Sexual Dysfunction Clinic
Male Sexual Problems
“Sexual dysfunction is when he's not able to perform with his sexual partner,” says Matt Broadway-Horner. “The main problem is being unable to get an erection. It’s much more common than people realise. In the 20-40 age group it affects around 7-8% of men, in the 40-50 age group it affects 11%. In the over-60s it affects 40%, and more than half of men over 70.” It can affect any man, whether he is straight, gay, bisexual or transgender. Read more about erectile dysfunction (impotence) and premature ejaculation
Erectile Dysfunction (Impotence)
This is when a man can’t get it up, or keep, an erection. Most men experience it at some time in their life. It only becomes a problem when the man or his partner considers it a problem
What Causes Erectile Dysfunction?
A variety of things cause it. Some psychological and some physical. Psychological issues tend to affect younger men, such as first night nerves and so on. Often, these problems don’t persist. But there can be more serious psychological problems about sex that need the help of a psychosexual therapist. Worries about work, money, your relationship, family, and even worrying about not getting an erection, can all be factors.
Physical reasons for erectile dysfunction include:
• Heart Disease
• Raised Blood Pressure
• Raised Cholesterol: this can lead to clogging of arteries, including the arteries in the penis, which are very narrow (1-2mm in diameter compared with around 10mm in the heart artery)
• Low Testosterone: testosterone levels fall as men get older, but not all men are affected by it. Those who are affected will have symptoms such as feeling tired and unfit, and loss of interest in (and inability to have) sex
• Some Prescription Drugs: these can include medicines (such as beta-blockers) used to treat raised blood pressure, and antidepressants, antipsychotic drugs and anticonvulsant drugs
• Recreational Drugs such as cannabis and cocaine
• Smoking: nicotine affects the blood supply to the areas of the penis that cause erections
What's the Treatment for Impotence?
First, adjust any lifestyle factors that might be causing your problem. If you stop smoking, drinking too much or using recreational drugs, the problem should eventually go away. But it can take months If you're prescribed blood pressure tablets or antidepressants, your doctor may be able to put you on a different kind
Low testosterone can be treated with hormone replacement therapy, which should resolve erectile dysfunction as long as it's used together with erection-helping drugs. Other conditions, such as diabetes and high blood pressure, can be treated, which may improve erections. Some men benefit from psychosexual therapy, which is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues or concerns. You can contact the CBT in the City or your GP to ask about psychosexual therapy
A specific type of sexual dysfunction suffered by men is Peyronie's condition is caused by scar tissue, called plaque, which forms along the length of the penis in the corpora cavernosa. This plaque is not visible, and depending on the severity of the condition, the plaque can cause the penis to bend, making sexual intercourse difficult and occasionally painful
What Causes Peyronie's Condition?
The cause of Peyronie's condition is unclear. Many researchers believe the plaque of Peyronie's condition can develop following trauma (hitting or bending) that causes localized bleeding inside the penis. The injury or trauma may not be noticeable. Other cases, which develop over time, may be genetically linked or inherited (passed on from parents to children through genes). The disorder could be caused by a combination of both factors
In addition, a number of medications list Peyronie's condition as a possible side effect. However, the chance of developing Peyronie's condition from any of these drugs is very low and there is no absolute evidence that Peyronie's is related to taking these drugs
Who Gets Peyronie's condition?
One study found that Peyronie's occurs in 1% of men, according to the National Institutes of Health. Although the disease occurs mostly in middle-aged men, younger and older men can get it. In some cases, men who are related tend to develop Peyronie's, suggesting the disease may be genetically linked
What are the Symptoms of Peyronie's?
Symptoms may develop slowly or appear overnight. When the penis is soft, no problem can be seen. But, in severe cases, the hardened plaque (which is benign, or noncancerous) reduces flexibility, causing pain and forcing the penis to bend or arc during erection. In most cases, the pain decreases over time, but the bend in the penis can remain a problem. Occasionally, milder forms of the disease will resolve spontaneously without causing significant pain or permanent bending. Overall, Peyronie's will resolve on its own between 5%-19% of the time
Some men with Peyronie's develop scar tissue elsewhere in the body, such as on the hand or foot
How Is Peyronie's Diagnosed?
First, your doctor will talk to you and ask about any circumstances, such as injury, that may have occurred prior to symptoms appearing. Your doctor can feel the hardened tissue caused by the disease during an exam, although sometimes it is necessary to do the exam with the penis erect. In some cases where the doctor's exam does not confirm Peyronie's, or in cases where the condition develops rapidly, your doctor may perform a biopsy. A biopsy involves removing tissue from the affected area to be examined in a lab
Can Peyronie's be Treated?
