An analysis of the effectiveness of two components in the treatment of erectile dysfunction

This study compared the effectiveness of two components, a ban on sexual intercourse and communication of sexual preferences, in the treatment of couples in which the male was experiencing erectile dysfunction. Sixteen couples were randomly assigned to one of two treatment conditions. In one condition spouses were asked to refrain from intercourse and to make an effort to communicate sexual tastes and preferences during noncoital erotic interaction. Couples in the second condition were assigned only the communication portion of the therapeutic instructions given to the first group. The treatment consisted of written instructions concerning tasks to be carried out at home. Therapist contact was minimal. Following a 1-month baseline period of self-monitoring using a daily record-keeping form, couples underwent a 1-month treatment period and follow-up testing after another month. Male subjects also underwent an endocrinological examination to ascertain testosterone and related hormone levels prior to participating in the treatment. Both treatment groups reported significant improvement in several measures of erectile functioning, general sexual functioning, and marital adjustment. However, the ban on intercourse did not add to the effectiveness of encouraging sexual communication, indicating that the former component probably did not contribute to change. Two pretreatment measures, the Sexual Interaction Inventory and testosterone level, were found to predict treatment outcome with sufficient accuracy to permit selection of future patients who might benefit from this type of treatment format. The effectiveness of a treatment consisting of written instructions with minimal therapist contact for males with erectile dysfunction have important cost-benefit implications.