Episode 2: The Ups and Downs of Erectile Dysfunction

In this episode, Kimberly discusses many aspects of Erectile Dysfunction. She begins with statistics on the prevalence of ED. She describes both the organic and psychological risk factors for erectile dysfunction; and how she determines whether to tackle ED in her psychotherapy office or whether a medical evaluation is indicated. She describes the key classifications that must be made to determine a man’s individual prognosis and treatment plan. She describes how the supplement industry exploits men’s insecurities related to sexual performance and how, for thousands of years, men have linked their masculinity to their sexual prowess. Kimberly shares her clinical observation that younger and younger men are seeking treatment for ED. She offers four theories as to why men in their twenties are struggling to get and stay hard. The four reasons are 1) Pornography Addiction, 2) Alcohol and Drug Abuse, 3) Having a Secret about their ‘Arousal Template,’ and 4) Anxiety, Depression, and OCD (and the side effects of medications used to treat these conditions). She explains which class of medications are likely to cause erectile dysfunction and what we can do about it.

Also in this episode, Kimberly dispels some myths about penis size, whether or not a man can ‘break” his penis, and erections during infancy and childhood. She also describes the range of medical interventions and treatments available for ED, from simple lifestyle changes (like losing weight or quitting smoking), vasodilators, penile injections, penile suppositories and vacuum pumps, to penile implants and revascularization surgery. She describes the pros and cons (and risks and benefits) of sexuo-pharmaceuticals , such as Viagra, Levitra and Cialis. She explains why more than half of men stop taking these drugs, even when they work. She discusses the negative side effects of these drugs, why it is important to get a ‘buy-in’ from a partner prior to use, and how the pressure to not ‘waste’ a pill can lead to tension in a relationship. She explains that many men are not given proper instructions on how to use these drugs and how some men become psychologically dependent on the medication. As always, Kimberly answers questions from her listeners.



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