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Erectile dysfunction causing depression, fear of getting into any relationship, no improvement with medications. Treatment?

im a femaie , my male friend has ed , i am really worried for him as he is very depressed , ihe won t enter into any kind of relationship with a woman he says he feels he is not normal , he has suffererd from this for 3 years , has tried everything , but wont take medication . I personally think he needs to train his negative thoughts . I m at my wits end /
Asked On : Mon, 28 May 2012
Answers:  1 Views:  69
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Psychiatrist 's  Response
Hi and welcome to Healthcare Magic. Thanks for your question...

Erectile dysfunction can be due to various causes. It can be due to medical conditions like diabetes, vascular problems, hormonal problems, etc. However, in young males it can very often be due to psychological factors... one of the most common being 'performance anxiety'.

The approach to ED firstly involves taking a thorough sexual, medical, and psychosocial history. This is both informative to the doctor and serves as an opportunity to educate the patient and clarify any misconceptions and allieviate any anxiety. A physical examination is also essential. A few tests may also be required to rule out any medical causes and sometimes, patients are advised to have a nocturnal penile tumescence testing done (this test helps to differentiate between medical and psychological causes).

It is also important to have a detailed discussion about the patient's ideas, concepts and expectations with regards to sexual performance and his sexual problems. Another very important thing is to realize that the person's sexual partner also plays an integral role in therapy. For successful and effective management to be achieved, the evaluation and discussion of any intervention should include both partners.

Unfortunately, people tend to have an oversimplistic idea about ED - that can just be treated with medication like viagra, cialis, etc., On the other hand, a wholistic approach is what will give most effective results.

I would suggest that you advise him to consult a psychiatrist and discuss his sexual problems, concerns and worries. The psychiatrist will be able to assess him in detail and suggest an appropriate management approach.

All the best.

- Dr. Jonas Sundarakumar
Consultant Psychiatrist
Answered: Mon, 28 May 2012
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