The emergence of a variety of new treatments for impotence is giving couples new options for dealing with a problem that affects an estimated 30 million men and their partners, according to the nonprofit Impotence Institute of America (IIA).

Although the new treatments regard impotence as a physiological rather than a psychological problem, it is an issue confronted by an unknown number of psychiatrists and other psychotherapists. Only about 20 percent of impotence cases are psychologically caused, according to an IIA spokesperson.

Until recently, couples had only limited options, including counseling. But as more couples begin to understand that 80 percent of those suffering from impotence have a physical problem, counseling will increasingly be seen as secondary to pharmacologically based treatments.

What IIA describes as "the wave of new treatments" started with Caverject by Upjohn. This permits a man to produce an almost instant erection by injecting himself with the drug alprostadil. Other drug makers are now marketing other preparations using the drug, including Edex, another injectable medication, from Schwartz Pharma.

Late last year Vivus Corporation announced approval by the Food and Drug Administration (FDA) to market Muse, another alprostadil-based treatment that delivers the drug through insertion of a small suppository into the urethra.

In addition, several transdermal patches, similar to the popular nicotine patches used to help people quit smoking, can be applied to the skin to deliver hormones essential for erections.

According to IIA, drug manufacturers are now testing pills that, if approved, would provide the first oral-treatment options for impotence sufferers. Such approval could occur as early as this year, according to IIA.

Faced with the explosion of new treatments, impotent men and their partners should reach a decision by first consulting "a qualified professional," said IIA President Marion Parker. But the biggest problem is getting those affected by impotence "to seek that advice in the first place," Parker added.

The problem of impotence shares something in common with psychiatric disorders: it bears a stigma that discourages sufferers from seeking professional care. Although 30 million men experience chronic impotence, "the real tragedy" is that only a small percentage seek any treatment, according to Parker.

Like psychiatric conditions that are now increasingly treatable, "impotence is more treatable than ever," commented urologist Myron Murdock, M.D.

For psychiatrists with patients suffering from impotence, it is often difficult to convince them that the cause is usually physical, not psychological. Men have for years heard "the myth that impotence is 'all in their heads,' " said Parker.

The mission of IIA is "to make impotent men, and their partners, aware that they no longer need to suffer needlessly and to identify qualified professionals who can help them decide on the treatment option that will work best for them," Parker commented.

IIA can be reached by calling (800) 669-1603. A confidential packet of information may be obtained by mailing a request with $2 to IIA, 10400 Little Patuxent Parkway, Suite 485, Columbia, Md. 21044-3502.

(Psychiatric News, April 18, 1997)