Category: Secondary Impotence

Secondary Impotence and Sex

Post author By The Beauty Nation
Post date 03/02/2021

The most distressing etiological influence upon any dysfunction in the cycle of male sexual inadequacy is a derogatory effect of consulted therapeutic opinion. Careless or incompetent professionals inadvertently may either initiate the symptoms of sexual dysfunction or, as is more frequently the case, amplify and perpetuate the clinical distress brought to professional attention.

There have been 27 cases in the total 213 units referred for treatment of secondary impotence that has been told at the first consultation with selected authority for relief of symptoms that nothing could be done about their problem.

These cases are represented in all categories of etiological influence described previously in the chapter as prime initiators of the symptoms of secondary impotence. When the sexually incompetent male finally gathers his courage and reaches for the presumed security of authoritative consultation only to be told that nothing can be done about his problem, the psychogenic effect of this denial of salvation is devastating.

Of the 27 men denied hope of symptomatic relief by consultative authority, 21 individuals were so informed on their first and only visit to their local physician.

Among these 21 men, 11 were told that the onset of symptoms of secondary impotence was concrete evidence of clinical progression of the aging process and that they and their wives would have to learn to adjust to the natural distress occasioned by the sexual dysfunction.

Among these 11 men the eldest was 68, the youngest 42, and the average age was 53 years. These men and their wives experienced an average of 28 months of sexual inadequacy before seeking further consultation.

In the 10 remaining instances of authoritative denial of hope of reprieve from symptoms of impotence, there were 4 instances of negation of clinical support by the consulted theologian; in 2 of these instances the men were informed that symptoms of impotence were in retribution for admitted adulterous behavior.

One of the husband and wife was informed by a clergyman that the symptoms of secondary impotence developed as a form of penance because this particular unit had mutually agreed that a pregnancy conceived prior to marriage should be terminated by an abortion.

Finally
One unit was assured that the symptoms of impotence would disappear if there were regularity in church attendance for at least one year. Two years later, despite fanatical attendance at all church functions, the symptoms of impotence continued unabated.

In each of the 6 remaining couples there were individual patterns of authoritative denial of hope of symptomatic relief. They ranged from the statement that “once a grown man has a homosexual experience, he always ends up impotent,” to the authoritative comment that “any man masturbating after he reaches the age of thirty can expect to become impotent.” The authorities consulted were psychologists, marriage counselor, and lay analyst.

The incidence of erective failure progressed rapidly after authoritative denial of support.

Sexual Disability

Male fears of performance were magnified and marriages were shaken and even disrupted by projection by the professional sources of a black future with full sexual disability.

This mutually traumatic experience for husband and wife could easily have been avoided had the consulted authority figure accepted the fundamental responsibility either by admitting lack of specific knowledge in this area or by acquiring some basic understanding of human sexual response, or at least by not confusing personal prejudice with professional medical or behavioral opinion.

In addition to the 27 cases in which the presenting symptoms of sexual dysfunction were amplified or perpetuated by consultative authority, there were 6 instances in which consultative authority was directly responsible for the onset of symptoms of secondary impotence.

The susceptibility of the human male to the power of suggestion with reference to his sexual prowess is almost unbelievable. Two classic histories defining iatrogenic influence as an etiological agent in onset of symptoms of secondary impotence provide adequate illustration of the concept.

Vaginal Penetration

A man in his early thirties married a girl in her mid twenties. Both had rather extensive premarital sexual experience. His was intercourse with multiple partners, hers was mutual manipulation to orgasm with multiple partners, but never vaginal penetration. She had retained her hymen for wedding night sacrifice.

However, the honeymoon was spent in repetitively unsuccessful attempts to consummate the marriage. The husband and wife felt that the difficulty was the intact hymen, so she consulted her physician for direction. She was told that it was simply a matter of relaxation, to take a drink or two before bedroom encounters.

