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Erectile Dysfunction: Male erectile disorder is also called erectile dysfunction or impotence. In primary impotence, the man has never been able to obtain an erection sufficient for vaginal insertion. In secondary impotence, the man has successfully achieved vaginal penetration at some time in his sexual life but is later unable to do so. In selective impotence, the man is able to have coitus in certain circumstances, but notion other for example a man may function effectively with a prostitute, but be impotent with his wife. Secondary impotence has been reported in 10 to 20 percent of all men .Fraud declared it to be a very common complaint among his patients. Among all men treated for sexual disorders, more than 50 percent have impotence as the chief complaint. Primary impotence is a rare disorder, occurring in about 1 percent of men under age 35 . The incidence of impotence increases with age. Among young adults it has been recorded in about 8% .Masters and Johnson report a fear of impotence in all men over 40, which the researcher belive reflects the muscle line fear of loss of virility with advancing. As it happens, however impotence is not universal in again men having wife is more closely related to continuing potency than is age. The etiology of impotence may be organic, psychological, or combination of both. The incidence of psychological as opposed to organic impotence has been the focus os many studies. Some researchers have reported the incidence of organic impotence in a medical clinic to be as high as 75 to 85 % . Others belives that these same populations have not had adequate psychological screen and maintain that more than 90% of cases of impotence have psychological cause. Side effects of medication may impair sexual functioning in a variative ways in men . Castration does not always lead to sexual dysfunctional , depending on the person. Efection may still occur after castration. Fraud described one type of impotence as caused by an inability to recoils feelings of affection with feelings of desire toward the same woman. Such men can only function with women whom they see as degraded. Other factors that have been cited as contributing to impotence include a punitive superego, an inability to trust feelings of inadequacy or sense of being undesirable as partner. There may an inability to express the sexual impulse be (Author is Consultant Psychiatrist at Raahat Hospital, Aurangabad.) |