Impotence responds to psychotherapy

Group psychotherapy can help treat impotence, also referred to as erectile dysfunction, according to the first-ever review of research on the topic.

But larger, long-term studies are needed to confirm if psychotherapy alone can provide effective treatment and to determine which types of therapy are most beneficial, Dr. Tamara Melnik of the University of Sao Paulo in Brazil and her colleagues conclude.

While the effectiveness of erectile dysfunction drugs, such as Viagra, as well as injections into the penis, and vacuum devices have been evaluated extensively, there has been little research investigating psychotherapy for treating erectile dysfunction, Melnik and her team point out in the current issue of The Cochrane Library.

However, psychological factors, such as performance anxiety, are leading causes of erectile dysfunction and may be important to resolve to restore normal sexual function, they add.

To investigate whether approaches addressing psychosocial issues are effective in men with erectile dysfunction, the researchers analyzed the results of 11 studies involving a total of 398 men.

In five of the trials, the researchers found that men who participated in group therapy were 60 percent less likely to have persistent erectile dysfunction than those on a waiting list who underwent no treatment.

Another two studies that looked at group therapy for sexual dysfunction found that 95 percent of men responded to the treatment, which reduced their likelihood of continued erectile dysfunction by 87 percent.

Two studies that compared the effectiveness of Viagra alone or Viagra plus group therapy found that men who received Viagra plus group therapy were less likely than those on the drug alone to have persistent erectile dysfunction or to drop out of the trial.

"For some couples sexual problems represent a neurotic reaction for deep relational conflicts, lack of communication, or power struggles, and drug therapy may not be a solution to these conflicts," the researchers write.

They conclude: "Integrating sex therapy and other psychological techniques into office practice will improve effectiveness in treating erectile dysfunction."

SOURCE: The Cochrane Library, July 17, 2007.