By relieving her tensions with alcohol she should be able to respond effectively. The drinks were taken as ordered, but the result was not as anticipated.

The marriage continued in an unconsummated state for three years, with the wife’s basic distress (in retrospect) a well established state of vaginismus. Throughout the three-year period, the husband continued penetration attempts with effective erections at a frequency of at least two to three times a week.

There usually was mutual manipulation to orgasm, when coitus could not be accomplished.

As a second consultant, her religious adviser assured the couple that consummation would occur if the husband could accept the wife’s (and the adviser’s) religious commitment. The husband balked at this form of pressure.

Hymen

Finally, a gynecologist, third in the line of consultants, suggested that the difficulty was an impervious hymen. The wife immediately agreed to undergo minor surgery for removal of the hymen. It is not only the human male that is “delighted to find some concept of physical explanation for sexual dysfunction.

When the physician spoke with the husband after surgery, the husband was assured that all went well with the simple surgical procedure and that his wife was fine. The physician terminated his remarks to the husband with the statement, “Well, if you can’t have intercourse now, the fault is certainly yours.”

Obviously, surgical removal of the hymen will provide no relief from a state of vaginismus, so three weeks after surgery, when coital connection was initiated, penetration was still impossible.

For two weeks thereafter, attempts were made to consummate the marriage almost on a daily basis, but still without success. By the end of the second week both husband and wife noted that the penile erections were no longer full or well sustained.

The symptoms of impotence increased rapidly over the next few weeks. Three months after the hymenectomy, the husband was completely impotent. Both partners were now fully aware that the inability to consummate the marriage was certainly the husband’s fault alone, for so he had been told by authority.

The problem presented in therapy two-and-a-half years later by this husband and wife was not only the concern for the wife’s clinically established vaginismus but additionally the symptoms of secondary impotence that were totally consuming for the husband.

In another instance:
The husband and wife in a three-year marriage had been having intercourse approximately once a day. They were somewhat concerned about the frequency of coital exposure, since they had been assured by friends that this was a higher frequency than usual.

Personally delighted with the pleasures involved in this frequency of exposure, yet faced with the theoretical concerns raised by their friends, they did consult a professional. They were told that an ejaculatory frequency at the rate described would certainly wear out the male in very short order.

The professional further stated that he was quite surprised that the husband hadn’t already experienced difficulty with maintaining an erection. He suggested that they had better reduce their coital exposures to, at the most, twice a week in order to protect the husband against developing such a distress.

Finally, the psychologist expressed the hope that the husband and wife had sought consultation while there still was time for his suggested protective measures to work.

Sexual Response

The husband worried for 48 hours about this authoritative disclosure. When intercourse was attempted two nights after consultation, he did accomplish an erection, but erective attainment was quite slowed as compared to any previous sexual response pattern.

One night later there was even further difficulty in achieving an erection, and three days later the man was totally impotent to his wife’s sexual demands with the exception of six to eight times a year when coitus was accomplished with a partial erection. He continued impotent for seven years before seeking further consultation.

When duly constituted authority is consulted in any matter of sexual dysfunction, be the patient man or woman, the supplicant is hanging on his every word.

Extreme care must be taken to avoid untoward suggestion, chance remark, or direct misstatement. If the chosen consultant feels inadequate or too uninformed to respond objectively, there should be no hesitancy in denying the role of authority. There is no excuse for allowing personal prejudice, inadequate biophysical orientation, or psychosocial discomfort with sexual material to color therapeutic direction from duly constituted authority.

There are innumerable combinations of etiological influences that can and do initiate male sexual dysfunction, particularly that of secondary impotence. It is hoped that the survey of these agents in this chapter will serve not only as a categorical statement but also render information of value to duly constituted authority.

Secondary impotence is inevitably a debilitating syndrome. No man, or, for that matter, no husband and wife emerges unscathed after battle with the ego-destructive mechanisms so intimately associated with this basic form of sexual dysfunction.

