The Psychology of Everyday Life:Love, Marriage, and the Baby Carriage


What are the most effective treatments for sexual problems?

With the arrival of sildenafil citrate (Viagra) in 1998, medical treatments for sexual problems have become more prominent. Viagra improves erectile function by increasing genital blood flow. This is accomplished through a type of chemical called the PDE5 (phosphodiesterase type 5) inhibitors. Several other drugs of the same class have been developed that are also effective with erectile dysfunction. Unfortunately, no similar drugs have been found to help women. Premature ejaculation is treated with the SSRIs, a class of antide-pressants that work on the serotonin system (e.g., fluoxetine [Prozac] or paroxetine [Paxil]). Hormone treatments, which increase the levels of testosterone and/or estrogen, have also been tried but they have shown limited effectiveness and can have dangerous side effects. When treating sexual dysfunction, however, it is still critical to address psychological issues, which may include patients’ attitudes toward sexuality as well as their body image, feelings of vulnerability, and/or performance anxiety. Couples’ issues are also extremely important, and can involve emotional distance, poor communication, unresolved conflict, and mutual misunderstandings about each partner’s sexual needs.


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