Individual Counseling, Couples Counseling and Sex Therapy

ED and the MD

Last night I was on the radio with a certain MD that specializes in men’s sexual health. In this post, he will be referred to as “Dr. X.” As is typical of me, I speak my mind even when it goes against what another professional may be saying. And, I tend to become more passionate than usual when I think that professional is operating in a less-than-ethical way. In this case, that includes perpetuating the following beliefs:

  1. Female sexual desire is dependent on male erections. I wish I were making this up. Dr. X stated that the female sexual desire drops due to their partners’ ED; implying that female sex drive is equally as high and as focused as male sex drive. I’m not sure where he came up with this one. Certainly not from the research, which indicates external things like relationship issues, stress, etc. affect female sex drive. I suppose the male erection could be included in that list, but it is far from the only factor. In addition, research shows that the male sex drive is higher as compared to female sex drive. To believe that female sexual desire operates like male sexual desire means you are not keeping up with the literature.
  2. If men cannot get an erection their sex life is over. To think that penile-vaginal penetration is the only sex act is myopic at best and devastating at worst. Even with the treatment that is available, what about the men who cannot take ED drugs, are unwilling to take them, or what if they don’t work? Assuming ED means never having sex again is akin to sentencing men to a life alone. Completely unacceptable and unnecessary. Fortunately, that is not the case. There are many more sexual acts to choose from. Plenty.
  3. And, the corollary: Having sex = having intercourse. Several times, Dr. X used these terms interchangeably. What about role-play, oral stimulation, manual stimulation, erotic massage, etc., etc., etc.? All of these are very enjoyable ways of being physically intimate with your partner that don’t require penetration. And erections are only required for penetration. Men can experience pleasure, including orgasm, without an erection.
  4. There are no psychological aspects of ED. During the show I raised the point that anxiety about ED can make the problem worse, and that the partner’s reaction to ED can also contribute to anxiety about it, creating a negative feedback loop. Rather than acknowledge that there is a psychological component, Dr. X simply spoke of all the “couples he has helped” by giving the men drugs. Clearly, he fails to view the problem holistically. Certainly physical issues are a possible cause (and I always send my clients for a medical check-up for this very reason), but psychological factors also contribute, and if they aren’t addressed the problem can continue. In another words, psychological treatment may make ED drugs unnecessary.

In summary, if you are experiencing ED, or any other sexual dysfunction, be sure to use a practitioner that believes in BOTH the physical and psychological aspects of the problem.

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