Potency is defined as the psychological desire for, and the successful completion of, the act of sexual intercourse. Whether a man ejaculates or not, he is potent if he desires to make love and can do so when the opportunity occurs.
Impotence can be defined as failure to erect in one fourth of attempts. It has two causes:
- The body is handicapped in some way due to organic disease. This is physical impotence.
- The psychologic desire is weak or absent. This is psychogenic impotence. Also called non-specific impotence.
The psychiatrist Sigmund Freud called impotence “the most prevalent failure of human life”. Estimates in the U.S. alone suggest 15 to 20 million men suffer – one in eight males. In Freud’s day, almost all cases were diagnosed as psychogenic. This is now known to be hopelessly inaccurate. Cynics say the reason for the wrong diagnosis was physicians did not know how to help!
It is now estimated 70 percent of cases are physical in origin; there is some organic disorder. Keep in mind even minor health problems rarely act in isolation but interact with other systems. So impotence can be perceived as a valuable health warning.
The four main organic disorders in their order of occurrence are:
- Diabetes, or pre-diabetes, which has not yet been diagnosed.
- Blood flow disorders which interfere with erections: hardening of the arteries, high blood pressure and heart disease.
- Nerve disorders which prevent the messages to erect from getting through. These are neurological conditions.
- Low testosterone reduces the sex drive. Hormone dysfunction is the least common cause of physical impotence.
- Psychogenic impotence is due to stress factors (often in the unconscious) which inhibit the erection process.
Whether physical or psychogenic, impotence feels much the same – calamitous. Once it starts, it is almost impossible for a man not to suffer distress. Behavior may become cranky and it can be difficult to unravel a physical cause from a psychogenic one. Because mind and body are not separate, physical impotence causes psychologic distress and the other way around.
Some men can erect, but not stay erect. They can “have” but not “hold.” This may seem a needlessly fine distinction but in issues of distress, fine distinctions matter. A man who perceives himself as impotent may become extremely upset. If he perceives himself as having a slight maintenance problem, he can stay on a more even keel.
Age is an important factor to consider. As a rule of thumb: At age 40, 80 percent is psychogenic in origin, and 20 percent physical. At age 80, 80 percent is physical, and 20 percent psychogenic. Whatever the cause of impotence, all men should know both kinds can be successfully treated or managed in about 95 percent of cases.
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