Submissive Men More Likely to Suffer Erectile Dysfunction
WebMD News Archive
Nov. 2, 2000 -- Say "erectile dysfunction" these days,
and the response is likely to be "Viagra." Such is the power of
advertising. But there was a time, not that long ago, when psychotherapy was
the mainstay of treatment for what was then known as "impotence." Has
it become outdated or irrelevant?
It shouldn't be, say the New England Research Institutes. In a
study published in the American Journal of Epidemiology, the Watertown,
Mass.-based organization analyzed nearly 800 men of whom more than 160 had
erectile dysfunction, and found that men who are submissive are much more
likely to develop erectile dysfunction than those who are not -- and that
problem can't be cured by the little blue pill.
Regardless, psychologists say they are feeling the pinch of the
Viagra revolution. "There's a very significant drop in the number of men
who come into a therapist now for ED [erectile dysfunction]," says Paul
Tobias, PhD, a psychologist in private practice in Santa Monica, Calif.
"Their primary response is to see an internist and get Viagra prescribed --
or not prescribed. As a psychologist, this [seems like] you deal with the
symptom, not the cause. It's very easy to use a Band-Aid -- but quite often it
doesn't take care of the root cause."
But even Tobias admits that Viagra can sometimes be the answer
even when a psychological problem is the primary cause of a failed erection.
Take the case of a man with performance anxiety -- perhaps the most common
psychological cause of erectile dysfunction. If you increase performance by
prescribing Viagra, then the anxiety part of the equation disappears.
But, Tobias says, Viagra is not a fix-all -- perhaps especially
when the problems involve younger men. "Younger couples need to work with
someone because the issues are quite often buried -- issues of power,
dominance, virility. Often ED is just a symptom of a conflict that exists
between a couple."
Psychologist Warren Edwards, PhD, remembers the days when
erectile difficulties were thought to be connected to males' too-early viewing
of a vagina. "In the early 1960s, we talked seriously about that stuff. Now
we're more recognizing that things have changed -- and we're once again going
back to the idea there's some organic component in most men's erectile
Edwards, a staff therapist with the Mercy Hospital in Des
Moines, Iowa, points out that the reverse scenario also is true in many cases
-- where otherwise psychologically healthy men develop erectile dysfunction for
physical reasons, and then develop psychological problems. "I've
worked a lot with men in their middle years, and typically they would have some
organic contribution. Maybe they were overweight or had a pain in their
back." Sex was uncomfortable for these men, he says, so they would resort
to trying to get it over with quickly. That would lead to problems. "If
you're 60 years old and trying to have sex in a hurry, you're probably going to