impotence(redirected from anatomical impotence)
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impotence (imˈpətəns), inhibited sexual excitement in a man during sexual activity that, despite an unaffected desire for sex, results in inability to attain or maintain a penile erection. Known medically as male erectile dysfunction, it affects younger and older men alike. Impotence can result from psychological factors (performance anxiety or fear of abandonment or unwanted pregnancy), sociocultural factors (negative sexual attitudes or religious beliefs), or physical causes. Impotence is distinguished from sterility (inability to produce sperm adequate for reproduction; see infertility).
Physical causes include low testosterone levels, diabetes, arteriosclerosis, prostate cancer surgery, and neurological diseases such as multiple sclerosis and Parkinson's disease. Many drugs, illicit (e.g., marijuana, heroin, and cocaine) and prescription (e.g., ulcer medicines such as cimetidine (Tagamet) and hypertension medicines such as beta-blockers and diuretics), have been associated with impotence in some men. Smoking and alcoholism also can inhibit sexual excitement. Often, more than one factor is involved. In general, anything that can affect the flow of blood to the penis can cause impotence.
Treatment depends on the underlying cause, and may involve education and counseling of the man and his partner. Treatments include self-injection of a vasodilating drug before intercourse, and implantation of rod-shaped devices into the penis that are inflated via an attached fluid reservoir. In 1998 the first prescription medication for the treatment of impotence, sildenafil (Viagra), was approved for sale in the United States. It acts by blocking an enzyme called phosphodiesterase 5 (PDE5), which can end an erection prematurely; vardenafil (Levitra) and tadalafil (Cialis) work similarly.
See also sex therapy.
a symptom of various pathological conditions manifested by a weak erection, which interferes with the normal course of the sex act. Impotence may accompany organic and functional disorders of the nervous system. It may also be a symptom of a urological disease.
Many male sexual deviations are associated with impotence. These deviations range from infertility to various forms of sexual incompatibility between partners. There is a tendency in modern sexology to be more exact in defining concrete sexual disorders, especially in cases of sexual incompatibility. Soviet sex pathologists have shown that many who seek the help of a sexologist are suffering from imaginary deviations. The male may be making excessive demands upon himself. He may also be imagining nonexistent sexual defects or overreacting to changes in his sex drive. Failure to observe the elementary requirements of sexual psychohygiene and improper behavior on the woman’s part can also lead to male sexual deviations. Sexual neuroses may result if psychosomatic deviations are not treated promptly. The counseling of a sexologist is usually effective.
REFERENCESIakobzon, L. Ia. Polovoe bessilie, 2nd ed. Petrograd, 1918.
Aktual’nye voprosy seksopatologii. Managing editor, D. D. Fedotov. Moscow, 1967. Pages 183, 270.
Vasil’chenko, G. S. O nekotorykh sistemnykh nevrozakh i ikh patogeneticheskom lechenii Moscow, 1969.
Problemy sovremennoi seksopatologii (collection of works). Moscow, 1972.
Masters, W. H., and V. E. Johnson. Human Sexual Inadequacy. London, 1970.
G. S. VASIL’CHENKO