Erectile and Ejaculation Issues

Erectile Dysfunction (ED)

Not being able to get or maintain an erection can be devastating for men and their partners. Although there are highly effective medications for ED, some men cannot take these medications, and others may still not be getting the results that they want. The causes of ED are often complex. Some of the most common reasons ED develops include:

  • Anxiety

  • Relationship issues

  • Medical issues or medications

  • Lack of sexual knowledge

I specialize in identifying how your erectile dysfunction developed, so we can most effectively reduce or eliminate ED symptoms and restore confidence and pleasure in your sex life. While it’s not possible to provide any guarantees, in many cases, men who complete treatment with us increase their ability to get and maintain an erection.

Phosphodiesterase-5 (PDE-5) inhibitors, such as Viagra, Levitra, and Cialis, help to relax the smooth muscles of the penis, thus allowing more blood flow and a firmer erection. When they are prescribed, however, doctors often do not address issues critical to treatment success including, “restarting a sexual life after an extended period of abstinence, partner resistance, partner concerns or dysfunction, lack of confidence, performance anxiety, and unrealistic expectations” (Althof, p. 7). If approved by your physician, Beth will work with you and you and your partner to successfully incorporate one of these medications to assist in improving the quality of your erection.

Sometimes when men have one sexual experience in which they lost or could not get an erection, they subsequently are very anxious about being sexual due to fear of it happening again. This fear can then cause the loss of erections. You can imagine how the man can now be stuck in a cycle of fear and loss of erection. Beth can often greatly help the individual in these situations by working to unwire the anxiety about sex that got wired in as well as teaching behavioral changes that allow for improvement in the quality of erections.

Reference
Althof, S. (2010). What’s new in sex therapy. Journal of Sex Medicine, 7, 5-13.

Premature Ejaculation (PE)
or Rapid/Early Ejaculation

Premature ejaculation, now more often called rapid ejaculation or early ejaculation, can be a very frustrating issue for you and your partner. The DSM-IV-TR defines PE as “persistent or recurrent ejaculation with minimal sexual stimulation before, on, or shortly after penetration and before the person wishes it” (p. 554).

Although the time it takes men to ejaculate varies by each individual, by country and by other factors, Waldinger, Quinn, and Dilleen (2005), found in their study of 500 couples from 5 countries that the overall median value of Intravaginal Ejaculation Latency Time (IELT) was 5.4 minutes. There are multiple factors that can contribute to Early Ejaculation, including new sexual partners, anxiety, medical/hormonal issues, neurobiological contributors, relationship problems, lack of body awareness, and previous traumas. We will complete a thorough assessment so we can most effectively identify and treat it and the underlying factors. Sometimes, an exam by a physician is recommended as part of the treatment process. Behavioral exercises that can be done at home can often lead to an improvement in ejaculatory control as well.

References
American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC.

Waldinger, M., Quinn, P.,Dilleen, M., Mundayat R., Schweitzer, D., Boolell M. (2005). Ejaculation disorders: A multinational population survey of intravaginal ejaculation latency time. Journal of Sexual Medicine, 2, 492-497.