Q&A Forum - Best of Elise

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Edwards, a staff therapist with the Mercy Hospital in Des Moines, Iowa, points out that the reverse scenario also is true in many cases -- where otherwise psychologically healthy men develop erectile dysfunction for physical reasons, and then develop psychological problems. "I've worked a lot with men in their middle years, and typically they would have some organic contribution. Maybe they were overweight or had a pain in their back." Sex was uncomfortable for these men, he says, so they would resort to trying to get it over with quickly. That would lead to problems. "If you're 60 years old and trying to have sex in a hurry, you're probably going to fail."

Edwards says it's not new that men with erection problems consult their medical doctors first. "They always did go to the medical doctors. Psychotherapists weren't their first choice. It was in the hope there was something their doctors could give them. And now there is." But, he says, many older couples he's seen have found a simpler, less expensive (and safer) solution: a good lubricant.

Tobias suggests that while there may be value in Viagra, the ads for the drug encourage indiscriminate use: "The ads themselves lead to tremendous expectations, and Viagra may not even be the answer." He says: "No matter how many caveats you put in the ads, all the man hears is the opening statement: 'Here's the solution to your problem.'" Maybe that's true, Tobias says -- and maybe not."