Male erectile disorder: characteristics and treatment choice of a longitudinal cohort study of men.

BACKGROUND: The objective was to collect characteristics of patients with male erectile disorder (MED) attending a male sexual dysfunction clinic and determine the level of psychological morbidity whilst recruiting subjects into a psychotherapy study. METHODS: This was a study of data of 132 patients diagnosed as having male erectile disorder who attended a sexual problems assessment clinic. Men with a psychological component to their condition who accepted couple therapy were compared with those who refused such a treatment as well as with the group of men who were diagnosed as having an organic basis for their condition. All male attendees at the sexual dysfunction clinic over a ten month period were reviewed. The proportion of men with psychogenic factors contributing to the MED and who choose psychological therapy were noted as were demographic factors correlating with accepting therapy. FINDINGS: Psychogenic factors were found to contribute towards the erectile disorder in the majority of cases. 28% of this group accepted couple psychotherapy in preference to a physical treatment. A significant proportion of these couples had returned preliminary questionaries to the clinic and had attended the assessment together. A younger age of onset of the problem for the man; a younger age of his partner; a shorter duration of the relationship together and not being married were all associated with accepting couple psychotherapy in preference to other treatments. CONCLUSIONS: Psychogenic factors are contributory in a majority of cases of erectile dysfunction. Epidemiological factors are identified in a group of men with MED. Where couple psychotherapy is indicated, certain factors are suggestive of patients who will accept such an option. Patient preference for a treatment option may play an important role in the outcome of therapy.