Erectile Dysfunction (ED) is extremely common, affects men of all ages, can be extremely discouraging – and is often highly treatable. I’m a Manhattan sex therapist with over 30 years’ experience helping men in NYC regain sexual confidence. I’m an MD as well as a sex therapist, so I understand how the mind and body interact. If you’re concerned about your erections, there’s never been a better time to get help. Contact me to get started.
There are three kinds of ED: medical, psychological, and mixed. Sometimes they’re easy to distinguish, but sometimes it takes an expert to tell the difference. As a sex therapist, I deal mostly with psychological and mixed ED, but I’m experienced in working with men with all kinds.
ED is one of the most treatable sexual conditions. Almost any man who is truly motivated can achieve better erections with currently available medical and/or psychological techniques, and treatments are improving all the time. There’s never been a better time to seek help.
Most men with ED can be treated in from 1 to 5 sessions.
Yes — usually in combination with brief counseling for ED-related issues. Short-term use of medication can often speed up ED treatment that used to take months.
Approximately half of the men who consult me for ED treatment are single, so you’re in good company. And many men with partners prefer to come in alone, which is fine.
Your body is built to prevent erections when you’re not feeling happy. Treatment simply requires figuring out why you’re unhappy, and what to do about it. Sometimes that can be accomplished in a single visit. Sometimes it’s more complicated.
Usually not. And even if there are other issues, it’s almost always best to treat the ED first.
Men with ED are acutely miserable. They need to feel better quickly before any other kind of treatment can take place.
They become so preoccupied with their erections that they forget to enjoy sex. They masturbate compulsively, to reassure themselves they can still get hard. Or they start to avoid partner sex.
The most common would be not taking a careful ED history in couples with sexual avoidance. Worry about ED is the most common reason men avoid sex – even if the ED happens only once in a while. (Hey, you’d probably avoid going to the movies too, if you knew there was a 20% chance the projector wasn’t going to work). Many therapists will work with a sexually avoidant couple for months or years without taking a careful ED history.
Does he require constant stimulation to stay hard? Does his partner have to ‘work’ to get him hard? Does he rush to penetrate, because he’s worried it’s ‘now or never’? Few therapists feel comfortable getting these raw details.
Too many therapists will accept a patient’s report that ‘the pills didn’t work,’ rather than ask in detail about side effects, timing, which pills were tried, and whether the dose was adequate.
Hardly any therapists will take the time to get a detailed account of what typically happens – step by step – when a couple has sex. Who does what first? How does that feel? What happens next, and why?
At what point does he usually lose his erection? Treatment is completely different if he loses hardness after 10 seconds, vs if it happens after half an hour.
Many marital therapists will only see the couple together – never separately. From a sex therapy perspective, that’s almost always a mistake. For most couples, there are important things you’ll never hear unless you spend time with each of them alone.
Very important. Erections involve the body and mind together, so it’s an advantage to be trained in both areas.
As an MD, I assume total responsibility for the overall treatment, and I do a thorough search to rule out possible medical causes. I can also call in urologists and other specialists as needed.
As you may know, there are two kinds of psychiatrists: the pill kind, and the counseling kind. I’m primarily a counseling psychiatrist, though I’m able to prescribe medication when needed.
Many men with ED also have other conditions such as social anxiety, OCD, or ADHD. And many people these days take psychiatric medications, many of which can affect sexual function. So it can be important to know about these things.
You can expect to gain a better understanding of exactly why you have ED, and to leave with a list of specific things you can do right away to start getting better erections.