Article 26: Rehabilitation Therapy for Erectile Dysfunction and Management of Temporary Erectile Dysfunction

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Treatment and recuperation of common diseases

Rehabilitation therapy for patients with erectile dysfunction

1. Relaxation Training: A significant proportion of men with erectile dysfunction experience varying degrees of sexual anxiety, and relaxation training is highly effective in eliminating anxiety and balancing physical and mental functions. This method is a treatment approach that relies on the patient's own control and experience under the guidance of a psychologist.

(1) Progressive relaxation training: First, have the patient sit in a comfortable position, half-close their eyes, and then take deep, slow breaths. After inhaling deeply, hold your breath for a few seconds, then exhale slowly while relaxing your whole body. Repeat this 3-5 times until you are completely calm. After the patient has calmed down, perform handshake training. Slowly clench your right hand, count to 5 silently, pause for a moment, and then slowly relax. Clench again, relax again, and repeat 3 times. Pay attention to the difference between the feeling of tension and relaxation. In the same way, clench and relax your left hand, wrinkle your forehead muscles, relax your jaw muscles, tighten and relax, contract your shoulders and relax, contract your abdominal muscles and relax, contract your leg muscles and relax, and perform the tightening and relaxation training of leg muscles, arm muscles, and perineal muscles in sequence. Repeat each exercise 3 times, and feel the warmth of the exercised area after each relaxation.

After repeated training as described above, the patient can automatically relax by recalling the sensations of relaxation in simple muscle groups. At this point, this tension-relaxation training can be stopped. Afterward, the patient can reflexively relax themselves when experiencing anxiety or tension.

(2) Imagery-based relaxation training: Have the patient close their eyes and rest quietly for 2-3 minutes, noticing their breathing sensations, as well as their feelings about room temperature and objects they are touching. Have the patient recall a particularly pleasant event from their past life, remembering every detail and allowing them to fully immerse themselves in the beautiful memory. Simultaneously, guide them through association, further enhancing their enjoyment of the pleasant experience. If the patient has time, they can practice this pleasant recall and association for 5-10 minutes, then slowly open their eyes to return to reality. Psychological training helps coordinate the patient's thinking and emotions, which has a certain therapeutic effect on restoring normal sexual function in patients with erectile dysfunction. It is especially suitable for psychogenic erectile dysfunction, and when combined with other traditional Chinese and Western medical treatments, the cure rate will be greatly improved.

2. Biofeedback Therapy: Using specialized equipment, information about physiological changes is converted into signals and automatically displayed to the patient. Under the guidance of a psychologist, the patient then practices changing these processes based on their own physiological characteristics to achieve therapeutic effects. Clinical application of biofeedback therapy typically involves two steps.

The first step is to teach patients how to reduce their mental burden, such as relaxation training, intuitive training, deep breathing training, and recall association, so that the patient's mind and muscles can remain relaxed and calm.

The second step involves using highly sensitive biofeedback instruments to help patients understand and grasp information about internal physiological changes, further learning relaxation techniques until operant conditioning is established, relieving tension and anxiety, and restoring normal physiological function. During biofeedback therapy, patients must first follow the guidance of a psychologist and learn how to operate the specialized instruments. With confidence in overcoming the illness, erectile dysfunction is curable.

3. Suggestion Therapy: Direct suggestion therapy refers to the use of language or facial expressions by a psychologist to guide the patient. For example, when treating a patient with erectile dysfunction, in addition to verbally affirming their sexual ability, the psychologist should also demonstrate affirmation through facial expressions. This helps the patient relax their anxiety, impatience, or depression, and fully believe the doctor's assessment. During the process of accepting the doctor's suggestion, that is, during the patient's internal logical thinking process, the patient also fully affirms that their sexual function is normal. In this way, suggestion enhances the patient's self-confidence and achieves the goal of improvement.

