Internet-Based Brief Sex Therapy for Heterosexual Men with Sexual Dysfunctions: A Randomized Controlled Pilot Trial

Abstract

Introduction Internet-based sex therapy for men with erectile dysfunction has been advocated as an easily accessible and cost-effective treatment. Aim To test whether Internet-based sex therapy is superior to waiting list. Methods Internet-based therapy was administered to heterosexual men with erectile dysfunction or premature ejaculation, without face-to-face contact, in a waiting-list controlled design, with pre-, post-, and follow-up measurements at 3 and 6 months posttreatment. Treatment was based on the sensate-focus model of Masters and Johnson, and supplemented with cognitive restructuring techniques. Main Outcome Measures Self-reported improvement of sexual functioning, erectile functioning (men with ED), premature ejaculation (men with PE), sexual desire, overall sexual satisfaction, and sexual self-confidence. Results Ninety-eight men participated (58 ED, 40 PE). Sexual functioning was much or somewhat improved in 40 participants (48%). In participants with ED, a near significant effect of treatment was found (P = 0.065), with higher levels of sexual desire (P < 0.05) and sexual self-confidence (P = 0.05) in treated men, in addition to improved erectile functioning (P = 0.01) and overall sexual satisfaction (P < 0.001) in both groups. In participants with PE, treatment was not superior to waiting list. In participants with ED, erectile functioning (P < 0.05) and overall sexual satisfaction (P = 0.002) improved significantly. In participants with PE, latency to ejaculation (P < 0.001), sexual desire (P < 0.05), and overall sexual satisfaction (P < 0.05) improved significantly from baseline to posttreatment, with no further changes at both follow-ups. Sexual self-confidence in men with PE remained unchanged during treatment until follow-up at 3 months posttreatment, and then was found to be improved at 6-months follow-up (P < 0.05). Conclusion Internet-based sex therapy for male erectile dysfunction was efficacious for male erectile disorder. For men with premature ejaculation, however, treatment was not superior to waiting list.

Functional and Psychological Characteristics of Belgian Men with Premature Ejaculation and Their Partners

“…This probably led to selecting a particularly proactive part of the Belgian population suffering from PE. Another study performed in the Netherlands by Van Lankveld, Leusink, Van Diest, Gijs, and Slob (2009) corroborates the possibility of such a selection bias: in their sample, also recruited from an invitation to test a treatment, they found a rate of previous consultations for PE reaching 30%. This is quite close to the 37% found in the present study.…”

Interventions to treat premature ejaculation: a systematic review short report

“…Golombok Rust Inventory of Sexual Satisfaction premature ejaculation subscale score: internet-based behavioural therapy compared with waiting list control The between-group MD in the Golombok Rust Inventory of Sexual Satisfaction (GRISS) PE subscale score at 3 months based on one RCT 50 (n = 37) was -0.20 minutes (fixed effect; 95% CI -1.75 to 1.35 minutes; p = 0.80) (Figure 2). …”

“…All patients (100%) were reported as completing the intervention. In the RCT by van Lankveld et al, 50 an internet-based sex therapy based on the Masters and Johnson sensate focus technique was compared with waiting list control and 40 patients were randomised. The number and frequency of therapeutic contacts was left to the judgement of the therapist and the participant.…”

“…36,38 Nine RCTs evaluating behavioural therapies were identified from these and other reviews of pharmacological therapies. [39][40][41][42][43][44][45][46][47] A further three RCTs of behavioural therapy were identified by the literature search: [48][49][50] one evaluated pelvic floor exercises compared with dapoxetine, 48 one evaluated a multicomponent behavioural therapy intervention compared with paroxetine alone or in combination with the behavioural intervention 49 and one evaluated an internet-based behavioural intervention compared with waiting list control. 50 Reviews The Cochrane review by Melnik et al 35 and the systematic review by Melnik et al 38 were conducted in Brazil.…”

“…39-50 nine 39-47 captured in two low-quality reviews and one moderate quality Cochrane review, plus three further RCTs [48][49][50] of unclear methodological quality. The quality of reporting and diversity of outcome data did not permit pooling of effect estimates.…”