Men who participate in group psychotherapy sessions and take medication to treat erectile dysfunction have better success than those who take medication alone, a new study shows.

A team of Cochrane researchers used data from nine randomized trials and two quasi-randomized trials involving 398 men with erectile dysfunction who had been given just psychotherapy, just medication, or psychotherapy and medication, or vacuum devices. Another 59 men with ED were placed in non-treatment control groups.

The Cochrane Systematic Review found that 95 percent of the men who received group psychosocial therapy benefited from the treatment. There was no benefit in the control group. Psychotherapy coupled with the drug sildenafil, more commonly known as Viagra, worked better than just using Viagra alone, the study also showed.

Researchers believe psychotherapy benefited the men because sexual function relies “on the coordination of psychological, endocrine, vascular and neurological factor.”

In particular, depression, low self-esteem, anxiety and other psychosocial stresses can play a large role in erectile dysfunction, the study said.

Impotence: A Growing Problem?

According to the National Ambulatory Medical Care Survey (NAMCS), for every 1,000 men in the United States, 7.7 physician office visits were made for erectile dysfunction in 1985. By 1999, that rate had nearly tripled to 22.3 visits per 1,000.

Although the erectile dysfunction appears to be a growing problem, the National Kidney and Urologic Diseases Information Clearinghouse notes that the upswing in cases came as treatments for impotence, such as oral and injectable drugs and vacuum devices, became more widely available.

NAMCS data estimated there were 2.6 million mentions of Viagra at physician office visits in 1999, and one-third of those mentions came during doctor's visits unrelated to ED.

Although the new study shows promise, the researchers said further analysis is needed.

“We now need some large randomized trials with longer follow-up periods in order to measure exactly how effective psychosocial therapy can be,” said researcher Tamara Melnik, a psychiatrist and professor working at the Universidade de São Paulo in Brazil, in a press release.

Further research should group the men according to personality and test different forms of psychotherapy, said Melnik.

“One problem with psychosocial therapy is that we are still uncertain which patients are most likely to benefit from it and if effectiveness depends upon personality factors, psychiatric co-morbid diagnosis, and length of therapy time,” Melnik added.