Psychosocial interventions for erectile dysfunction.
Adding structured therapy to an erectile-dysfunction medication worked better than the medication alone in a Cochrane review — can we do both rather than picking one?
Top of the evidence hierarchy, independently funded. how we score evidence
Caveat on this rating: The high trust score reflects the review's method, funding, and journal, not the strength of the underlying trials: 398 men across 11 studies, several from the 1970s and 1980s, with waitlist controls and confidence intervals touching 1.0. The single trial claiming group therapy outperformed sildenafil alone (WMD -12.40 on the IIEF) had 20 participants and was run by one of the review's own authors, which is a direct conflict on the review's most eye-catching result.
Pooling 11 randomised or quasi-randomised trials in 398 men with erectile dysfunction, group psychotherapy reduced persistent erectile dysfunction versus a waitlist (RR 0.40, 95% CI 0.17 to 0.98) with the benefit still present at six months (RR 0.43, 95% CI 0.26 to 0.72). Adding group therapy to sildenafil beat sildenafil alone (RR 0.46, 95% CI 0.24 to 0.88) and cut dropout (RR 0.29, 95% CI 0.09 to 0.93). The trials are old, tiny, and mostly at the edge of statistical significance, so this supports offering therapy alongside a drug rather than proving therapy is equivalent to one.
Worth asking
Adding structured therapy to an erectile-dysfunction medication worked better than the medication alone in a Cochrane review — can we do both rather than picking one?
What to watch for
Evidence quality tells you whether to trust the finding — not whether the treatment is safe. These are the risks this research reports.
- Sexual side effects
Source
Psychosocial interventions for erectile dysfunction. — Melnik T, Soares BG, Nasselo AG. (2007)
Top-tier peer-reviewed journal
Read the source: https://doi.org/10.1002/14651858.CD004825.pub2
DOI: 10.1002/14651858.CD004825.pub2
How this was scored
- Study design
- Systematic review of randomised trials
- Funding
- Independently funded
- Published in
- Top-tier peer-reviewed journal
- Sample size
- 398
- Preregistered
- Yes
- Conflicts disclosed
- Yes
- Independent of proponent
- Yes
- Retracted
- No
Read the full scoring rubric, including what it can't tell you.
Published August 19, 2026.
Where we put this study in context
Questions
How strong is the evidence behind this?
Resolv rates this source "gold standard". Top of the evidence hierarchy, independently funded. It scores 95 out of 100 on our published rubric. One caveat travels with that badge: The high trust score reflects the review's method, funding, and journal, not the strength of the underlying trials: 398 men across 11 studies, several from the 1970s and 1980s, with waitlist controls and confidence intervals touching 1.0. The single trial claiming group therapy outperformed sildenafil alone (WMD -12.40 on the IIEF) had 20 participants and was run by one of the review's own authors, which is a direct conflict on the review's most eye-catching result. The score is calculated from recorded facts about the source — study design, funding, publication venue, sample size, preregistration — not typed in by an editor.
What is the source for this?
Psychosocial interventions for erectile dysfunction. — Melnik T, Soares BG, Nasselo AG. (2007). Published in: Top-tier peer-reviewed journal. DOI: 10.1002/14651858.CD004825.pub2. The full source is linked on this page so you can read it yourself.
Who paid for this research, and does that matter?
Study design: Systematic review of randomised trials. Funding: Independently funded. The researchers were independent of whoever benefits from the result. Industry sponsorship is one of the most reliably measured biases in medicine, which is why funding carries real weight in the score rather than sitting in a footnote.
Is this medical advice?
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.
This is information to bring to your prescriber, not medical advice and not a reason to change anything on your own. Nothing here is an instruction to stop or reduce a medication. If you are in crisis, call or text 988.