Modernizing the Treatment of Sexual Dysfunction in Men

Modern, couple-oriented treatment for male sexual dysfunction takes the psychosocial aspects of sex into account, as well as focussing on the purely physical aspects of the problem. The importance of this biopsychosocial approach, whether one looks at disorders of desire, arousal or orgasm, is supported by intercultural comparisons, among other data.
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But sexual dysfunction can also arise as a consequence of a variety of diseases and their treatments, such as depression or diabetes, or can even be an early warning sign of serious physical illness such as heart disease. Hence an interdisciplinary approach, drawing on both medical and psychological techniques and insights, is essential.

In this week's Deutsches Ärzteblatt International, Urologist Dirk Rösing and coauthors present an overview of current thinking and practice in the area of male sexual dysfunction.

The authors use research on prostate cancer to underline the place of one important new development in German sex therapy, a form of the internationally familiar "couples" therapy called "syndiastic" therapy. Questionnaire surveys to men with prostate cancer show that while the importance of the genital aspects of sexuality decreased in importance following radical surgery, the relationship and physical intimacy remained as important as before.

"Syndiastic" sex therapy was introduced in Germany in 2004, and focussed for the first time explicitly on fundamental psychosocial needs, in a wider way, rather than purely on sexual function itself. Derived from a word Aristotle uses, meaning a disposition to "live in pairs" or "belonging," this approach differs importantly from some other somatic or psychological treatments which focus mainly on restoring sexual function. Instead, it aims to broaden the understanding of sexuality, extend the range of physical experience, and improve overall satisfaction within the relationship.