Sex Therapist or Urologist: How to Tell Which One You Need (First)
Early on in my career as a Sex Therapist, I noticed something strange happening. I was getting a lot of phone calls from men. Now for those of you who are not therapists, you may wonder why that would be so strange. What’s the big deal there? Well, it was strange because it was so different. Having been a “regular” therapist for many years, I can tell you that the vast majority of people who reach out to therapists are female. Even in the case of Couple Therapy, it’s women who typically make that first phone call.
But not when it comes to Sex Therapy.
So, of course I came up with a few theories about what could be going on; because you know me, I like to wonder about stuff.
I’m thinking it may come down to this: Men are willing to pay for sex - or to clarify - to have a better sex life (friendly reminder: sex therapy does NOT include sexual contact). Or to fix a “broken” penis. Whatever it takes. Whatever the cost. Dudes love their penises (and why shouldn’t they?). And sexuality is a big part of their identity. As a result, they appear to value and prioritize sex & pleasure in a way that women don’t or at least haven’t (let’s hope THIS is changing). Men feel angry or stressed when their penis doesn’t work properly, and they have much less of a problem reaching out for help. Women, on the other hand, often feel embarrassed or ashamed when they are experiencing sexual difficulties. And they sometimes suffer in silence for many years. (God, I hope this is changing for women!)
So, back to my phone calls. I get a lot of inquiries from men of all ages who have sexual performance problems, erection problems topping the list. Many of these men have not consulted a doctor because they believe it must be “mental” (and perhaps they also don’t’ like going to doctors or taking medication). So, I’m often their first phone call, and that makes me happy. I think Sex Therapists are the best place to begin, even if we end up recommending that you consult with a Urologist, too.
What is sex therapy like?
A lot of people are nervous before their first sex therapy session, because they don’t know what to expect.
The following is just a sampling of what you will get in your personalized 90-minute consult with me:
Some helpful psycho-education: Erectile dysfunction is roughly understood as trouble getting and/or maintaining an erection at least 75% of the time. The 22 risk factors involved in Erectile Dysfunction can be divided into 4 categories; Medical/Medication; Lifestyle; Psychological; Relationship. Did you know that the majority of E.D. cases involve Physical/Medical & Lifestyle factors? Yup. And that’s why I make sure to spend a significant amount of time in your first visit assessing and ruling out those things (because frankly, “mind over matter” approaches will not change a blood flow problem).
Lifestyle Factors that can cause E.D. and negatively impact sexual functioning in men include:
Obesity & poor diet
Lack of exercise
Alcohol
Smoking
Stress
Medical/Medication Factors:
Diabetes
High Blood Pressure & High Cholesterol
Sleep Apnea
Heart Disease (erection problems can be an early warning sign)
Gum Disease
Low Testosterone
Injury
Prostate surgery side effects
Medication Side effects (medications for depression & anxiety are notorious at this, BTW)
Straight up: Here’s the quickest & easiest way to determine if you need an MD:
Can you get and/or maintain an erection through masturbation or self-stimulation?
Are you getting nocturnal/morning erections?
If you answered “No” to these questions, a visit to your PCP or Urologist is in order, pronto!
But if you answered “Yes” to one or both of these questions, these are the things I can help you to TACKLE & OVERCOME.
Psychological & Relationship Factors that OFTEN impair sexual functioning in men:
Anxiety, Worry & OCD
Depression
Stress
Past sexual abuse/trauma
Performance anxiety, pressure to perform & unrealistic expectations
Confidence issues
A partner’s negative reaction (past or present) that you can’t seem to let go of
Changes related to aging (needing more stimulation & arousal)
After a full assessment, in your very first session, I will begin to formulate a roadmap for improving your sexual functioning and health. Some men benefit from just a few sessions, while others may need some ongoing assistance in practicing new skills & behaviors. Erection problems, in the vast majority of cases, are treatable. And research shows that the best treatment is often a combination of medication AND sex therapy.
So, why not start with someone who is going to really sit down and talk with you for more than 15-minutes, someone who is dedicated to treating you as a whole person, someone who gets how important this is to you, how important sex is to your well being and the well being of your relationships? May I recommend that you begin with consulting a Sex Therapist?
If you’re located in New York State, you can learn more about services here. If you’re located outside of New York, you can check out my resources here.
