Erectile dysfunction (ED) treatment that targets both physical and psychosocial factors could be the most effective, according to American researchers.
ED can lead to a variety of emotional and psychological problems for men and their partners, including depression, guilt, frustration, and relationship problems.
However, the researchers explained, studies often focus more on the physical aspects of ED treatment than the psychosocial ones.
To learn more, the researchers conducted a systematic review of 40 studies involving ED treatment with phosphodiesterase type 5 (PDE5) inhibitors. Specifically, they examined the psychosocial outcomes of ED before treatment with and the change in such outcomes after treatment.
The included studies used validated measures of quality of life, mental health, and well-being, such as the Self-Esteem and Relationship (SEAR) questionnaire and the Psychological and Interpersonal Relationship Scale (PAIRS).
At baseline, the men in the studies tended to have a generally good quality of life and good relationships, but their sexual relationships were unsatisfactory. Many of the men had low self-confidence, low self-esteem, and depression.
After treatment, most of the men saw improvements, except in their overall satisfaction with life and relationships. The researchers explained that this result may have been due to the short follow-up time in the examined studies or a “ceiling effect” that made it more difficult for the men to judge any changes.
There appeared to be a cyclical relationship between ED treatment and depression. If men’s depressive symptoms improved, their erections tended to improve as well. With better erections, they were less likely to feel depressed. “Thus, treatment of ED with a PDE5 inhibitor would be expected to have a broader impact on a man’s psychological functioning than just improvement in physical symptoms,” the researchers wrote.
They added, “PDE5 inhibitors are effective in the treatment of ED and, as shown by this review, may be effective in addressing a number of psychosocial factors.”
Future research may provide more insight on these two aspects of ED and how they work together.
The study was first published online in November in the Journal of Sexual Medicine.
The Journal of Sexual Medicine
McCabe, Marita P., PHD, FAPS and Stanley E. Althof, PhD
“A Systematic Review of the Psychosocial Outcomes Associated with Erectile Dysfunction: Does the Impact of Erectile Dysfunction Extend Beyond a Man's Inability to Have Sex?”
(Full-text. First published online: November 20, 2013)
“Erectile Dysfunction Drugs May Not Make Men Happier”
(November 26, 2013)