There must be support, there must be relief, and there must be release for those embattled husband and wifes condemned by varieties of circumstance to contend with male sexual dysfunction. As emphasized earlier in this chapter, most men are influenced toward secondary impotence by manifold etiological factors.

Although case histories have been held didactically open and brief for teaching purposes, it must be understood that frequently there was a multiple choice of determining agents. Other professionals well might make a different assignment if given an opportunity to review the material.

For example
there remain 12 cases referred for treatment that could not be categorized from an etiological point of view. No dominant factor could be established among a multiplicity of influences despite in-depth questioning by Foundation personnel.

It must be emphasized that, regardless of the multiplicity of etiological influences which can contribute to incidence of secondary impotence, it is the untoward susceptibility of a specific man to these influences that ultimately leads to sexual inadequacy. It is this clinical state of susceptibility to etiologic influence about which so little is known.

A statistical evaluation of the returns from therapy of secondary impotence will be considered as an integral part of the chapter on treatment of impotence. Present concepts of treatment for secondary impotence have been joined with those of the current clinical approaches to primary impotence in a separate discussion devoted to these therapeutic considerations.

Tags Impotence, Secondary, Secondary Impotence, Secondary Impotence Sex, Secondary Sex, Sex

Post author By The Beauty Nation
Post date 03/02/2021

Definition of secondary impotence depends upon acceptance of the concept of primary impotence as expressed and discussed in primary impotence. Primary impotence arbitrarily has been defined as the inability to achieve and/or maintain an erection quality sufficient to accomplish coital connection.

If erection is established and then lost from real or imagined distractions related to the coital opportunity, the erection usually is dissipated without an accompanying ejaculatory response. If diagnosed as primarily impotent, a man not only evidences erective inadequacy during his initial coital encounter but the dysfunction also is present with every subsequent opportunity.

If a man is to be judged secondarily impotent, there must be the clinical landmark of at least one instance of successful intromission, either during the initial coital opportunity or in a later episode. The usual pattern of the secondarily impotent male is success with the initial coital opportunity and continued effective performance with the first fifty, hundred, or even thousand or more coital encounters.

Finally, an episode of failure at effective coital connection is recorded.

Tags Impotence, Secondary, Secondary Impotence

Secondary Impotence

Physiological Impotence

Post author By The Beauty Nation
Post date 03/02/2021

The subject of physiological influence on sexual inadequacy will be considered in this chapter because at least 95 percent of the time when physical disability affects male sexual response.

The symptoms are those of secondary impotence.

It is almost impossible to list the diversity of physical defects, metabolic dysfunctions, or medications that may influence onset of secondary impotence.

Below is a list of some of the physical influences that have been reported to have resulted in secondary impotence on at least one occasion. This listing does not imply that these physical influences have been demonstrated in male patients referred to the Foundation for sexual dysfunction.

The list has been culled from the literature and is presented only as a reminder that almost any physical dysfunction that reduces body economy below acceptable levels of metabolic efficiency can result in the onset of the symptoms of erective incompetence. Physical causes are:

Anatomic:
Congenital deformities, Testicular fibrosis, Hydrocele.

Cardio Respiratory:
Angina pectoris, Myocardial infarction, Emphysema, Rheumatic fever, Coronary insufficiency, pulmonary insufficiency.

Drug Ingestion:
Addictive drugs, Alcohol, Alpha-methyl-dopa, Amphetamines, Atropine, Chlordiazepoxide, Chlorprothixene, Guanethidine, Imipramine, Methantheline bromide, Monoamine oxidase inhibitors, Phenothiazines,Reserpine, Thioridazine, Nicotine (rare), Digitalis (rare).

Endocrine:
Acromegaly, Addison’s disease, Adrenal neoplasms (with or without Cushing’s syndrome).

