[Erectile dysfunction: psychological causes, diagnosis and therapy]

Ther Umsch. 1998 Jun;55(6):352-6.
[Article in German]


For clinical practice, erectile dysfunction is the most important form of male sexual disorders. In the majority of patients causation and course of their erectile disorder is determined by a close interplay of somatic and psychosocial factors. This psychosomatic interaction has to be taken into account during diagnostic assessment and therapy. The old dichotomous concepts (psychogenic versus organic) of erectile dysfunction have to be replaced by multidimensional models that include dispositonal as well as chronifying factors. The main causes of psychogenic erectile disorders can be divided into three groups, each belonging to a different phase of time: 1. immediate factors (performance anxiety), 2. antecedent life events from recent history, 3. developmental vulnerabilities from childhood and adolescence. The most important instrument for the psychological evaluation of sexually dysfunctional patients is a comprehensive sexual history in which partner related aspects should be particularly focused. In treating psychogenic erectile dysfunctions sex therapy is a reliable and efficient treatment option with a reasonably good long-term prognosis. In future, sex therapy should be combined with somatic treatment options to reach a truly integrative approach to this complex disorder.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adolescent
  • Adult
  • Child
  • Diagnosis, Differential
  • Erectile Dysfunction / psychology*
  • Erectile Dysfunction / therapy
  • Humans
  • Male
  • Prognosis
  • Psychophysiologic Disorders / diagnosis
  • Psychophysiologic Disorders / psychology*
  • Psychophysiologic Disorders / therapy
  • Psychosexual Development
  • Risk Factors
  • Sex Counseling
  • Somatoform Disorders / diagnosis
  • Somatoform Disorders / psychology*
  • Somatoform Disorders / therapy