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Psychotherapy is a type of therapy indicated to cope with emotional problems and mental disorders.
Psychotherapy is a talk with a professional therapist, individual, in a group or with a sexual partner, wife, or husband. It enables a patient to look into the depth of a problem, your concerns and fears. Besides, it can help to manage certain habits and mental disorders, such as depression, anxiety, manic disorders and others.
Psychotherapy can be of different types depending on its goal, privacy and intimacy of the matter discussed:
• Single or personal therapy – the talk between the patient and the therapist.
• Group therapy – the talk between more than 1 patient and the therapist. Patients may talk about their concerns and worries and understand they are not alone with their problems and there are other people with the same difficulty.
• Marital or family therapy – involves partners and family members understand each other better, find points of contact and learn how to solve problems together.
There are different therapy methods a doctor may offer and use during treatment. These methods are based on the individual condition and underlying factors contributing to this condition. The most common are talking, reading, art, music, drama or dancing (movement) and others.
For males with ED couple or family therapy is most beneficial for both partners. Still if a male is not ready to discuss his erectile difficulty with a sexual partner, he may probably benefit from individual psychotherapy.

A psychosocial exam is often used to determine psychological factors which may contribute to erectile dysfunction in men. This involves interviewing and special questionnaires to find out expectations and sensibility to the subject of a man and his partner.
Psychotherapy is a special treatment recommended for different mental conditions which may contribute to erectile dysfunction. During psychotherapy, a man talks to a mental professional. This helps to find out the factors or situations that cause anxiety, stress or depression.
A patient learns to understand the situations, emotions, and ideas that lead to his mental disorder and provokes sexual problems. The psychotherapy determines the life problems or events contributing to the problem and how to solve these difficulties to improve the situation. The techniques used in psychotherapy help to restore control over the situation and have again a feeling of happiness and pleasure in life.

The most common condition affecting sexual health in men is erectile dysfunction. This condition prevents penis from getting hard to have satisfactory sexual intercourse. Atherosclerosis, diabetes and alcoholism are the most common causes of erectile dysfunction.
A painful, prolonged erection known as priapism condition which consequences may be even necrosis of the penile tissue and impotence is a very serious medical condition which requires immediate help.
Paraphimosis condition is characterized by the inability of the foreskin of the penis to be removed to its normal position.
Hypospadias is a defect from birth, characterized by the improper place of the urine opening. The condition can be fixed with surgery.
A penis deformity such as abnormal curvature of its shaft is known as Peyronie’s disease. This condition may develop after injuries to the genital area.
Urethritis infection or inflammation is a medical condition caused by gonorrhea and Chlamydia. The condition demands serious medication treatment.
Gonorrhea, Chlamydia, and Syphilis are caused by bacteria transmitted during sexual intercourse. The other very often condition is herpes caused by viruses HSV-1 and HSV-2.
Penis cancer is the condition very often met in the countries where circumcision is not practiced. The procedure of circumcision greatly lessens the chances of penis cancer.

The normal penile anatomy prevents different conditions and diseases leading to sexual problems and disorders. The male sex organ, penis contains two chambers – corpora cavernosa and urethra. Corpus cavernosa consists of two columns of tissue going along the length of the upper side of the penis. Naturally, blood fills corpus cavernosa and this causes an erection. The corpora cavernosa inside is a spongy tissue consisting of smooth muscles, fibrous tissues, spaces, veins, and arteries.
The urethra is the channel for urine and ejaculation. It goes along the underside of the corpora cavernosa.
Other parts of the penis are albuginea membrane which surrounds the corpora cavernosa, veins which drain blood out of the penis, glans or heads, corpus spongiosum. The glans of uncircumcised males are protected with special tissue -mucosa. The circumcised males do not have the foreskin tissue, because it is surgically ejected.
Corpus spongiosum is a tissue going along the front of the penis. It gets filled with extra blood during an erection.
Normally penis reaches its full size during the development of a young man to an adult. The penis as a male’s sexual organ performs its main sexual function and works as an organ helping urine to evacuate from the body.
A natural erection occurs when certain changes in blood flow happen in the penis and its tissues. In a sexually aroused man nerves work stimulating blood vessels in penis to expand. Extra blood gets in and stays within the penis, making the corpus cavernosa tissue hard and strong.
Physical abnormalities of the penis or injuries to the penile tissue may cause different sexual disorders including erectile dysfunction and prevent a person from having normal sexual life.

The choice of the treatment for erectile dysfunction directly depends on the cause of the problem. The treatment is usually started with the therapy of the underlying condition which contributes to the impotence in a person, in addition, lifestyle alterations are advised to enhance the general health and sexual life of a person. If there is a special need for medical treatment of erectile dysfunction doctors usually recommend using one of the PDE5 inhibitors, known as sexual agents improving man’s sexual abilities. This drug class includes most popular Viagra, Cialis, Levitra and other generic alternatives. In case a person cannot use these medications because of other conditions he may have, he may be recommended to try other methods to fight erectile problems:
• Medications inserting (placing) directly into the urethra;
• Medications injected into the penile tissue;
• Penile surgery;
• Special mechanic devices to provide extra blood flow into the penis.
Remember that it is always necessary to consult your doctor before trying any of the mentioned methods to treat ED.

Many common drugs for treating certain disorders such as depression, hair loss in men, hypertension, and high blood lipids can contribute to the development of impotence in men.