Castration:
Chromophobe adenoma, Craniopharyngioma, Diabetes mellitus, Eunuchoidism (including Klinefelter’s syndrome), Feminizing interstitial-cell testicular tumors, Infantilism, Ingestion of female hormones (estrogen), Myxedema, Obesity, Thyrotoxicosis.

Genitourinary:
Perineal prostatectomy (frequently ), Prostatitis, Phimosis, Priapism, Suprapubic and transurethral prostatectomy (occasionally), Urethritis

Hematologic:
Hodgkin’s disease, Leukemia, acute and chronic, Pernicious anemia

Infectious:
Genital tuberculosis, Gonorrhea, Mumps

Neurologic:
Amyotrophic lateral sclerosis, Cord tumors or transaction, Electric shock therapy, Multiple sclerosis, Nutritional deficiencies, Parkinsonism, Peripheral neuropathies, Spina bifida, Sympathectomy, Tabes dorsalis, Temporal lobe lesions.

Vascular:
Aneurysm, Arteritis, Sclerosis, Thrombotic obstruction of aortic bifurcation.

While the above listing is of import, it must be emphasized in context that many of these conditions have been identified in individual case reports that are in many instances unsubstantiated by adequate patient evaluation.

True biophysical dominance in the etiology of impotence is not a frequent occurrence. In any reasonably representative clinical series, the incidence of primary physiological influence upon onset of secondary impotence is indeed of minor consideration.

Among the 213 men referred to the Foundation for treatment of secondary impotence, there have only been 7 cases in which physiological dysfunction overtly influenced the onset of sexual inadequacy.

Impotence Drug

In the neurological group there has been one case of spinal-cord compression at the level of the eleventh and twelfth thoracic vertebrae subsequent to an automobile accident; this particular man did not accomplish erective success with therapy.

In the drug ingestion category, the influence of alcohol has been previously mentioned and is not included in this listing. There has been one case of the use of Reserpine for relief of hypertension that was referred without consideration of the possible influence this product might have had in the onset of secondary impotence.

Reversal of the impotence was possible after alteration of the patient’s medication. Eunuchoidism (Klinefelter’s syndrome) has been recorded in one instance of referral to the Foundation for treatment that was not successful. There also has been a case of acromegaly and one of advanced myxedema, both referred without prior authoritative association of onset of symptoms of secondary impotence with exacerbation of the disease.

In the first instance failure and in the second success marked therapeutic effort.

In two instances genitourinary surgical procedures have been responsible for onset of symptoms of secondary impotence. In one case a perineal prostatectomy was performed for carcinoma of the prostate.

Technically, the prostatic capsule was necessarily removed during surgery, damaging the innervation that controls the erective process. This is the usual result of such surgery. As expected, treatment was unsuccessful.

Tags Impotence, Physiological, Physiological Impotence

Secondary Impotence

Male Impotence Cause

Post author By The Beauty Nation
Post date 03/02/2021

A typical history of an acute episode of alcohol consumption as an etiological factor in the onset of secondary impotence is classic in its structural content. The clinical picture is one of acute psychic trauma on a circumstantial basis, rather than the chronic psychosocial strain of years of steady attrition to the male ego as described in the case history for the premature ejaculator.

There has been a specific history of onset of symptoms of secondary impotence as a direct result of episodes of acute alcoholic intake in 35 men from a total of 213 men referred with a complaint of secondary impotence.

The onset of secondary impotence in an acute alcoholic episode is so well known that it almost beggars description. A composite example is that of a relatively “successful” male aged 35-55, college graduate, working in an area which gears productive demand more to mental than physical effort.

The perfect environmental situation for onset of secondary impotence is any occupational hazard where demands for high levels of psychosocial performance are irrevocably a part of the nine-to-five day and frequently carry over into an evening of professional socializing.

Alcohol Impotence

Mr. A is a man with a habit of alcohol before dinner, frequently a few glasses of wine with his meals, and possibly a whisky. Alcohol intake at lunch is an integral part of his business as well.

