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Erectile dysfunction as a result of pressure

Time to read 4 min

As a sex therapist, I repeatedly engage with diverse and interesting life stories. People come to my practice in Basel because they are experiencing difficulties with their sexuality and, as a result, are experiencing a great deal of distress. This distress can also affect their romantic or other relationships, thus creating even more stress.

Pressure has significant consequences for erections . Here, I'll discuss what erectile dysfunction is, what causes it, and how I address it in therapy .

One thing to note: A person's erectile function changes over the course of their life. It's perfectly normal for an erection to malfunction or fluctuate at times!

What is erectile dysfunction?

“Erectile dysfunction is a persistent or recurring difficulty or inability to achieve or maintain a functional erection—in terms of volume and hardness.” (K. Bischof, A. Bischof-Campbell, S. Fuchs, (2020): Training in Sexocorporel, Issue 4, p. 4.

ICD-11 confirms this definition. Furthermore, erectile dysfunction can persist despite sexual desire and penile stimulation. Erectile dysfunction can be defined as occurring when the difficulty has persisted for several months and the subjective level of suffering is increasing.

The definition also distinguishes whether erectile dysfunction has always been present or whether it has developed over the course of a person's life. It also determines whether erectile dysfunction is common or situation-specific. For example, some people may struggle with erectile dysfunction exclusively during couple sex, while everything functions perfectly during solo sex.

What does pressure have to do with erectile dysfunction?

The following scenarios are conceivable when it comes to pressure and its effects on erectile dysfunction:

The pressure…

…not being able to have sex even though you want to.

…feeling like a failure.

…not being able to satisfy the other person “properly”.

…not being a “real” man.

…no longer feeling any sexual desire because of erectile dysfunction.

These reasons can lead to people suffering from erectile dysfunction feeling considerable pressure, and this can also have an impact on their general well-being or sexual desire.

Physical causes

In addition to psychological factors, physical influences also play a role in the development of an erection. If erectile dysfunction develops over time, it is advisable to consider a urological evaluation . If the penis exhibits nighttime and morning erections and also functions during solo sex, it can be assumed that everything is fine on a physical level. What emotional consequences can erectile dysfunction have?

Emotional consequences and other aftereffects of erectile dysfunction

- Thought carousel

- Suffering

- shame

- speechlessness

- missing and limited connection to the body

- sexual discomfort

- sexual disinterest

This list is not exhaustive and does not contain a hierarchical progression. Nevertheless, many clients report these symptoms in therapy. What are the consequences?

Am I normal?

The question "Am I normal?" is one that particularly draws many people to my practice, and although the topic of erectile dysfunction is a widespread theme in many studies and in the media, the question seems central here as well. Here, I clearly emphasized: Yes, it's normal for the penis to not always be perfectly erect or for its hardness to fluctuate!

Clients suffering from erectile dysfunction question their masculinity. As a result, the topic is rarely discussed, even in male circles or among friends, because questioning one's masculinity can be very personal and sometimes even emotional. This means that sex therapy can play a decisive role in counteracting the progression of erectile dysfunction.

Procedure in sex therapy according to Sexocorporel

In my therapeutic work, I work with the Sexocorporel model. It is based on the unity of body and mind. In addition to talk therapy, I also provide guided physical and perceptual exercises. These can then be intensified and repeated at home. The exercises are tailored to the client's needs and support their resources.

Specifically, this means the following: In sex therapy, I first evaluate how the erectile dysfunction manifests, how long it has been present, and in which situations it occurs. I clarify medical factors and include them in the medical history. Any medications currently being used are also considered and included if necessary. The following steps are central to my discussions:

Therapeutic steps

Identifying a client’s strengths and resources in order to incorporate them into therapy.

“Developing an understanding of the penis”: This means that the client understands that his actions, habits and ways of thinking influence and may even cause erectile difficulties.

Once this foundation is established, exercises can be incorporated and adapted to the client's strengths and resources.

Practice examples

"Getting to Know Your Penis": Incorporate mindful touch into your daily routine, focus on your body, and appreciate the resulting sensations. The experience is key!
Pelvic swing (below an example while standing)

Play with the pelvic floor muscles (initially without arousal)
Abdominal breathing to promote and connect emotions and the relationship to the penis
Incorporate and play with soft and sensual movements
Inclusion of the voice for more enjoyment

It's important to note: This implementation takes time! The body needs time to process these new movements, experiences, and perceptions. When practicing solo sex, there's always a chance of setbacks before you feel confident and comfortable in your body. The more repetitions you do, the more positive connections you can make between your body and brain. Beginning to practice solo sex is also crucial for gaining confidence with erections. As awareness of your own body increases and you learn to "stay with yourself," your ability to achieve an erection can improve, making it possible for you to also succeed in partnered sex.

Without any pressure, you have the power to make your erection soar!

literature
K. Bischof, A. Bischof-Campbell, S. Fuchs, (2020): Training in Sexocorporel, Issue 4

Pictures
https://unsplash.com/de

video
https://www.youtube.com