Beyond the Erection: The Many Benefits of Beating Erectile Dysfunction
Erectile dysfunction (ED) can negatively affect a person's sex life, self-confidence, psycho-emotional health and relationships. Conversely, successfully beating erectile dysfunction—or, often enough, just engaging in the ED treatment process—can result in a number of benefits.
Defeating ED and realizing the benefits, or at least learning how to overcome and process the psychological pitfalls that lead to and result from penis-related sexual dysfunction, often requires guided reflection on thoughts and behaviors that could be contributing to the problem.
Critical self-talk is a common problem among men experiencing ED, according to Rossana Sida, Psy.D., L.M.F.T., a sex and relationship therapist based in Los Angeles.
"The work is then about challenging these negative beliefs about themselves and finding ways to combat the negativity when it does creep in," Sida explained. "Once they can do that, they begin to see that the way they think of themselves has been affecting them throughout their life and it is unhealthy for them."
Expanding the definition of sexuality as part of the treatment for sexual dysfunction is vital, said Robert Mendelsohn, L.M.F.T., the assistant clinical director at the Center for Healthy Sex in Los Angeles.
"What you find is when you do enough of this, the ED problem solves itself," he said. "That can occur with psychogenic ED caused primarily by mental and emotional factors."
Mendelsohn further noted that he and other therapists typically entreat someone with ED to first see a urologist so physiological factors can be ruled out as contributors, or identified and dealt with to the degree possible.
"Whether it is or whether it isn't [caused physiologically], you want to maximize the sex life, you want to maximize people's pleasure and expand the definition, if it needs expanding, beyond intercourse, beyond the erection," he added.
A whole host of benefits—including the five described below—can accrue when a man does the sort of work Sida and Mendelsohn alluded to: figuring out how to reframe, transcend or manage the experience of ED
Reductions in anger, anxiety and shame
Psychogenic ED can stem from a number of causes, each typically requiring a different treatment approach or focus, according to Danielle Harel, Ph.D., a clinical sex expert and the co-founder of the Somatica Institute, an organization in San Francisco that trains and certifies people to become experiential sex coaches.
"Most often, [ED] is because of performance anxiety: a fear of not getting hard or not being able to please their partner, which then becomes a self-fulfilling prophecy," Harel said.
Sex therapy for ED decreases the anxiety levels of many men and can lessen their experiences of shame, Mendelsohn added.
"That's why it becomes a kind of self-perpetuating issue," he added.
Underlying shame can trigger ED, and experiencing ED can, in turn, engender or reinforce an erection-precluding sense of shame. Therapy can be used to interrupt such cycles.
"I find that, generally, they become less reactive," Mendelsohn said about men who treat ED through therapy. "There's less anger, generally, in their life."
A boost in confidence
Spotting and recasting critical self-talk spurred by and potentially contributing to sexual performance problems pertaining to the penis can work wonders in beating erectile dysfunction.
"Through learning how to talk to themselves in a more balanced and healthy way, they have increased levels of confidence, begin to stand up for themselves, set firmer boundaries with others, and begin to see that sex isn't just a bodily act but that the mind is really what brings pleasure," Sida explained.
ED can cause feelings of inadequacy in men and threaten their personal sense of what it means to be a man, according to Harel, co-author of "Cockfidence: The Extraordinary Lover's Guide to Being the Man You Want to Be and Driving Women Wild." Their confidence tends to return when they work through their ED.
"It also helps when they can realize that they are an amazing lover whether or not their penis is erect," Harel noted.
"Overcoming ED can help create an environment for mindful pleasure without the fear or concern or problems with functioning," said Shannon Chavez, Psy.D., a sex therapist and clinical psychologist with a practice in Beverly Hills, California. "Increases in confidence after treatment lead to improvement in sexual satisfaction and increase in desire and initiation of sexual activity."
Bodily awareness and mind-body connection
Effectively beating erectile dysfunction tends to entail a guy actively recuperating a connection with his body.