In short, consumption of alcohol has become a part of his life.

This man and his wife leave home one night for a party and alcohol is available in large quantity. Somewhere in the late evening, the party comes to an end. Mr. A has had entirely becomes tipsy and so his wife drives them home for safety’s consideration.

His wife retires to the bedroom, and with a sense of vague irritation, a combination of a sense of personal rejection and a residual of her social embarrassment, prepares for bed. Mr. A has stumble but with the aid of a strong banister and even stronger nightcap, manages to arrive at the bedroom door. Suddenly he felt that his wife is indeed fortunate tonight, for he is prepared sexually satisfied her.

Alcohol Hangover

It never occurs to him that all she wants to do is go to bed and avoid a quarrel at all costs. He jumped into the bed, moves to meet his imagined commitment, and nothing happens. He has simply had too much alcohol.

Dismayed and confused both by the fact that no erection develops and that his wife obviously has little or no interest in his gratuitous sexual contribution, he pauses to resolve this complex problem and immediately falls into deep, anesthetized slumber.

Next day, he is further traumatized by the symptoms of an acute hangover. He surfaces later in the day with the concept that things are not as they should be. The climate seems rather cool around the house. He can remember little of the prior evening’s festivities except his deeply imbedded conviction that things did not go well in the bedroom. He is not sure that all was bad but he also is quite convinced that all was not good.

Obviously he cannot discuss his problem with his wife, she probably would not speak to him at this time. So he putters and mutters throughout the evening and goes to bed early to escape. He sleeps restlessly only to face the new day with a vague sense of alarm, a passing sense of frustration, and a sure sense that all is not well in the household this Monday morning.

He pondered about it over a drink or two at lunch and another, and while contending with traffic on the way home from work, decides to check out this evening the little matter of sexual dysfunction, which he may or may not have imagined.

Sexual dysfunction within 48 hours!

If the history of this reaction sequence is taken accurately, it will be established that Mr. A does not check out the problem of sexual dysfunction within 48 hours of onset, as he had decided to do on his way home from work. He arrives home, finds the atmosphere still markedly frigid, makes more than his usual show of affection to the children, retires to the security of the cocktail hour, and goes to supper and to bed totally lacking in any communicative approach to his frustrated, irritated marital partner.

Tuesday morning, while brushing his teeth, Mr. A has a flash of concern about what may have gone wrong with his sexual functioning after the party night. He decides unequivocally to check the situation out tonight.

Instead of thinking of the problem occasionally, his concern for “checking this out” becomes of paramount importance. On the way to work and during the day, he does not think about what really did go wrong sexually because he does not know. Rather he worries constantly about what could have gone wrong.

Needless to say, there is resurgence of concern for sexual performance during the afternoon hours, regardless of how busy his schedule is.

Mr. A leaves the office in relatively good spirits, but thoroughly aware that “tonight’s the night.” He does have vague levels of concern, which suggest that a little relaxation is in order; so he stops at his favorite tavern for a couple of drinks and arrives home with a rosy glow to find not only a forgiving, but an anticipatory, wife, ready for the reestablishment of both verbal and sexual communication that a drink ‘or two together before dinner can bring.

Probably for the first time in his life, he approaches his bedroom on Tuesday night in a self-conscious “I’ll show her” attitude. Again there has been a little too much to drink-not as much as on Saturday night, but still a little too much.

And, of course, he does show her. He is so consumed with his conscious concern for effective sexual function (the onset of his fears of performance) that, aided by the depressant effect of a modest level of alcoholic intake (modest by his standards), he simply cannot “get the job done.”

When there is little or no immediate erective reaction during the usual sexual preliminaries, he tries desperately to force the situation-in turn, anticipating an erection, then wildly conscious of its abscence, and finally demanding that it occur. He is consciously trying to will sexual success, while subjectively watching for tumescence. So, of course, no erection.

