When Man Says No: Controversies and Contraindications in the Treatment
In Spanish
Introduction: to discuss the controversies and contraindications
in the treatment of Sexual Desire Disorder
in men that involving organic and psychocultural
factors.
Methods: We reviewed the published literature
involving testosterone and psychotherapeutic
techniques.
Findings & Discussion: The best method for dosing
testosterone is controversial, being recommended the
Calculated Free or Bioavailable Testosterone (TLC).
Always the benefits of testosterone treatment should be
weighed against possible damage and these should be
clarified. Testosterone should not be prescribed if there
is desire for fertility, in these patients we can use
clomiphene, HCG and aromatase inhibitors. Absolute
contraindications for testosterone using are presumed
or confirmed breast cancer and suspected or confirmed
prostate cancer. Relative contraindications: congestive
heart failure, erythrocytosis / polycythemia, severe sleep
apnea, gynecomastia, severe obstructive symptoms of
the lower urinary tract resulting from prostatic hyperplasia.
There are controversies and there are absolute
and relative contraindications to the use of testosterone
The desire is multifactorial, while each man is unique
INTERNATIONAL JOURNAL OF SEXUAL HEALTH A49
about what promotes his sex drive, we know that many
men have the sexual desire triggered by vision, so
besides the techniques of the Behavioral Cognitive Line
which includes Sexual Therapy are important techniques:
1) To discuss machismo in the culture that
preaches the demonstration of sexual desire as a symbol
of virility ; 2) Identify and work on sexual fantasies;
3) Reestablish sexual inciters ; 4) Male Sexual Menu
Technique : To erotize the mind thinking about sexual
images and fantasies (3x a day) and using it during
intercourse, replacing the “lack of erotic thoughts”. 5)
During intercourse prohibited technique can be prescribed
Focus of Sensations I and then the II.
Recommendations: More studies are needed to
evaluate testosterone safety and also the effectiveness of
psychotherapeutic techniques, but techniques that use
the sex-specific male inciters have a chance of being
effective.
Keywords: Male Sexual Desire Disorder,
Contraindications, Controversies
Conflict of Interest and Disclosure Statement: None
