[Impotence]

"Impotence" is a vague term for a variety of sexual dysfunctions in the male, such as libido disturbance, erectile impotence, dyspareunia and a number of ejaculatory problems. They are very rarely caused and maintained by any single factor. Usually a combination of organic and psychic factors is involved; the symptoms may give some indication as to what factors are dominant. Organic and surgical treatment should be considered cautiously and should have a clear indication. Frequent psychic causes are partnership or personality problems and the so-called vicious circle of performance anxiety. Sexual counselling is often all the therapy needed, especially when sexual knowledge is inadequate or when relative trivial partnership problems are involved. The kind of psychotherapy offered depends on the main problem: partner therapy, therapy directed at the control of personality problems, or therapy based on the Masters and Johnson method may be indicated.