While in an immediate state of panic, as lie sweats and strains for the weaponry of male sexual functioning, he simultaneously must contend with the added distraction of a frightened wife trying to console him in his failure and to assure him that the next night will be better for both of them.

Sexual Incompetence

Both approaches are equally traumatic from his point of view. He hates both her sympathy and blind support which only serve to underscore his “failure,” and reads into his wife’s assurances that probably he can do better “tomorrow” a suggestion that no longer can he be counted on to get the job done sexually when it matters “today.”

A horrible thought occurs to Mr. A. He may be developing some form of sexual incompetence. He has been faced with two examples of sexual dysfunction. He is not sure what happened the first time, but he is only too aware this night that nothing has happened. He has failed, miserably and completely, to conduct himself as a man.

He cannot attain or maintain an erection.

Further, Mr. A knows that his wife is equally distressed because she is frantically striving to gloss over this marital catastrophe. She has immediately cast herself in the role of the soothing, considerate partner who says, “Don’t worry dear, it could happen to anyone,” or “You’ve never done this before, so don’t worry about it, dear.”

In the small hours of the morning, physically exhausted and emotionally spent from contending with the emotional bath her husband’s sexual failure has occasioned, she changes her tune to “You’ve certainly been working too hard, you need a vacation,” or “How long has it been since you have had a physical checkup?” (Any of a hundred similar wifely remarks supposed to soothe, maintain, or support are interpreted by the panicked man as tacit admission of the tragedy they must face together: the progressive loss of his sexual functioning.)

From the moment of second erective failure,

72 hours after the first erection failure, this man may be impotent.

In no sense does this mean that in the future he will never achieve an erection quality sufficient for intromission.

Occasionally he may do so and most men do. It does mean, however, that any suggestion of wifely sexual demand either immediate in its specific physical intensity or pointing coyly to future sexual expectations may produce pressures of performances quite sufficient to reduce Mr. A to and maintain him in a totally no erective state.

In brief, fears of sexual performance have assumed full control of his psychosocial system.

Mr. A thinks about the situation constantly. He occasionally asks friends of similar age group how things are going, because, of course, any male so beleaguered with fears of sexual failure is infinitely desirous of blaming his lack of effective function on anything other than himself, and the aging process is a constantly available cultural scapegoat.

Sexual Approach

He finds himself in the position of the woman with a lifetime history of non orgasmic return who contends openly with concerns for the effectiveness of her own sexual performance and secretly faces the fear that in truth she is not a woman. In proper sequence he does as she has done so many times.

He develops ways and means to avoid sexual encounter.

He sits fascinated by a third-rate movie on television in order to avoid going to bed at the usual time with a wife who might possibly be interested in sexual expression. He fends off her sexual approaches and jumps at anything that avoids confrontation as a drowning man would at a straw.

His wife immediately notices his disinclination to meet the frequency of their semi established routine of sexual exposure. In due course she begins to wonder whether he has lost interest in her, if there is anyone else, or whether there is truth in his most recent assertion that he couldn’t care less about sex.

For reassurance that she is still physically attractive, the concerned wife begins to push for more frequent sexual encounters, the one approach that the self-pressured male dreads above all else.

Obviously, neither marital partner ever communicates his or her fears of performance or the depth of their concerns for the sexual dysfunction that has become of paramount importance in their lives. The subject either is not discussed, or, if mentioned even obliquely, is hastily buried in an avalanche of words or chilled by painfully obvious avoidance.

Sexual Anxiety

Within the next 3 months, Mr. A has to fail at erective attainment only another time or two before both husband and wife begin to panic.

She decides independently to avoid any continuity of sexual functioning, eliminate any expression of her sexual needs, and be available only should he express demand, because she also has developed fears of performance.

Her fears are not for herself, but for the effectiveness of her husband’s sexual functioning.

