title: Improvement of chronic pain by treatment of erectile dysfunction.
abstract: BACKGROUND
  Pain specialists, who do not routinely examine patients regarding their sexual medicine problems, need to be aware that sexual problems can and do aggravate the patient's pain. Patients may refuse to admit suffering from erectile dysfunction (ED) but complain about continuous or progressive severe pain. These patients may be best managed by the combined team effort of a sexual medicine specialist and pain specialist.
  
  
  OBJECTIVE
  This report documents the management of three cases with long-term intractable pain after severe trauma. Treatment of occult ED led to significant improvement of their pain.
  
  
  METHODS
  The association of the treatment of uncovered ED and improvement of chronic severe pain.
  
  
  METHODS
  Three case reports of patients with severe pain who attended a pain clinic in an academic medical center.
  
  
  RESULTS
  Three men suffering from chronic pain due to severe trauma were observed for several years by different physicians as well as pain specialists. In spite of different treatments, including administration of several analgesics, psychotherapy, and physical therapy, pain was not alleviated. After finding ED problems, patients were referred to the family health clinic. Using different therapies such as psychosexual therapy, correction of sexual misconceptions, relaxation training, treatment of interpersonal difficulties, and pharmacological intervention ED was cured. Treatment of ED was accompanied by a significant reduction of chronic pain in all three patients.
  
  
  CONCLUSIONS
  The present report indicates that uncovered ED in patients suffering from chronic pain may trigger their somatic pain or reduce its threshold. Significant improvement in sexual functioning may improve the pain and reduce its complications.
authors.affiliation: Shafa Neuroscience Center, Tehran, Iran.
authors.forename: Jalil
authors.initials: J
authors.lastname: Arabkheradmand
authors.forename: Seyed Kazem
authors.initials: SK
authors.lastname: Foroutan
authors.forename: Shayan
authors.initials: S
authors.lastname: Ranjbar
authors.forename: Tehrani
authors.initials: T
authors.lastname: Abbasi
authors.forename: Salahodin
authors.initials: S
authors.lastname: Hessami
authors.forename: Ali
authors.initials: A
authors.lastname: Gorji
mesh_terms: D000328:Adult; D002908:Chronic Disease; D003131:Combined Modality Therapy; D007172:Erectile Dysfunction / Q000523:psychology / Q000628:therapy*; D006801:Humans; D007989:Libido; D008297:Male; D018710:Pain Clinics; D010147:Pain Measurement; D010148:Intractable Pain / Q000523:psychology*; D010348:Patient Care Team; D012736:Sex Education; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000150:complications / Q000523:psychology