Sexual Healing by Dr. Margarita Kressin

After our determination that Joe (worth repeating here that all of my "patient" names and stories are made up) has erectile dysfunction, we then reviewed his medical history (he has mild blood pressure problems and pre-diabetes that is supposed to be diet controlled), surgical history (none), social history (used to smoke a pack per day, but quit 10 years ago). He is not following a diabetic diet and does not exercise. He does not take any medications.

We looked over to his wife and made sure that she is supportive and that she herself does not experience sexual issues. She thinks that their sexual relationship is very important and besides a slight decrease in libido she has no issues. She explains that once she and her husband get going, she does well.

We then focused on lifestyle changes for Joe, what he can do on his part to help his erectile function and prevent further deterioration. We then discussed all his options, from first line therapies (medications, intraurethral systems), second line therapies (injection, vacuum devices, surgeries). We discussed the pros and cons of each therapy, the side effects and possible complications (there is no free ride, no matter what we’d like to think, in medicine), and the benefits of one therapy versus another.

We outlined all of these and made certain recommendations depending on what he would use consistently, and something he and his wife can be comfortable with and incorporate into their sexual activity.

We also offered our sex therapist for sexual counseling (not marital counseling, a point that was important to make) to give them tips and educate them about their sensuality and sexuality. This could also potentially address other issues that we did not address from a medical standpoint. As I always point out — the brain is still the biggest sex organ (as much as Joe would like to think the penis is THE sex organ).

And I reminded them to be careful about what they see and hear in ads. Please do not use any herbal or supplement "medications" advertised on TV.  And yes, there are no guarantees. If there were, don't you think legitimate physicians would be using it already?

The biggest lesson Joe and his wife learned was that this was more about erectile dysfunction. It involved sexual health, a couple’s sexual function, and a myriad of therapies that he can choose from.