may be due to many different causes. In fact, the origin is inexact. 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 collaborate in the existence of this dysfunction we find predisposing factors (for example, family history, circumstances that accompanied the first sexual relations and poor learning), precipitating factors (among which stand out the low sexual frequency, the demanding partner and performance anxiety), and maintaining factors (where performance anxiety, lack of psychosexual skills and couple conflicts stand out again), without forgetting all those Biological aspects that could exist in each case.