Erectile dysfunction (ED) is a common issue that affects around 40% of Australian men with that number increasing as men age. Erectile dysfunction is defined by the difficulty gaining or maintaining an erection during sexual activity and can impact experiences of sexual well-being and satisfaction. While physical health problems like heart disease, diabetes, and hormonal imbalances can contribute to erectile dysfunction, psychological factors also play a big part. Let's break down how ED is diagnosed, explore different treatment approaches and talk about the importance of pleasure-focused sexual activity.
Having a few instances of erectile difficulty is very common that this alone would not meet criteria for erectile dysfunction. To meet diagnostic criteria, difficulty with obtaining and maintaining an erectile or decrease in rigidity is needed to occur more often than not over a 6 month period.
Diagnosing erectile dysfunction typically involves a comprehensive assessment that includes a detailed medical and sexual history, physical examination, assessing quality of your relationship/s, exploring stress levels and conducting other diagnostic tests. Your GP may inquire about the frequency, duration, and quality of erections, as well as any underlying medical conditions or medications that might contribute to the difficulties.
Whilst medical management (such as viagra) can be a useful strategy in helping you gain/maintain an erection, medications do not attend to the psychological factors that can contribute to erectile difficulty. In cases when a GP has not been able to identify a physiological factor to erectile dysfunction then psychological treatments are most effective and will not require individuals to rely on medications. For those who have a physiological component to their ED then medications along with psychological treatment is the best approach as therapy can assist individuals and couples incorporate medications into pleasurable sexual play.
There are a few different therapeutic approaches when treating ED and the approach will largely depend on the assessment and individual factors that are contributing to the erectile difficulties.
One common approach is mindfulness-based therapies, like mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT). This approach can be really helpful for men with erectile dysfunction as it teaches people to be present in the moment, reduce stress, and become more aware of their bodies. Mindfulness practices can help men tune into their bodies and sexual sensations, easing anxiety and improving sexual function.
Couples based sex therapy is another common approach. A couples based approach can focus on improving communication between partners, enhancing intimacy, and addressing any relational barriers to sexual satisfaction/activity. Techniques may include sensate focus exercises, which encourage couples to explore non-sexual touch and gradually build up to sexual activity without the pressure of performance.
Regardless of the way in which you approach treatment, one of the most crucial aspects of addressing ED is shifting the focus from performance to pleasure. Pleasure-focused sexual activity emphasises the enjoyment of sexual experiences rather than the achievement of an erection or orgasm. It’s important we recognise that sexual satisfaction is not solely defined by the ability to achieve an erection or orgasm. Expanding the definition of sexual satisfaction to include emotional connection, intimacy, and the enjoyment of shared sensual experiences can significantly reduce performance pressure and anxiety which helps to create a more relaxed and enjoyable sexual experience for all partners.
Erectile dysfunction is an issue that often needs a well-rounded approach to treatment. While medical solutions can help, addressing the psychological side through therapy and focusing on pleasure over performance can lead to a more satisfying and fulfilling sex life. By understanding how ED is diagnosed, exploring psychological treatments, and emphasising pleasure, men can improve their sexual health and overall quality of life.
If you or your partner is experiencing difficulties with erections and would like to find out how you can improve the quality of your sexual life, get in contact with our clinic and our clinicians can support your sexual wellbeing.
