Dr. Tra Anh Duy, MD, PhD, of Men’s Health, reported that the patient's testosterone, blood glucose, and lipid levels were normal. A penile Doppler ultrasound also showed normal blood flow. However, the patient scored moderately high on anxiety and depression scales.
The doctor prescribed medication combined with psychological counseling. After three months, the patient's erectile function improved, and his anxiety levels decreased. He expressed confusion about how a single massage could have such a lasting impact.
According to Dr. Duy, "massages with extra services" can trigger psychologically induced sexual dysfunction. This stems from negative emotions activating a chain reaction in the biological, neurological, and endocrine systems. The amygdala and prefrontal cortex, responsible for emotional and behavioral control, suppress the pleasure center when guilt arises, reducing dopamine release—a neurotransmitter crucial for sexual desire.
Anxiety and guilt also overstimulate the sympathetic nervous system, constricting blood vessels in the corpus cavernosum and hindering the effects of nitric oxide, the primary pathway for erections. This often creates a vicious cycle: the more the patient tries to achieve an erection, the greater the fear of failure, increasing stress and causing the erection to quickly subside. This explains why physical examinations might show normal genital function despite poor sexual performance.
A study by Shamloul and Ghanem published in Nature Reviews Urology indicates that psychological factors are the primary cause in 20-30% of erectile dysfunction cases. In men under 40, this figure can exceed 50%. In other words, the key to the issue often lies in the brain, not the blood vessels.
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Medical examination for the patient. Photo: Quynh Tran |
Dr. Duy advises that if tests and ultrasounds are normal but sexual intercourse consistently fails, psychological erectile dysfunction should be considered. This group of patients should be treated with structured psychological therapy, partner support, and lifestyle changes. PDE5 inhibitors are only a temporary solution to regain confidence.
Men with psychologically induced erectile dysfunction should understand that this is not a permanent condition. Negative emotions can temporarily disrupt the body's erectile reflexes, but this is entirely reversible with treatment and lifestyle adjustments. Maintaining a relaxed mindset, communicating with one's partner, and seeking specialized medical advice will facilitate faster improvement.
Le Phuong
