The word “impotence” literally translates to the inadequacy of energy or strength. In the field of medicine, impotence refers to male sexual dysfunction, which completely incapacitates a man to initiate or sustain a penile erection prior to a sexual encounter.
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More specifically, termed erectile dysfunction (ED), impotence is estimated to affect around 30% of the male population worldwide. It is not uncommon for impotent males to develop long-term anxiety disorders along with a sense of low self-esteem. Being a sensitive issue, a majority of men often feel hesitant about discussing ED with their doctors. Therefore, it is highly imperative to recognise this disorder and offer affected couples a complete range of therapeutic options.
It is extremely rare for impotence to arise due to an organic cause, and most of the medical community considers this dysfunction to stem from a variety of psychological factors. Psychogenic impotence may arise due to various forms of emotional lability, including depression, personality disorders, and feelings of disgust and animosity towards the female partner. Depressive mood and anxiety have been strongly reported as contributing factors in the pathogenesis of erectile dysfunction.
The psychological impact of anxiety is often manifested in the form of “climacteric” in older males, where emotional instability becomes a significant finding. Personality characteristics such as neuroticism also constitute a key finding among young males who possess impotence. In addition, it is fairly common for a sexually incompetent male to possess feelings of distaste, abhorrence, and disgust towards the sexual act and/or his partner, which sets in a major hindrance in a marital relationship.
Erectile dysfunction treatment and traditional medicine—can Eastern and Western medicine coexist?
“Erectile dysfunction (ED) is a common sexual problem affecting many men, irrespective of cultures, beliefs, and nationalities. While medical therapy for ED has been revolutionised by the advent of oral phosphodiesterase type 5 inhibitors and intracavernosal injections of vasoactive agents, recent technological advances, such as stem cell therapy, low-intensity shock wave therapy, and a newer generation of penile prosthesis implants, offer hope to men who do not respond to conventional medical therapy.
In contrast, traditional and complementary medicine (TCM) focuses on the restoration and better overall bodily regulation with the use of various herbal and animal products as well as exercises to invigorate qi (energy) in vital organs. Western medicine involves an analysis of ED symptoms and underlying causes that contribute to ED, while TCM emphasises the concept of holism and harmonisation of body organs to achieve natural sexual life. The following article reviews our current understanding regarding the philosophical approach and evaluates the evidence surrounding various ED therapies between mainstream Western Medicine and TCM.”
More here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5313309/
It is plausible to treat psychogenic impotence by offering the patient a series of psychological therapy sessions. Psychiatric intervention comprises counselling the affected person about managing ideal conditions where optimal treatment can be sustained effectively. It is also substantially helpful if the therapist involves the female partner in these sexual discussions so that the couple can be adequately enlightened about various sexual practices.
It is highly essential that all forms of sexual misconceptions are cleared up at this stage so that both partners can achieve complete sexual satisfaction. Moreover, the couple should learn how to develop a deeper sense of mutual intimacy. For this purpose, medical experts even suggest the adoption of unconventional, consensual sexual activities in case they are able to stimulate full sexual arousal in both partners. It is important to note that coitus can be delayed until a full and sustainable erection has been achieved by the male partner.
Besides psychological mediation, medical therapy is often considered the mainstay of treatment in ED. Major drugs include phosphodiesterase inhibitors such as sildenafil (Viagra) and tadalafil (Cialis). Regardless, an effective approach encompassing couples counselling and behavioural intervention can lead to improvement in as many as 50% of cases.