Impotence is the inability to have a sufficient erection or maintain a sufficient erection until the completion of sexual intercourse. Other names – erection dysfunction, erection disorder, sexual arousal disorder.

Impotence is a common misfortune of modern men. The intense rhythm of life, high mental stress, alcohol abuse, interpersonal and official conflicts and many other reasons can lead to a decrease and even loss of the former potency.

Among men who turn to a sex therapist, up to 50% call impotence as the main complaint.

Impotence among young men, according to G. Kaplan, B. Sadok, is 8%. With age, the number of cases of impotence increases. At the age of 80, 75% of men are impotent.

If from time to time due to some reason a man is not able to have sexual intercourse, and in general, with his general mental and physical well-being with potency, everything is fine with him, then in these cases we are not talking about impotence.

Impotence is considered only those cases when more than 25% of sexual attempts fail.

American sexopathologists W. Masters and V. Johnson distinguish primary (congenital) and secondary (acquired) impotence.

With primary impotence, a man could never and cannot achieve an erection sufficient to insert a penis into the vagina and have successful intercourse. Primary impotence is a rare disorder and occurs in 1% of men under 35 years of age.

With secondary impotence, a man loses his previously existing ability to have an erection, sufficient for sexual intercourse, in some periods of his sexual life. Impotence is considered secondary if a man was able to have sexual intercourse at least once in his life (to introduce the penis into the vagina), regardless of whether it ended in success or disappointment. In practice, most often men before the onset of erection disorders already had many successful sexual intercourse.

Erection disorders can occur at any age and in its most diverse forms. In the case of acquired impotence, it can occur both in young and in adulthood. Secondary impotence occurs approximately 10 times more often than primary, and is observed in 10–20% of all men.

Impotence can be functional, that is, caused by psychological reasons, and organic, that is, associated with some kind of disease.

In cases where a man has spontaneous (spontaneous) or morning erections, a normal erection during masturbation or during sexual intercourse with another, and not with a constant sexual partner, for example, with a new lover, a normal erection, and with a wife is insufficient, or vice versa, with a constant partner, a normal erection, and with a new, still unfamiliar, insufficient – this is not about organic, but about functional impotence.

The most common psychological causes of impotence are as follows:

• conflicts associated with a sexual partner;
• problems in the relationship between partners (for example, a failed marriage);
• various traumatic situations not related to the partner (for example, a conflict at work);
• stress
• self-doubt and sexual abilities;
• depression or neurosis;
• violation of sexual orientation (for example, latent homosexuality).

With psychological reasons, American psychiatrists associate the inability to sexual stimulation, if a person experiences fear, anxiety or moral prohibition.

Braking effects that violate an erection already at the first attempt to have sexual intercourse with a woman can have a different character. These include religious, ethical, aesthetic influences, fear of contracting a sexually transmitted disease, pregnancy of a partner, fear of being ridiculed or condemned by a partner.

If a man seeks closeness with a woman, but at the same time feels fear due to one of the above reasons, then he may experience a violation of the erection. At the same time, according to K. Imelinsky, sexual intercourse becomes a signal of danger (fear of pregnancy and its socio-psychological consequences for a man, fear of being ridiculed by a partner, losing reputation, ruining relationships). In situations not related to sexual intercourse, an erection in such a man is not broken. However, the closer the time of intimacy, the stronger the feeling of fear (often not realized, but associated with long-acquired ideas and beliefs), the worse things are with an erection. Under these conditions, sexual intercourse, which seeks a man, subconsciously carries a threat to him. The closer the target, the higher the threat. Immediately before sexual intercourse or even during it, an erection disappears when fear exceeds the severity of sexual arousal. If in such conditions it is not possible to perform the first sexual intercourse, then this can become a psychological trauma, on the basis of which a sexual neurosis is formed, and each subsequent failure aggravates the violation of the erection and strengthens the feeling of fear.

The disappearance of an erection during sexual intercourse may be due to a poor mood of a man, overwork, sexual unattractiveness or passivity of a partner. This disorder can also occur with sexual neurosis.

If this violation is superimposed on the so-called neurotic readiness inherent in suspicious and fearful men, and then repeated several times, then it becomes a inhibitory factor that makes it impossible to have sexual intercourse in general.

The repeated disappearance of an erection during intercourse makes it impossible to end it and becomes the cause of the so-called satisfacendi impotence, that is, the inability to provide sexual satisfaction to the partner.

At the same time, erectile dysfunction does not allow a man to achieve sexual satisfaction. Dissatisfaction, disappointment and fear of a partner’s reaction to his failure can be so pronounced that even if a man experiences an orgasm, it gives him a feeling of only physical relaxation, but does not give emotional satisfaction.

Difficulties in maintaining sexual arousal may result from psychological conflicts with a sexual partner or for another reason. They can be caused by anxiety, depression, guilt, for example, after adultery or contracting a sexually transmitted disease. The role of hormonal drugs or certain drugs also plays a role.

In itself, an erectile dysfunction can also lead to interpersonal conflicts with a sexual partner, depression, guilt, a sense of bankruptcy and an inferiority complex and can be a stress factor or significantly aggravate the mental state caused by a different traumatic situation.

In some cases, the cause of functional impotence in suspicious, inspired men is intimidation by all sorts of “terrible consequences” of masturbation in childhood, and as an adult, a man begins to fear closeness with women, doubting whether teenage masturbation affected his sexual abilities.

The more a man doubts his abilities and exaggerates the consequences of masturbation (masturbation), the more problems he becomes with potency, he fears failure with another sexual intimacy, and from this fear his erection is really insufficient. All this can be fixed, and then sexual neurosis will form, and erectile dysfunction can become persistent.

Many insecure men who have an “inferiority complex” that is not even connected with their sexual lives experience the fear of being powerless sometime.

Such men constantly doubt whether they did the right thing in a given situation, analyze their mistakes, repeatedly check themselves and what they have done, before making any, even unimportant decision, they think and consult with close people for a long time, they are painful about everything that can offend them pride. Such character traits are called psychasthenia. And if failure ever occurs (and this can happen in the sexual life of every man, even “without complexes”), then the fear of losing potency increases.

The more a man fears that at the next sexual intercourse he may have an insufficient erection, the less he has sexual arousal, which is suppressed by this fear, and, accordingly, an erection is weaker. And a vicious circle arises.