"By far the best professional book ever published about understanding, assessing,
and treating male sexual dysfunction."
Sexual dysfunctions in men, such as erectile dysfunction, ejaculatory disorders,
and low sexual desire, are typically sources of significant distress for men. This
book, being published with the companion volume Sexual Dysfunction in Women,
provides general therapists with practical, yet succinct evidence-based guidance
on the diagnosis and treatment of the most common male sexual disorders encountered
in clinical practice. It assumes that mental health professionals and
other clinicians without expertise in the field of sex therapy have much to offer
these men by combining a multidisciplinary understanding of issues surrounding
sexual problems with their general clinical knowledge and expertise. With tables
and marginal notes to assist orientation, the book is designed for quick and easy
reference while at the same time providing more in-depth understanding for
those desiring it. The book can serve as a go-to guide for professional clinicians in
their daily work and is an ideal educational resource for students and for practiceoriented
continuing education. Recent Praise:

"Simply put, this is by far the best professional book ever published about understanding, assessing, and
treating male sexual dysfunction. David Rowland examines the biopsychosocial model of sexual function
and dysfunction and applies a multi-dimensional, complex approach to understanding and changing male
sexual dysfunction. This book makes a major contribution to the field and should be on the bookshelf
of every psychologist, physician, and couple therapist treating men individually or in couple therapy."
Barry McCarthy, Professor of Psychology, American University, Washington DC; certified marriage and
sex therapist; coauthor of Men's Sexual Health and Sexual Awareness (5th ed.)
"David Rowland's text is an important addition to the literature and belongs in every therapist's library.
It is especially valuable because it is designed to help the generalist deal with sexual problems and is
written clearly with a practical emphasis."
Robert Taylor Segraves, MD, PhD, Professor of Psychiatry emeritus, Case Western Reserve University,
Cleveland, OH; Editor of Journal of Sex and Marital Therapy
"Written for both professionals and the general population, David Rowland's work provides a comprehensive,
scholarly review of men's sexual problems and up-to-date treatments. He concisely examines
physiological and psychological causes and provides the theoretical underpinnings necessary for accurate
diagnosis and treatment. This compact volume is a valuable source of useful information succinctly
covering an all-too-often ignored area of human function and interaction."
Diane Morrissette, PhD, Psychotherapist specializing in sex and relationship counseling, Palo Alto, CA
"The interdisciplinary expertise of Dr. David Rowland makes this comprehensive book on sexual dysfunction
in men an essential read for any professional. The excellent descriptions of assessment and treatment
will prove enlightening to medical health providers as well as anyone in the mental health field. The
inclusion of the empirical evidence of varying treatments will help clinicians focus on the most efficacious
approach. Sex Dysfunction in Men is a welcomed addition to evidence-based practice."
Lin Myers, Professor of Psychology, California State University, Stanislaus, researcher, educator, clinician
in the field of sexology for over 25 years, full member of the International Academy of Sex Research,
and a member of SSTAR, and ASSECT

Table of Contents
Preface
Acknowledgments
1. Description
1.1 Terminology
1.2 Definition
1.3 Epidemiology
1.3.1 Low Sexual Desire
1.3.2 Erectile Dysfunction
1.3.3 Premature Ejaculation
1.3.4 Delayed and Inhibited Ejaculation
1.3.5 Other Considerations
1.4 Course and Prognosis
1.4.1 Psychophysiology of Male Sexual Function: A Brief
Overview
1.4.2 Etiology of Male Sexual Dysfunction
1.5 Differential Diagnosis
1.6 Comorbidities
1.7 Diagnostic Procedures and Documentation
1.7.1 International Index of Erectile Function (IIEF)
1.7.2 Sexual Health Inventory for Men (SHIM)
1.7.3 Self-Esteem and Relationship Questionnaire (SEAR)
1.7.4 Male Sexual Health Questionnaire (MSHQ)
1.7.5 Premature Ejaculation Prevalence and Attitudes
(PEPA)
1.7.6 Index of Premature Ejaculation (IPE)
1.7.7 Premature Ejaculation Diagnostic Tool (PEDT)
1.7.8 Quality of Erection Questionnaire (QEQ)
1.7.9 Sexual Quality of Life Measure for Men (SQOL-M)
2. Theories and Models of Sexual Dysfunction
2.1 Introduction and Issues
2.2 Modified Biopsychosocial Model
2.2.1 Biological/Physiological Factors
2.2.2 Psychological Factors
2.2.3 Relationship Factors
2.2.4 Sociocultural Factors
2.2.5 Interaction of the Biopsychosocial Domains
3. Diagnosis and Treatment Indications
3.1 Establishing a General Framework for Evaluation
3.2 Organization of the Evaluation
3.3 Identifying the Problem and Quantifying Severity
3.4 Identifying Etiological Factors
3.4.1 Biomedical Assessment and Medical History
3.4.2 Psychosexual and Psychological Histories
3.4.3 Relationship Assessment
3.4.4 Probing Sociocultural Factors
3.5 Defining the Desired Outcome
3.6 Treatment of Male Sexual Dysfunction: Setting the
Context
4. Treatment
4.1 Treatment of Low Sexual Desire
4.1.1 Nomenclature and Definition
4.1.2 Prevalence
4.1.3 Risk Factors, Comorbidities, and Other Red Flags
4.1.4 Methods of Treatment
4.2. Treatment of Erectile Dysfunction
4.2.1 Nomenclature and Definition
4.2.2 Prevalence
4.2.3 Understanding the Mechanisms of Erection
4.2.4 Risk Factors, Comorbidities, and Other Red Flags
4.2.5 Methods of Treatment
4.2.6 Combinations of Methods
4.3. Treatment of Premature Ejaculation
4.3.1 Nomenclature and Definition
4.3.2 Prevalence
4.3.3 Risk Factors, Comorbidities, and Other Red Flags
4.3.4 Methods of Treatment
4.3.5 Combinations of Methods
4.4 Treatment of Delayed and Inhibited Ejaculation
4.4.1 Nomenclature and Definition
4.4.2 Prevalence
4.4.3 Etiology, Risk Factors, and Comorbidities
4.4.4 Evaluation
4.5.5 Methods of Treatment
4.4.6 Treatment Efficacy
5. Final Thoughts and Notes
5.1 Overarching Strategies
5.2 Eleven Pointers from Clinical Notes
6. Case Vignette
7. Further Reading and Resources
8. References
9. Appendix: Tools and Resources