Indirect suggestion refers to therapeutic methods involving examinations, drug injections, or the use of certain instruments. When employing indirect suggestion, combining it with direct verbal suggestion techniques can enhance its effectiveness. For example, an electrostimulation therapy device can be used to stimulate the penis of a patient with erectile dysfunction, inducing a reflexive erection, followed by reassuring the patient that their sexual ability is normal. This method is more effective than direct verbal suggestion alone.

Before administering suggestive therapy to patients with erectile dysfunction, it's crucial to understand the underlying cause. Suggestive therapy is suitable for patients with high suggestibility; those with low suggestibility respond poorly to suggestion, making treatment less effective. Therefore, screening cases before initiating suggestive therapy can significantly enhance its efficacy.

4. Systemic desensitization therapy:

(1) Muscle relaxation training: In systematic desensitization therapy, the ability of muscles to relax is the key to successful treatment. Patients should first tighten the muscles in various parts of their body, and then gradually relax them until the whole body is completely relaxed. Therefore, before treatment, doctors should provide basic guidance and training to patients, allowing them to imagine themselves in a relaxed and pleasant environment.

(2) Classify anxiety levels: Based on the different levels of anxiety experienced by patients, psychologists help patients rank them in order of severity and have patients conduct self-assessment and anxiety standard tests.

(3) Desensitization training according to the anxiety levels: The doctor describes the least anxiety-inducing situation to the patient and asks the patient to imagine themselves in this situation while training. That is, the patient is repeatedly trained under this level of anxiety stimulus until they can remain relaxed in this anxiety situation. When the anxiety no longer occurs or the level of anxiety is greatly reduced, the next higher level of anxiety training is carried out. If the patient cannot relax under a certain level of anxiety situation no matter what, they can return to the previous lower level and start training again. When the patient can remain relaxed even when imagining the most frightening situation, the systematic desensitization treatment is considered successful. The behavioral therapy systematic desensitization method involves training at one level every 3-4 days, with each treatment lasting about 30-40 minutes. However, due to individual differences and human factors, desensitization therapy may sometimes fail. The reasons are as follows: relaxation training is unsuccessful, and the patient cannot relax the various parts of their body; the anxiety situation is improperly divided into levels, with too large a difference between levels; the doctor's pre-treatment training and the imaginary cues provided to the patient are incorrect.

What to do about temporary erectile dysfunction

Temporary erectile dysfunction (PED) refers to erectile dysfunction that occurs occasionally due to unfavorable environmental conditions, medications, alcohol, or other factors, even though the patient normally achieves an erection and engages in normal sexual intercourse. This is also a cause of psychogenic erectile dysfunction. Patients often suspect they have erectile dysfunction, experiencing significant anxiety. They may believe they have a history of masturbation or other reasons that create a psychological burden, causing them to fear they won't be able to achieve an erection during intercourse and will cause their partner to be averse to it. This psychological burden can lead to distracting thoughts during intercourse, exciting the cerebral cortex and inhibiting the spinal cord's sexual arousal center, resulting in temporary erectile dysfunction.

What should I do if I experience temporary erectile dysfunction as described above?

First, understand the cause of erectile dysfunction and eliminate psychological barriers. Try to relax as much as possible during intercourse. Maintain a good sexual environment. If appropriate, masturbate to ejaculation once first, and then wait half a day or a day until libido is low before engaging in intercourse. The woman lies on the edge of the bed with her legs raised and spread apart, exposing her genitals. The man stands, holding the base of his penis with one hand and parting the woman's labia with the other, locating the vaginal opening and aligning his penis with it. Squeeze the limp penis with both hands, forcibly inserting it into the vagina. Then release your hands and press down with your body, keeping the limp penis inside the vagina without moving. After a while, the penis will be stimulated by the warmth of the vagina. Simultaneously, stroke the woman's breasts, buttocks, and thighs (try not to think about whether the penis is erect). This stimulation will excite the sexual nerves, and the penis will gradually become erect, completing intercourse. Once successful once, the psychological burden will be reduced, and the penis will naturally become erect again.