The antihypertensive medications often cause sexual dysfunctions in males. There are different classes of antihypertensives such as beta-blockers, diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), and angiotensin receptor blockers (ARBs). The lowering blood pressure medications are often used in combination with other drugs to manage blood pressure. Each class of blood lowering medications has different effects on male sexual function. Some of them such as calcium channel blockers and ACE inhibitors do not affect male abilities, while others beta blockers and diuretics cause erectile dysfunction. It is necessary to discuss with your doctor possible side effects of antihypertensive medications and their combinations.

You should also tell your doctor about other medications which you take on a regular basis. These drugs may include antidepressants and other psychiatric medications, Parkinson’s disease medications, hormonal medications, opiate analgesics, recreational drugs such as alcohol, amphetamines, nicotine, heroin, cocaine, marijuana, barbiturates.

Sometimes doctors need more information to put the correct diagnosis or to determine the actual cause of the problem. In this case doctors usually recommend making other tests which specifically help to understand the underlying cause and severity of ED condition. One of these tests may be prostaglandin E1 injection test. It is performed to assess the penile blood flow. Prostaglandin is directly injected into the corpora cavernosa of the penis, this is made to cause the blood vessels wide and provide blood flow into the penile tissues. If erection occurs as a result of this procedure it assures normal blood flow to the organ. In addition the procedure provides information for possible therapeutic possibilities.
The other method or procedure which monitors erections that happen during sleep is called nocturnal penile tumescence. This helps distinguish if erectile dysfunction is a result of psychological or physical disorders. During two or three night a man has to sleep with a band around his penis to determine intensity and duration of erections if they occur. If nocturnal erections do not happen, erectile dysfunction affliction is of physical rather than psychological character. Still this procedure is not absolutely reliable and should be accompanied by other tests and methods.
One of the methods to estimate the penile nerve function is direct vibrational stimulation which is known as biothesiometry. Vibration amplitude is adjusted with the help of electromagnetic electrodes which are put on the shaft of the penis. The patient is tested to notice the sensation of the penis to this vibration. The procedure is used as a screening method to discover any sensory nerve loss caused by impotence.

A medical professional will adjust for you common laboratory tests to evaluate erectile dysfunction. They may include: complete blood tests, lipid profile to estimate the level of LDL cholesterol which can have harmful effects on the health. If a doctor suspects that a patient may have diabetes he will adjust to make urinalysis and blood glucose level testing, blood hemoglobin A 1 c and serum creatinine. Other special tests may be recommended to undergo if a patient has other diseases. These may contain: liver enzymes and liver function tests to find out if there are any hormonal imbalances leading to low testosterone levels.

If a patient is over 40 years of old a doctor may advise to make a total testosterone level testing. Other hormone levels tests may include luteinizing hormone (LH), prolactin level, and cortisol level which may reveal other causes of erectile problems.

Doctors usually order to undergo prostate specific antigen (PSA) test and prostate examination to determine if a person may suffer from prostate disorders.

Mineral deficiency such as zinc can also lead to ED in men. Tests to evaluate potential risks of having colon cancer, sickle cell anemia and leukemia may also be adjusted.

The tests necessary to perform are followed by  each individual’s history and symptoms.

When you first visit a doctor to consult about your problems with erections you may expect that your doctor will do special manipulations to evaluate your general health and your condition.

First of all your doctor will make a physical examination which is necessary to find out if there are any physical causes of erectile dysfunction. The penis may not respond to touching may reveal damaged nerves and problems in the nervous system. Absence of facial hair, enlarged breasts and lack of sexual desire can be the signs of hormonal imbalance such as low testosterone levels. A medical professional may also listen with a stethoscope to the pulse in the arteries of legs. If the blood flow is reduced in the arteries, there may be a problem with arteries and atherosclerosis.

Peyronie’s disease of deformed penis may also be the affliction of the erectile dysfunction.

A careful medical examination is a very important part of putting the right diagnosis and adjusting the right treatment. After physical examination your doctor may recommend you to undergo special laboratory tests and procedures to evaluate your erectile dysfunction.

A diagnosis of erectile dysfunction is put only by a medical professional. ED is a repeated inability in men to achieve and/or maintain an erection for satisfactory sexual performance for at least three months.

A frank and open communication between the patient and the doctor is essential in making the correct diagnosis of erectile dysfunction. Only a doctor can assess the severity of ED and determine the underlying factor causing it. Doctors usually ask their patients the following questions:

1.     Are you suffering from erectile dysfunction or from lack of desire as well? Or from rapid ejaculation?

2.     Is erectile dysfunction caused by psychological or physical afflictions? Healthy males usually have reflex erections in the early morning and at night. Men with erectile dysfunction caused by psychological factors such as stress and anxiety usually have these reflex erections. Men with physical underlying afflictions of impotence such as atherosclerosis, diabetes, nerve diseases usually do not have these uncontrolled erections.

3.     Does ED result from physical disorder? What disorder causes ED? Such habits as cigarette smoking, drinking alcohol as well as history of heart attacks, strokes, and atherosclerosis can provoke erectile dysfunction. If penile sensation is diminished or there is a bladder dysfunction a doctor may suggest diabetic nerve damage. Lack of sexual libido and gynecomastia may be the signs of low testosterone levels.

4.     Are you taking any medications that can contribute to development of erectile dysfunction? Such medications belong to the drug classes of pain relievers, antidepressants or for hair regrowth.

Then your doctor will make a thorough physical examination and adjust special tests to evaluate the severity of ED in each individual case.