Potential for Long-Term Benefit of Cognitive Behavioral Therapy as an Adjunct Treatment for Men with Erectile Dysfunction.

INTRODUCTION: Psychosexual counseling may enhance sexual performance outcomes in men with erectile dysfunction (ED) treated with a phosphodiesterase type 5 (PDE5) inhibitor.

AIM: To determine the potential long-term effects of cognitive behavioral therapy (CBT) on Pakistani men with ED who had undergone treatment with a PDE5 inhibitor (PDE5i).

METHODS: In a 15-18-month follow-up, we reassessed a subsample of 20 men who had been treated with either PDE5is (monotherapy group) or CBT + PDE5i (combined group) on 2 dimensions: sexual functioning and mental health functioning.

MAIN OUTCOME MEASURE: International Index of Erectile Function was used to assess sexual function, and 2 Mental Health Inventory subscales were used to assess anxiety and depression. A brief semi-structured interview assessed men's current sexual status and evaluation of their CBT experience.

RESULTS: Men in the combined group continued to show improvement on erectile function and several other sexual parameters, whereas men in the monotherapy group showed either no further improvement or a decrement in sexual response parameters. The results did not appear to be related to changes in relationship satisfaction or mental health indices.

CLINICAL IMPLICATIONS: Adjunctive CBT shows long-term benefits in men with ED treated with a PDE5i.

STRENGTH & LIMITATIONS: Effect sizes were strong, overcoming the small sample size, but attrition may affect the generalizability of the findings.

CONCLUSION: In the first long-term follow-up study of its kind, CBT proved an effective and supportive adjunctive treatment for Pakistani men with ED taking a PDE5i, with benefits extending long after the end of treatment. Khan S, Amjad A, Rowland D. Potential for Long-Term Benefit of Cognitive Behavioral Therapy as an Adjunct Treatment for Men with Erectile Dysfunction. J Sex Med 2019;16:300-306.