What is Impotence?

Impotence is the inability to achieve or maintain penile erection sufficient to complete satisfactory intercourse or any other chosen sexual activity; ejaculation (coming) may or may not be affected. Impotence is also known as Erectile Dysfunction (ED).

Impotence can be classified as primary or secondary.

Primary Impotence:

A man has never had successful intercourse with a partner but may achieve normal erections in other situations.

Secondary Impotence:

despite current impotence problems, there is some history of success with completing intercourse in the past.

How Common Is Impotence?

Most men will experience occasional impotence, usually resulting from stress, tiredness, anxiety or excessive alcohol or other drug consumption. Worrying about impotence may then set the scene for a more persistent problem due to "fear of failure" known as performance anxiety. Research has established that prevalence of ED among Australian men ranges from:

• 13.1% of 40-49 year olds
• 33.5% of 50-59 year olds
• 51.5% in 60-69 year olds
• 69.2% of 70-79 year olds

Unfortunately, many men do not receive treatment or wait a long time before seeking treatment. Erections can change over time, sometimes stronger or weaker than other times. When men are in their teens they often have little control over their erections and obtain erections when not in a sexual situation. For most men this stops in their late teens to early twenties. As men get older, erections may not always be obtained when they want one. Almost every man has the occasional time when their erection is less strong than they would like but sometimes it becomes a problem.

What Causes ED?

The cause may be physical or psychological. For most men the cause is both physical and psycological. In 75% of cases of impotence there will be a physical cause.

Physical causes of ED include:

• Diabetes
• High cholesterol
• Heart disease
• Post prostate cancer
• High blood pressure
• Alcohol or other drug use
• Some prescribed drugs
• Disease of the liver and kidney
• Surgery to the bladder, prostate gland, lower bowel and spine
• Poor blood flow to the penis resulting from blocked arteries

• anxiety or stress
• anxiety about sexual performance or sexual identity
• fear of sexual contact (from issues such as pregnancy or HIV/Sexually Transmitted Diseases)
• psychological trauma or abuse
• sexual problems with partner
• sexual boredom
• depression
• lack of communication in the relationship or other relationship issues
• grief or the effects of illness of self or family member