Treating erectile dysfunction without medication
Reviewed by our clinical team
Although erectile dysfunction (ED) is predominantly associated with physical causes, such as circulatory problems, psychological contributions to the problem are not given enough attention. This can occur when the functioning of the penis is completely capable of erection, but erection is inhibited by pyschological factors.
Sex is an extremely subjective experience, requiring body and mind to work together. When you hit this sweet spot, you may find your cure for erectile dysfunction.
It is often forgotten that achieving and maintaining an erection requires a man to be psychologically engaged, rather than being a puppet of a mindless physical response.
In this article we're going to look at the psychological causes of ED and assess the usefulness of the different types of therapy for ED available. To find out more about the cause of your ED, and to find out the best treatment options for you, you can complete a free online consultation through our ED clinic.
Causes of psychological ED
Lots of cases of ED have psychological causes, which can include:
- Performance anxiety
- Loss of arousal and interest in sex
- Relationship issues
- Low self-esteem and body image
- Unrealistic sexual expectations
- Previous traumatic sexual experiences
If left unaddressed, psychological ED can lead to a vicious cycle, whereby fear of embarrassment and failure eclipse pleasure, sexual intimacy is increasingly avoided, and relationships breakdown.
It is important to understand the nature of your ED in order to get the right treatment. If the cause of your ED is psychological, using medication targeting physically-induced ED alone may not always be very effective. Viagra, for example, will only work if you are sexually aroused. Many men might also prefer a non-invasive means of approaching their ED, as an alternative to penile injections.
The good news is that there are a multitude of different therapies available for addressing ED. These can also be very beneficial for patients with predominantly physical ED, when used in conjunction with erectile dysfunction medication.
Yoga for erectile dysfunction
Erections are a great indicator of your cardiovascular health. So if you are not getting it up then it could be an early sign of developing heart related diseases. To ensure you have a healthy heart one key aspect is regular exercise which will ensure blood flow to penis is good.
Studies have shown that approximately 40 minutes of exercise four times a week or either moderate to vigorous intensity is proven to decrease ED caused by cardiovascular conditions.
But not all exercise is the same and hopping back into football, basketball or even some weight-lifting may be too much for you, especially if most of your life been sedentary. The last thing you would want is injuring yourself.
Therefore, there is yoga! Yoga increases your strength, mobility, flexibility and general health and could help you be more flexible and mobile in the bedroom.
Yoga also helps psychological aspect not just physical. Yoga, with a focus on breathing and body awareness, is a proven way to relax, reduce stress and calm the sympathetic nervous system (the fight or flight response). The mind-body connection is key and that is what yoga strives to develop. It helps you stimulate your parasympathetic nervous system (the rest and digest response). This ultimately, makes you more resilient and flexible towards stressful situation.
There are various yoga poses to trial which can be beneficial, including:
- Standing forward fold
- One legged chair
- Downward facing dog
- Seated spinal twist
CBT for erectile dysfunction
What is CBT?
Cognitive behavioural therapy (CBT) is perhaps one of the most useful forms of therapy for addressing ED, especially related to performance anxiety, low self-esteem, and loss of sexual arousal. CBT is a proactive and actionable therapy targeted at helping you change the way you think and behave. It privileges the idea that thoughts, feelings, and physical sensations are all interlinked.
Following this method, you work to understand how specific triggers can evoke thoughts, feelings, sensations and behaviours. As a result, you can adopt a more positive and realistic approach to sex more generally and take the focus off getting an erection.
What does CBT for ED involve?
Your therapist will work to develop a shared understanding of how thoughts – such as negative predictions, unrealistic expectations and distorted beliefs about a partner’s needs – can lead to a physical reaction such as ED. Sexual education, developing communication methods, and undoing negative thought patterns are essential to this therapy.
Discussion is structured so you can tackle specific goals and have a clear sense of direction and progress.
An individual treatment plan will then be worked out collaboratively, and between appointment sessions you will be encouraged to practice strategies and techniques to overcome certain issues. The focus is very much on current problems and feelings, as opposed to a more traditional therapy approaches of delving into your past.
