Reading in the Los Angeles Times about the lawsuits settled against Boston Medical Group made me think of the Wizard of Oz, the man behind the curtain manipulating everyone into thinking he had great power. In this case, the "great power" comes in the form of a shot of drugs to the penis, almost guaranteed to give a man a rock hard erection. Once the curtain is pulled back, what we see is a doctor and his minions, doctors turned into salespeople talking men into purchasing the drug at an outrageous price, $1500 for 60 doses.
I already knew from my clients that Boston Medical Group could be a strange and scary place. The company is headquartered near my Newport Beach office (not, weirdly, in Boston), so there are plenty of men in the area who have tried them and found the experience less than ideal. Many clients complained to me that they had no idea they were going to get an injection. A few were mightily embarrassed that they were made to produce an erection in front of the practitioner. Some were disgusted by the high price of the injections. Others found that the medication didn't always work; like oral medications, if there are psychological problems like anxiety, depression, or relationship stress, the medications may not do the job.
It seems to me that there is a lot of preying on men (and women, but that's another story), who experience the loss of erection as catastrophic. Many are so upset by this event that they will seek out any treatment and pay any price to regain their ability to have an erection
After treating several hundred men for erectile dysfunction, I have come to learn:
- Some men do need medical intervention in order to have an erection. But they should visit a urologist, who can go over all the treatment options with them, from the variety of oral medications to surgically implanted pumps. The treatment will depend on their age, their health, and their willingness to try different levels of intervention.
- Of those men who require medical intervention, some portion of them will also need psychological treatment, hopefully from a sex therapist. They may have suffered a medical event, such as prostate cancer, and are a bit down or upset, which blocks the effect of the medication. Or they may have unresolved difficulties in their relationship, which needs attention before they can be fully sexual.
- Another group of men really don't need anything but someone to help them sort things out. Losing an erection can be a result of or the cause of low self esteem. There may be pre-existing problems, including some that a man or his partner have never considered, such as ADD, Obsessive-Compulsive Disorder, or even Hypochondriasis (health anxiety; see my book Sex, Love, and Mental Illness: A Couple's Guide to Staying Connected.) Whatever the psychological issue, the majority of men in this group do find sex therapy to be helpful if they have a supportive relationship and are capable of follow-through with reading and assignments.
I feel truly bad for the men who weren't warned about priapism, a condition in which the penis is erect too long, which can cause permanent damage. I've met with men in my office who have had this occur; fortunately, they all got to the emergency room for help in time. But I also feel for all the men looking for a quick fix, scouring around for a way to get treatment without embarrassment and with 100% certain results.
In my worldview, all men with erectile dysfunction would see a urologist and also be evaluated by a sex therapist. Very few men--very few people--know much about desire, arousal, and orgasm beyond what Masters and Johnson famously described as "body works and friction." A sex therapist can help a man discover a great deal about himself, his body, and his sexuality. Need to find a sex therapist but don't live in Southern California? Visit AASECT, click on the map, and find someone certified in treating sexual problems of all kinds.