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Hildt and Keeler 1 I. (Elliott, 2011)Male Erectile Disorder (ED) II. General Description & Clinical Presentation Male Erectile Disorder is an inability to adequately obtain and/or retain an erection satisfactory for sexual activity. It is also known as impotence, erectile incompetence, and erectile dysfunction. This disorder is categorized as being an “acquired” sexual dysfunction “versus” a “lifelong” sexual dysfunction. It is also categorized as being “generalized versus situational”. If the erectile dysfunction is considered lifelong, the disorder is viewed as “more serious” and harder to treat. Many men who suffer from the disorder feel shame, embarrassment, loneliness, and guilt. Etiology Male Erectile Disorder was once looked at as being an “organic versus functional” comparison. However, many studies have shown that it stems from one or many of the following intertwined as to the cause of the disorder: psychological, social influences, and biological factors. a. Biological Factors can account for indirect and direct explanations as to why a male has erectile dysfunction. A man may have a disease that does not directly affect his ability to have an erection, but because of the affects of his disease it can influence his sexual performance. Factors that directly affect a males’ ability to have an erection or sustain it are some of the following: low testosterone, heart disease, diabetes, and nervous system disorders. One of the major diseases that affects’ erectile Hildt and Keeler 2 dysfunction is diabetes. This is due to the poor blood flow that a person experiences which then affects a male’s possible lack of erection. III. Psychosocial Factors such as anxiety play a big part in male erectile disorder. The pressure a man may put on himself to perform sexually affects his ability to create an erection. The thoughts one has can greatly have an impact on how one may or may not perform sexually. IV. Differential Diagnosis of male erectile disorder is important. There are many supports in the media, groups and online that may help a man self-diagnose. Although this disorder can be very embarrassing for a man, he should begin with a visit to his physician. The physician will go through a series of questions and possibly tests to help rule out factors that may be the cause. This will help the physician focus in on what may be causing it and then assist the patient in moving in the right direction to help with the dysfunction. V. Prevalence of erectile disorder is not uncommon. About half “of all men” will encounter the dysfunction at one time or another in life. As a man ages, so does the possibility of the dysfunction especially due to other diseases common in an aging man. Such as cardiovascular disease. VI. DSM-IV Diagnostic Criteria a. “Persistent or recurrent inability to attain, or to maintain until completion of the sexual activity, an adequate erection.” b. “The disturbance causes marked distress or interpersonal difficulty” c. “The erectile dysfunction is not better accounted for by another Axis I disorder (other than a Sexual Dysfunction) and is not due exclusively to Hildt and Keeler 3 the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.” VII. Pharmacological Interventions The use of medications to treat male erectile disorder exist, however they are dependent on the reasoning for the patients’ disorder. Medications such as testosterone replacement, intraurethral or other oral medications, and vacuum devices may be used to help with the disorder. VIII. Counseling Interventions Sex therapy is an option for male erectile disorder. The therapy is dependent on if the client is able to have an erection at all. The client should be in good health and have passed blood and any other tests to rule out physical reasons to the dysfunction. The counselor will give homework assignments for the client to do. This type of treatment works best when the partner is a willing participant in the therapy. IX. Perceptions/Reflections from Contemporary Media This disorder was widely known as impotence and it has been viewed as only a psychological issue. It was all in ones’ mind. However, it is now known that there are other factors that have an impact on a man’s ability to create and/or sustain an erection. Hildt and Keeler 4 X. Additional Resources for Therapeutic Support Elliott, S. M. (2011, November). Hot Topics in Erectile Dysfunction. Retrieved June 3, 2013, from BC Medical Journal: http://www.bcmj.org/articles/hot-topicserectile-dysfunction Erectile Dysfunction/Impotence. (n.d.). Retrieved June 3, 2013, from The Ohio State University-Wexner Medical Center: http://medicalcenter.osu.edu/patientcare/healthcare_services/mens_health /erectile_dysfunction_impotence/Pages/index.aspx Knott, L. (2012, December 4). Erectile Dysfunction. Retrieved June 3, 2013, from Patient.co.uk: http://www.patient.co.uk/doctor/erectile-dysfunction Miller, T. A. (2000, January 1). Diagnostic Evaluation of Erectile Dysfunction. Retrieved June 3, 2013, from American Family Physician: http://www.aafp.org/afp/2000/0101/p95.html XI. Additional Scholarly Resources Erectile Dysfunction Basics. (n.d.). Retrieved from Everyday Health: http://www.everydayhealth.com/erectile-dysfunction/erectile-dysfunctionbasics.aspx Lee, D. (n.d.). Erectile Dysfunction (Impotence ED). Retrieved from Medicine Net: http://www.medicinenet.com/impotence_ed/article.htm Liou, L. S. (2011, September 19). Erection Problems. Retrieved from MedlinePlus: http://www.nlm.nih.gov/medlineplus/ency/article/003164.htm Sex Therapy for Erectile Dysfunction. (2011, February 23). Retrieved from WebMD: http://www.webmd.com/erectile-dysfunction/guide/sex-therapyerectile-dysfunction Staff, M. C. (2012, February 10). Erectile Dysfunction. Retrieved from Mayo Clinic: http://www.mayoclinic.com/health/erectile-dysfunction/DS00162 Steers, W. D. (2002). Pharmacologic Treatment of Erectile Dysfunction. Retrieved from US National Library of Medicine: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1476024/