"Often, one of the characteristics of ED is a kind of disconnection of the mind from the body," Mendelsohn said. "Often with ED, men are getting into their heads. They're getting into their anxiety or they're getting into expectations; they're getting into negative cognitions and they're forgetting their bodies. So the work is often based around really getting in touch with the body in a way that they haven't been before. So their relationship to their bodies, to pleasure, to what they like is generally enhanced. And, very often, the work leads to deeper issues."
Learning how to attend to subtle cues that indicate a need to relax, release tension and breathe is part of the therapeutic process, according to Chavez.
"Helping men become more embodied helps to normalize the variation in sensation and sensitivity that penis owners experience and also helps to build intensity from caressing and gentle touch versus hard stroking and pressure," she said.
She mentioned hip stretching, pelvic floor exercises and yoga as helpful modalities for individuals in the process of beating erectile dysfunction. They have the potential to improve blood flow, reduce tension and tightness around the pelvis, and heighten the mind-body connection during stimulation and pleasuring.
Greater self-knowledge, less pressure to perform
Working through ED with a therapist frequently yields knowledge about deep-seated issues dating back to emotional wounds or trauma some men have experienced, Mendelsohn said.
"So they come out of it, generally, with a better understanding of who they are, why they do what they do, why they want what they want; [they] kind of have a better sense of themselves and the context in which they live," he said. "And then I find often there's more assertiveness, and that tends to ripple out in other areas of their lives, because part of the treatment for ED involves getting in touch with what they want, what they need, how to express needs [and learning] to be less performance-oriented."
Sida said sex therapy can educate a person about the effects of various, frequently interacting factors that contribute to ED: excessive masturbation, low self-esteem, lack of or perceived deficiency in sexual knowledge, and negative self-talk, among others. The client can learn to replace unhealthy behaviors with healthier ones and reconfigure unhelpful frameworks for thinking about oneself, sex and relationships.
"In sessions, men learn a lot about themselves, how they think, how their body works and what sex is about," she explained. "Contrary to popular belief, sex is not about orgasm. Sex is about play, pleasure and connection. I am confident that going into sex with a more playful, pleasurable and connected attitude would improve the sex life of anyone. This lesson is very important for men with erectile difficulties to understand, because it takes a lot of pressure to perform off of them and allows them to enjoy it instead."
Enhanced communication equals better sex
Communicating with a therapist or a coach can enable better communication with partners en route to and in support of beating erectile dysfunction, Sida said.
"Men's relationships begin to improve early in the treatment of ED because communication is a key piece of how they will heal," Sida noted. "Early on, I ask clients in what ways the erection difficulties affect their partner. Often, the answer is that their partner feels unattractive, worries that they are unloved or feels that they are bored with their sex life. Essentially, their partners are blaming themselves and they begin to feel incredibly self-conscious."
Someone shouldn't assume responsibility for a partner's ED, Mendelsohn said, adding that the female partner often internalizes such feelings. Removing these feelings by having conversations about what type of touch is preferred and what turns the other person on can help. Having a partner, especially one willing to participate in the "homework" therapists assign, can be a big help.
Mendelsohn said therapists often assign homework for the person struggling with ED to do individually and, when possible, with a partner. The work has the potential to enhance relationship satisfaction.
"Most fundamentally, there's improved communication, because it's very important that the man becomes aware of his anxiety moment to moment," Mendelsohn said. "Often, the anxiety about sex starts even before the initiation of sex—already, anxiety is present."
He added that he teaches men to be in tune with their anxiety and able to stop and say a few important phrases:
- Hold on, I think my anxiety is coming up.
- Let me work with that.
- Let me connect with my partner.
- Let me communicate with my partner.
- Let me be present in the moment.
"For guys who are still struggling with ED, I want to tell them the first thing to remember is that everyone's body changes over time and that we will all have to deal with differences in function in our lifetime," Harel explained. "These differences don't make you less of a man, and you can still have an amazing, satisfying and passionate sex life no matter what. For [men] who have recently overcome ED, I'd tell them that overcoming ED can be the beginning of a journey to having the most amazing sex of your life. Sex can be about so much more than just an erection or [intercourse], and I'd encourage them to keep learning, growing and [experimenting]."
