1 / 15

Introduction to Psychosexual Medicine

Introduction to Psychosexual Medicine. Doctor Gillian Vanhegan Member of the Institute of Psychosexual Medicine. Session Four. Male Problems Incidence of ED Physical causes Psychological causes Medical treatment Surgical treatment Psychodynamic therapy. Erectile Dysfunction.

johnajohn
Download Presentation

Introduction to Psychosexual Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Introduction to Psychosexual Medicine Doctor Gillian Vanhegan Member of the Institute of Psychosexual Medicine

  2. Session Four • Male Problems • Incidence of ED • Physical causes • Psychological causes • Medical treatment • Surgical treatment • Psychodynamic therapy

  3. Erectile Dysfunction • Persistent inability to attain and or maintain an erection sufficient for sexual performance • ED has a significant impact on the quality of life for patients and their partners

  4. Massachusetts Male Ageing Study • In men aged 40 to 70 years (1290 subjects in study) 52% had ED • 10% seek or receive treatment

  5. Organic causes • Vascular • Neurogenic • Hormonal • Penile injury or disease • Medications

  6. Underlying diseases • 68% of men with hypertension have ED • 60% of men with ED have dyslipidaemia • 20% of men with ED have Diabetes • 11% of men with ED have depression

  7. Psychogenic causes • Depression • Performance anxiety • Relationship problems • Psychosocial problems • Psychological distress

  8. Differences between organic and psychogenic • Masturbation • Early morning erections • Nocturnal erections • Situational ED

  9. The Erection • Complex neurovascular phenomenon, which is under hormonal control • Arterial dilation • Trabecular smooth muscle relaxation • Activation of corporeal venous occlusive mechanism

  10. Physical treatments • First Line = PDE5 inhibitors • Sildenafil (Viagra) • Tadenafil (Cialis) • Vardenafil (Levitra) • Followed by vacuum devices

  11. PDE5 Inhibitors • They inhibit the degradation of cyclic GMP to enhance smooth muscle relaxation, thus allowing increased blood flow to the penis • Side –effects are flushing, headache and disturbance of colour vision • Contraindication: Nitrates

  12. Physical treatments • Second Line = Intracavernosal injection, or intraurethral Alprostadil • Third Line = Penile prosthesis or implant

  13. Physical Treatment for PE • SSRIs, Dapoxetine • Local Anaesthetic in condoms, such as ‘Performa condoms’ • Squeeze technique

  14. Psychogenic causes • Younger men, nervousness and performance anxiety. Cultural or religious influences. Possible sexual bullying or abuse. • Older men, midlife relationship problems, redundancy and loss of self esteem, competition from younger men.

  15. Next Session • Female Problems • Pain with sex • Vulvodynia • Vaginismus

More Related