The Use of Online Cognitive Behavioral Therapy to Treat Erectile Dysfunction During the COVID-19 Pandemic

The Use of Online Cognitive Behavioral Therapy to Treat Erectile Dysfunction During the COVID-19 Pandemic

Nonorganic erectile dysfunction (ED) is ED that is not related to organic risk factors like vascular problems, neurological issues, or penile deformities like Peyronie’s disease, and is instead linked to psychological causes.

During the COVID-19 pandemic, many medical resources were diverted to help stop the spread of the virus, disrupting nonemergency medical services such as the outpatient treatment of ED. Nevertheless, ED can have a substantial negative impact on male sexual functioning and mental health.

Fortunately, cognitive behavioral therapy (CBT) is considered to be an effective intervention for nonorganic ED, supported by studies demonstrating its benefits in improving sexual functioning, anxiety, and depression.

Recently, investigators presented the results of the first randomized controlled trial to evaluate the efficacy of online CBT for nonorganic ED during the pandemic. For this study, participants received either CBT alongside conventional oral medicine treatment or only the latter, providing valuable insights into these treatment approaches.

A total of 87 individuals participated in this study. The participants were randomly assigned to the CBT group or the wait list control group at a 1:1 ratio. During a six-week period, all participants took oral medications for ED. However, the people in the CBT group had one 45-minute CBT session per week for six weeks, while the people in the control group did not.

All participants were asked about their basic information including their age, education level, marital status, employment status, smoking status, alcohol consumption, and parental status.

Then, they completed the Index of Erectile Function–5 (IIEF-5) to measure their sexual functioning, as well as the Rosenberg Self-Esteem Scale (RSES), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7) to assess their psychological state.

After treatment, the CBT group showed significant improvements in their IIEF-5 scores, indicating mild ED compared to the control group’s moderate ED. The CBT group also exhibited better self-esteem and reduced depression and anxiety after completing treatment, highlighting the positive impact of online CBT on sexual health and psychological well-being during the pandemic.

In the end, the participants who received CBT and oral medications showed significant improvements in self-rated erectile function, emotional states, and self-esteem compared to the control group. As such, these findings show the potential of online CBT as a valuable tool in enhancing mental health and addressing sexual functioning issues during times of medical disruptions, such as the COVID-19 pandemic.

For individuals with ED, incorporating online CBT alongside conventional treatment can offer comprehensive support, improving emotional well-being and overall treatment outcomes.


  • Han, M., Wang, X., Yang, H., Wang, X., Zhu, H., & Song, M. (2023). Efficacy of online cognitive behavioral therapy for nonorganic erectile dysfunction in reproductive-age males during the COVID-19 pandemic: a randomized wait list–controlled trial. The Journal of Sexual Medicine20(11), 1325-1332.

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