Yes. But, since some people's condition improves without treatment, doctors often suggest waiting one to two years or longer before attempting to correct it. Mild cases of the condition rarely require treatment. Also, the pain associated with Peyronie's occurs only with an erection and is usually mild
What Treatments Are Available?
Possible treatments for Peyronie's include surgery and medical treatment
2. Psychological treatment for Pain Management & self esteem
In the majority of men with penile pain due to Peyronie's disease, the discomfort usually will resolve on its own as the penile injury heals and matures over time
What Is the Outlook for Peyronie's Disease?
Peyronie's disease may be a self-limiting condition. Pain usually disappears with time, plaque formation stops, and the erection deformity stabilizes. Most men with Peyronie's disease are able to have sexual intercourse and mutual enjoyment with their partner
If intercourse is satisfactory then no treatment may be needed
Female Sexual Problems
These can be divided into two types: primary (when a woman has never had an orgasm) and secondary (when a woman has had an orgasm in the past but can't now). Some women don’t need to have an orgasm to enjoy sex, but inability to reach orgasm can be a problem for some women and their partners. Reasons why a woman can’t have an orgasm can include fear or lack of knowledge about sex, being unable to ‘let go’, not enough effective stimulation, relationship problems, mood disorders (such as depression), and previous traumatic sexual experience. Research is being done into certain medical conditions that affect the blood and nerve supply to the clitoris to see whether this affects orgasm
Psychosexual therapy can help a woman overcome orgasm problems. It involves exploring her feelings about sex, her relationship and herself
Pain during sex (also called dyspareunia) is common after the menopause as oestrogen levels fall and the vagina feels dry. This can affect a woman’s desire for sex, but there are creams that can help. Ask your GP or pharmacist
Vaginismus is when muscles in or around the vagina go into spasm, making sexual intercourse painful or impossible. It can be very upsetting and distressing. Vaginismus can occur if the woman associates sex with pain or being ‘wrong’, if she's had vaginal trauma (childbirth, episiotomy), relationship problems, fear of pregnancy, or painful conditions of the vagina and the surrounding area
Vaginismus can often be successfully treated, by focusing on sex education, counselling and the use of vaginal trainers. Vaginal trainers are cylindrical shapes inserted into the vagina. A woman will gradually use larger sizes until the largest size can be comfortably inserted
To establish the cause of sexual dysfunction, a doctor or Psycho-sexual therapist will need to ask you questions about your medical, sexual and social history. Your GP can carry out tests for underlying medical conditions
If your problem is related to lack of hormones (such as testosterone or oestrogen), hormone replacement therapy (HRT) can help
Treating other conditions such as diabetes or depression might also alleviate symptoms of sexual dysfunction
In many cases of sexual dysfunction, sexual therapy can help. Talk with your partner about your problem, and see a therapist together if you can. Don't be embarrassed. Many people experience sexual dysfunction, and there are ways to get help
Your GP can refer you to a therapist or you can see one privately here at CBT in the City
Aims of therapy in Health Wellbeing Clinic:
• To talk about problem with an expert
• To talk about the condition and explore options
• To understand the link that how I think is how I feel and vice versa
• To work collaboratively on their problem and thus help the process of taking charge
• To feel supported by a health professional who understands the difficulties that you are going through
• To aid knowledge
• To feel more confident in being able to manage Peyroine’s condition
Please use the contact form and tell us your requirements and a response will be provided by email or by phone 0207 467 1508
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Sexual Dysfunction Solutions with CBT
I have Peyroine’s and it ruined my life. I became depressed and suicidal not knowing who to turn to. I have had the diagnosis for 4 yrs and I did not see any point in living as my dick is bent so bad that I am ashamed to have sex with women for fear of them laughing. Then I sought help for depression with CBT in the City and there I saw a male therapist talking about my depression without mentioning the Peyroine’s. The therapist eventually found out as I was in pain in a therapy session and he wondered if I was ok. I then broke down in tears and shared my disgust of having Peyroine’s. He told me that he had treated men before with this condition and I felt relief using the therapy now for Peyroine’s which lifted my depression. I am not cured but I am feeling a lot better, brighter and can see a future. For all men out there DON’T SUFFER ALONE get help and come to CBT in the City
All the best Shane
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