Sex Therapy for ED in Roanoke, Virginia

Erectile dysfunction affects millions of people and it is treatable.

 When the issue is not just medical

There are lots of great treatment options for erectile dysfunction when it is medical in nature, but what about when it is caused by anxiety or relationship dynamics?  As a sex therapist located in Roanoke, Virginia, I can help.  Even problems with a biological basis have a psychological and emotional component.  For example, what if medication really helps performance, but you’re so stressed and plagued by past failures that you don’t even want to try again?  What if your partner said hurtful things to you when you weren’t able to perform that you aren’t able to get out of your mind?  Even with medical improvement, the mental and interpersonal barriers can linger until they are treated and addressed.

Performance anxiety

A big cause of erectile dysfunction is… past erectile dysfunction, or even just the fear of being unable to perform.  Enjoying sex requires relaxing and letting go.  It’s hard to do this if you’re replaying bad memories and feeling overcome with worry.  If things get really bad, the thought process can go, “What if I can’t keep it up?  My partner is going to think I’m not attracted to her, or judge me, or be angry with me.  I’ll feel like a failure.  She’ll probably leave me.  No one will want to be with me if I can’t perform sexually.  I’m going to die alone.”  These are the exact opposite of sexy thoughts!  Our culture puts SO much pressure on penetrative sex as the gold standard… sometimes people forget that there are other ways to connect sexually and have fun.

Partner dynamics

The partner of someone with ED might take it personally.  She might feel unattractive, hurt or rejected.  She might lash out in a vulnerable moment and become angry and critical.  At the very least, she might be disappointed, and this can be hard to handle.  As a sex therapist, I like to help the partner to understand that there are a lot of factors that go into getting and keeping an erection.  Challenges in this area are much more likely due to anxiety, stress, or even tiredness than lack of attraction and motivation.  When a woman becomes distracted from feeling aroused, her partner might not even know.  Yet when an erection goes away, it can’t be concealed, which adds a lot of pressure.

Common physical factors include:

-            Cardiovascular disease

-            Diabetes

-            High blood pressure

-            Hormonal imbalances

-            Medication side-effects

-            Smoking

-            Excessive alcohol consumption

-            Drug use

Lifestyle modifications that can help:

-            Healthy diet

-            Regular exercise

-            Reducing or avoiding substances that cause issues

Common psychological factors include:

-            Stress

-            Anxiety

-            Depression

-            Relationship problems

Treatment options for psychological factors:

-            Stress reduction practices like meditation, deep breathing, time spent in nature, or yoga

-            Therapy, either individually or with a partner

Medication options:

Phosphodiesterase-5 (PDE-5) Inhibitors:

These medications, such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis), relax blood vessels in the penis, allowing for increased blood flow and easier erection.  Generic options are available and are relatively inexpensive.  A primary care physician will often prescribe these medications.  There are also online services to meet with a prescriber remotely and receive the medication through the mail (such as Hims at www.hims.com and Roman at https://ro.co/erectile-dysfunction/ )

Hormonal Therapy:

In some cases, hormone replacement therapy, such as testosterone replacement therapy, may be used to treat ED caused by hormonal imbalances.

Vacuum Erection Devices (VEDs):

VEDs (also called penis pumps) are devices that create a vacuum to draw blood into the penis, resulting in an erection.  A medical provider can write a prescription or recommend a specific model, and these can also be purchased without a prescription online and in adult entertainment stores.

Penile Implants:

In severe cases of ED, penile implants may be considered as a surgical option. These devices are surgically inserted into the penis and can be inflated to produce an erection.

Don’t lose hope

There are many treatments for ED, including medical treatment, lifestyle factors, and addressing stress and relationship concerns.  Many people are able to enjoy sex again with the right treatment, education, and support.

Consult with a sex therapist

If you live in or near Roanoke, Virginia, or are interested in online sessions from anywhere in Virginia, please reach out to schedule a free consultation with me.