CBT can be provided by the NHS or privately, and in case you do not wish to see a therapist face-to-face, you can always try internet-based CBT. Ask your GP for a referral to ensure you get the right therapist for you.
Potential outcomes of CBT for ED
CBT is a shorter form of talking therapy than psychosexual therapy and can be completed relatively quickly if you commit yourself to it. The strategies for managing negative thought cycles are extremely practical and can affect real change in terms of breaking down overwhelming feelings of failure, hopelessness, depression and anxiety.
Armed with new structure and strategies, you can reach a point where you can deal with your issues without a therapist.
Psychosexual therapy for erectile dysfunction
What is psychosexual therapy?
This type of counselling is a deeper-dive, relationship ‘talk therapy’ looking at the emotional, psychological, and sexual issues which may be influencing your ED. It offers a great opportunity for you and your partner to communicate and express very difficult feelings in a managed environment.
What does psychosexual therapy for ED involve?
It will involve exploring and talking about your relationship to identify trouble areas, and analysing your sexual patterns and habits before the advent of ED. You can let loose about your personal sexual expectations, needs, and desires, as well as any anxiety you may feel.
The counsellor can also provide you with activities and tips to improve trust and communication within your relationship.
This form of therapy can be great at building a more communicative, honest relationship, as well as helping to reduce sexual anxiety. Many find the opportunity to have an open conversion on their sexual life to be invaluable, and the increased communication can strengthen their feeling of connection as a result. You may even gain new ideas on how to approach future sexual issues together.
Psychosexual therapy needs to be slowly developed and can take quite a long time to work. Results have been mixed and are not at all guaranteed, although progress is more likely to be achieved if both partners approach sessions with an open-mind and willingness to share.
Sex therapy for erectile dysfunction
What is sex therapy?
This form of therapy has a shorter-term focus and centres on the experience of sex itself. It will involve both discussion with a sex therapist and mini assignments between sessions.
Sex therapy is particularly useful for addressing ED caused by stress and poor sexual communication, as opposed to deeper psychological or sexual issues. It can take the form of about 20 one-hour sessions.
What does sex therapy for ED involve?
You can expect to talk about your attitudes to sex and any perceived problems, so that your therapist can recommend specific exercises to overcome or improve on these. A therapist can provide advice on how to boost the sexual experience, such relaxation and stimulation techniques, as well as ways of communicating.
The ‘senate focus’ exercise is particularly popular, where both partners agree to abstain from sex for a few weeks but increase non-sexual bodily contact and understanding. You gradually begin to incorporate sexual elements into your touching until you are both ready for sex, increasing the other person’s understanding of how you like to be touched.
Again, including your partner will make this form of therapy more effective. The therapy can be used to discuss sexual concerns, or for advice on how to approach conversations on ED treatment with a partner, especially when they are invasive measures, such as surgical treatment.
General sexual education around male sexual response, the context in which you have sex, the psychology of sexual interest, and the effect of age, medication and health problems are major benefits of this therapy.
This kind of therapy is unlikely to be very effective if a man or a couple stops the treatment after only have a few sessions. Again, dedication and investing time in the exercises outside of sessions are needed for maximum effectiveness.
How can I find a sex therapist that can help with erectile dysfunction?
Any man suffering from ED, regardless of whether psychologically or physically rooted, is strongly encouraged to be assessed by their GP. This is to exclude potentially serious underlying physical causes such as diabetes, high blood pressure, and high cholesterol.
If the cause of your ED is deemed to be psychological, your GP may refer you to a sex therapist if they think it will help. However, sex therapy is not widely available on the NHS, you can look for qualified registered therapists on the College of Sexual and Relationship Therapists (COSRT) or the Institute of Psychosexual Medicine.
Other treatments for erectile dysfunction
Aside from therapy, there are lots of other treatments available for ED. Lots of men find that medications like Viagra or Cialis, help their ED. Other might find that Vitaros cream works for them or devices like a vacuum pump or constriction rings.
You can take our free online consultation in our ED clinic to find out more about treatments that might be suitable for you.