I see many adolescents these days with erectile dysfunction (ED).  To their credit, most of them discuss this with their parents and then come in to see me.  Most of the time they have seen another specialist and are told that it is all psychological and that if they just relaxed it will go away.  Unfortunately, this rarely works.  90% of the time in men, ED is physical.  Though in men under 35, 90% of the time it is psychological.  Thus most likely it is primarily psychological, but there is that 10% as well.

My approach has been to do a full evaluation.  If there is no physical component found, we then discuss our options.  Most of the time, this is not an indication of severe pathology or even of sexual ambivalence etc.  Often, it is an isolated problem, which gets worse over time because of the anxiety it creates.  I will usually treat it physically (though obviously not surgically.)  Most of the time it will correct itself over time with treatment, and he can wean himself off treatment.  It has been a very successful approach, and one that the parents (if involved in their son’s care) have been very accepting of and pleased with.