A significant number of men develop impotence purely from psychological causes. Also, men with an underlying physical disorder can develop psychological problems because of concern about performance. Even if the physical problem is corrected, a man's self-image and confidence may be affected enough to prevent normal functioning. Counseling is the typical form of treatment when psychological reasons are causing impotence. Qualified therapists can work with couples to reduce tension, improve communication, and create realistic expectations for sex.
Sex therapy is also helpful in patients who have premature ejaculation problems.
For some men, psychological therapy alone is not effective. In these cases, the sex therapist or counselor can work with the physician, prescribing a t echnique such as a vacuum erection device or self-injection therepy. As the patient's self-confidence improves, these therapies can be stopped. Sex therapy is usually not covered by insurance policies, but since it is unlikely that counseling will have to continue more than six months or so, costs can usually be kept down. Hormone Replacement Therapy Hormone replacement therapy can be used to treat men with hormone deficiencies.