Q.67. Discuss impotence?

Ans. Impotence is the lack of capability in a man to perform sexual stages of intercourse successfully with a woman because of failure of erection of the penis. Impotence may have sexual stages varying from complete inability to get an erection of the penis, erection of penis with less than normal rigidity, failure in maintenance of erection and extreme degree of premature ejaculation. Virility, power and potency form the basis of sexual intercourse. Virility is the result of secretion of androgens in the body. Impotence indicates inhibited sexual stimulation in man unlike frigidity which indicates inhibited sexual desire in woman. Impotence is a ground for seeking divorce unlike infertility. Impotence may be primary when a man never had a satisfactory erection of the penis. Such a person would never be capable of performing sexual intercourse satisfactorily. Secondary impotence is the condition in which a man is initially potent but later on loses the capability of penile erection. Primary impotence is always of permanent type and usually cannot be cured. Secondary impotence may be permanent or temporary. Permanent secondary impotence is when a person will probably never be able to perform the sexual act in his future life which may be complete or partial. Complete impotence is when a person is incapable of performing the sexual act with any woman. Partial impotence is that a man may be sometimes capable and sometimes incapable of performing the sexual act or is potent for some woman and impotent for other woman. Temporary secondary impotence is the inability developed in the erection of penis due to some .disability which is likely to be cured in future and it may be complete or partial. The sketch flow chart of types of impotence in men is as follow:

Types of Impotence

Primary                                    Secondary

Permanent                    Permanent                    Temporary

Complete           Complete      Partial                           Complete                     Partial
(Absolute)          (Absolute)      (Relative)                      (Absolute)              (Relative)     

Types of Impotence                  Second Permanent                    Permanent                    Temporary

Complete           Complete      Partial                           Complete                     Partial(Absolute)          (Absolute)      (Relative)                      (Absolute)                    (Relative

Of all the cases of impotence, about 85 percent have psychological causes, 12 per cent have biological causes and 3 per cent have mixed biological and psychological causes. Most cases of primary and complete permanent secondary impotence have a biological basis while most cases of partial permanent secondary and temporary impotence have a psychological basis. Anxiety of any type including performance anxiety is the main psychological cause of impotence. Intoxicants, tiredness and emotional deprivation between the couple can cause impotence. Biological causes are defects in testes and penis, damage to nerve and blood supply, sex organs, decrease of male sex hormones, diabetes and systematic diseases. Environmental pollution and alcoholism constitute psycho-biological causes of impotence. Treatment of impotence lies in restoring confidence of a person by the psychologist and wife, full visual and touch stimulation prior to sexual behavior act, serene environment, sex arousing talks, treatment of systematic disease and use of natural aphrodisiac like meat of testes of animals, shilajeet, ashwagandha, gold ash, milk, honey and dry fruits in diet. It should be noted that the use of chemical salts like sildenafil citrate helps in erectile dysfunction by maintaining erection as it increases the blood flow in the penis but in the long run the person becomes addicted to it and even a normal person cannot perform the act without taking the drug besides the side effects of priapism of penis and precipitating of heart attack. In the long run the effect of the drug becomes minimized.