Sex therapy and cognitive psychotherapy for ED

[Yannis]

Hey!
I am writing this post in order to comment on the fact that sex therapy is almost totally underestimated in this forum!
I even read posts from people saying for example that performance anxiety is caused by a "biochemical" mechanism in the brain for which you can do nothing about,except for taking drugs which is completely wrong medically speaking and let me explain why.
Genaralised anxiety disorder as well as depression are multifactoral,such as performance anxiety,but one of the main causes is probably an imbalance in the neurotransmitters in the brain.Both psychiatrists and psychologists believe that taking drugs for these disorders is effective at the beginning in order to be relieved from the symptoms,but they deal by controlling the symptoms and not the cause.In the long term and in order to change the way you think,psychotherapy is much more effective than drugs.
Master and Johnson's sex therapy and the newest modified sex exercises have been used for years with a high success rate.Of course they have their limitations: 1)you have to be willing to try,it takes time and patience 2)you have to be in a relationship with a supportive partner.The main idea is this:for a certain period of time you and your partner agree that you can do whatever you want sexually except for intercourse,even if you have a firm erection.This is very important because the thing that people with ED do is that when they have an erection they go on intercourse because of the fear that they will lose their erection.The "STICK-IT-BEFORE-YOU-LOSE-IT" thing is understandable,but very destructive for people with ED.After all,every mature person knows that the idea "sex=intercourse"is wrong,i mean you can please your partner with so many other ways!
Let me say something else:A certain guy here always says "visit your urologist,visit your urologist"!Of course,this is right and i agree,but at the same time the same guy who says that we should take only approved drugs,he uses oral phentolamine,a drug which is only used in ...brazil and since i am a doctor(microbiologist,nothing to do with urology)i can assure you that no European or American urologist would prescribe oral phentolamine,especially combined with viagra,levitra or cialis,this is nonsence!
For more information about sex and all the available treatments concerning ED,we should all read Bernie Zilbergeld's book "The New Male Sexuality" which has sold millions of copies worldwide and the author is probably the most reputable sex therapist in the US.
Thanks for your time reading my ideas,greetings from Greece!

[Flavio]

I'm the guy who said 'visit your urologist'.

I'm sure you agree that seeing a doctor before you decide to try any ED treatment is a sensible piece of advice.

I didn't underestimate the benefits of sex therapy. I didn't mention it simply because I never tried it, that's it. Maybe you can post a thread on the mechanics of psychotherapy - you are a doctor, you seem to be an expert on the subject and it would be a welcome addition to these forums.

[Flavio]

[...] a drug which is only used in ...brazil [...]

It is an approved ED treatment in Brazil (and Brazilian authorities are very strict in these matters) and produced by Cimed Pharmaceuticals, a giant corporation and a reliable source. And it's not just Brazil, it is also available in other countries (e.g. Venezuela) and, correct me if I'm wrong, European doctors may legally prescribe it as a generic drug.

[BonersAtAllCosts]

A first-stage approach for performance anxiety, that much is sure. In a relationship, this is definitely a lot easier to tackle. Make sure you've cut out porn/fapping, share the materials you're reading with your significant other, and have at it.

I'm in a situation where I can't see myself necessarily being in a relationship for the next year or two. My recent approach instead will be pretty similar to how you're classically tough to deal with social or rejection anxiety, especially with approaching women: put yourself in the uncomfortable situation as many times as you can, and try to do what you can to make it a bit better each time. You can experiment with methods of relieving the pressure to have sex by just telling the woman you'd prefer to do everything but sex, just because you don't like to jump right in to things. Of course, you know what happens -- she'll be more comfortable doing stuff with you, and with the pressure to have sex removed, you'll undoubtedly escalate relaxation beyond anxiety.

I will let you folks know if this works for me to any degree.