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Impotence

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Updated June 19, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Impotence is a term that has mostly fallen out of use, in favor of the more descriptive and clinical term erectile dysfunction, although it is still used at times in both in popular culture and by some physicians when talking about sexual dysfunction in males (for example, there is still a medical journal called The International Journal of Impotence Research).

What Is Impotence?

The way it's used today, impotence refers in general to a man's inability to perform sexually, and specifically to his inability to get an erection. Of course, impotence has many other meanings, including powerless, helplessness, weakness, etc... The inaccurate idea that if a man can't get an erection, he has no sexual power, is what makes impotence such a dangerous but also popular term. It's a word that strikes fear in the hearts of those who are worried it might happen to them, and causes pain when it's directed at someone as an insult.

Impotence isn't an accurate term because the truth is that men have sex all the time with and without erections, and a man's sexuality or power isn't related to just one part of his body. When we confuse ability to get erections with ability to give and receive sexual pleasure, we make worse a complicated and common sexual complaint -- an inability to get an erection that is satisfactory for sexual pleasure.

In order to understand why erections don't work, you need to understand the basics of how erections work. Getting an erection involves multiple parts of your body, including your brain, nerves, hormones, muscles, and heart. Anything that interrupts this any of these systems may result in what gets called impotence.

Causes of Impotence

Because erections involve multiple systems, there are often multiple causes of impotence, even for one man. Causes of impotence are often broken down into different categories. These include:

Physical Causes:

Psychological Causes:

Treatments for Impotence

Once you've determined the cause or causes, there are various treatment options, including:

What Should I Do If I Think I'm Impotent?

If you are experiencing difficulty with erections, the first step should be to speak with a doctor. Erectile difficulties may be an early warning sign of other potentially serious health problems -- your body's way of telling you that something else is going on. It's important to understand what might be causing the changes in your erections.

In addition to seeing a physician, you may want to consider speaking with a therapist or counselor, and perhaps a sex therapist. Sex therapists specialize in the diagnosis and treatment of sexual dysfunctions. If you see a sex therapist, you'll also need to get a medical exam, but a therapist will likely have more information than your regular doctor about the details of sexual dysfunction.

One of the most difficult aspects of erectile difficulties is the way that our thoughts and feelings can perpetuate our difficulties. We all have the right to use language we want to describe ourselves. But you may want to consider how describing this problem as impotence, or calling yourself impotent, is actually working against your goal of feeling positive about yourself and your ability to both give and receive sexual pleasure.

What Should We Call Impotence?

The term impotence is already in the process of disappearing from medical literature (although it's a slow process). Impotence is a problem in part because of the way it makes men feel, and also the message it explicitly sends about sexual power being only about erections. Impotence is also a problem because it isn't precise. This might be fine for literature, but if you're trying to isolate and solve a health problem, the more precise you can be, the better. So impotence should be called whatever it actually is. If it's erectile dysfunction, call it that. If it's premature ejaculation, call it that. If it's a bad relationship, or a bad year, call it that.

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