Medical Treatment of Erectile Dysfunction:
Increasing Patient Compliance via Psychodynamic Factors

An enormous number of patients will take Viagra and similar drugs to enhance their sexual functioning. Too many will discontinue use soon after starting: some because their unrealistic expectations are not met, others because of the unanticipated personal and relationship impacts of the medication.

Physicians can increase patient compliance, and medication effectiveness, by attending to certain simple psychodynamic factors. This workshop discusses strategies including:

• Asking the patient to talk about the exact circumstances in which he intends to use the medication
• Discussing what problems (relationship and personal) the medication will not fix
• Discussing the possible unintended effects the medication may have on the patient's relationship(s)
• Rehearsing a sample conversation the patient can have with his partner
• Inquiring about the patient's partner's role in the decision to obtain the medication.

This talk examines how physicians can quickly help patients understand how they can best integrate this medication into their sexual relationships. We will discuss specific questions about the patient's history and expectations that can identify and prevent potential problems.

The workshop also covers the unintended effects this medication can have, including increased marital conflict; power struggles; exacerbating an existing desire discrepancy; and how it can be an unwanted "truth drug."