She goes to great lengths to negate anything that might be considered sexually stimulating, such as too-long kisses, handholding, body contact, caressing in any way. In so doing she makes each sexual encounter much more of a pressured performance and therefore, much less of a continuation of living sexually, but the thought never occur to her. All communication ceases.

Each individual keeps his own counsel or goes his own way. The mutual sexual stimulation in the continuity of physical exposure, in the simple physical touching, holding, or even verbalizing of affection, is almost totally withdrawn.

The lack of communication that starts in the bedroom rapidly spreads through all facets of marital exchange: children, finances, social orientation, mothers-in-law, whatever.

In short :
Sexual dysfunction in the marital bed, created initially by an acute stage of alcoholic ingestion, supplemented at the next outing by ah “I’ll show her” attitude and possibly a little too much to drink can destroy the very foundation of a marriage of 10 to 30 years duration.

As the male panics, the wife only adds to his insecurity by her inappropriate verbalization, intended to support and comfort but interpreted by her emotionally unstable husband as immeasurably destructive in subjective content.

The dramatic onset of secondary impotence following an in stance of excessive alcohol intake is only another example of the human male’s extreme sensitivity to fears of sexual performance.

In this particular situation, of course, the onset of fears of performance was of brief but dynamic duration as opposed to those in the preceding example of the premature ejaculator whose fears of performance developed slowly, stimulated by continued exposure to his wife’s verbal denunciation of his sexual functioning.

Discussed above are examples of combinations of psychological and circumstantial factors that contribute the highest percentage of etiological input to the development of secondary impotence. Continuing through the listing of major influences there remain environmental, physiological, and iatrogenic factors.

In the final analysis:
Regardless of listing category, secondary impotence is triggered by combinations of these etiological factors rather than by any single category with the obvious exception of psychosocial influence. Once onset of erective failure has been recorded, regardless of trigger mechanism, involved, the individual male’s interpretation of or reaction to functional failure must be dealt with on a psychogenic basis.

The etiological factors recorded above are little more than categorical conveniences. From his initial heterosexual performance through the continuum of his sexual expression, every man constantly assumes a cultural challenge to his potency.

How he reacts to these challenges may be influenced directly by his psychosocial system, but of particular import is the individual susceptibility of the man involved to the specific pressures of the sexual challenge and to the influences of his background.

When considering etiological influences that may predispose toward impotence, it always should be borne in mind that most men exposed to parallel psychosexual pressures and similar environmental damage shrug off these handicaps and live as sexually functional males.

It is the factor of susceptibility to negative psychosocial input that determines the onset of impotence. These concepts apply to primarily as well as secondarily impotent men.

When considering environmental background as an etiological factor in secondary impotence, the home, the church, and the formative years are at center focus.

What factors in or out of the home during the formative years tend to initiate insecurity in male sexual functioning?

The preeminent factor in environmental background reflecting sexual insecurity is a dominant imbalance in parental relationships dominant, that is, as opposed to happen stance, farcical, or even fantasized battles for family control.

Secondary, but still of major import is the factor of homosexuality, which is to be considered in the environmental category. In no sense does this placement connote professional opinion that homophile orientation is considered purely environmental in origin.

Since homosexual activity may have derogatory influence upon the effectiveness of heterosexual functioning, the subject must be presented in the etiological discussion. The disassociations developing from homophile orientation are considered in the environmental category only for listing convenience.

Tags Impotence, Impotence Cause, Male, Male Impotence

Secondary Impotence

Impotence Male

Post author By The Beauty Nation
Post date 03/02/2021

There are innumerable classic examples in the literature of maternal dominance contributing to secondary impotence. Thirteen such instances reflecting maternal dominance have been referred to the Foundation for therapy. Since the picture is so classic, a composite history can be provided to protect anonymity without destroying categorical effectiveness.

Impotence In Young Man

Maternal dominance primarily depreciates the young male’s security in his masculinity and destroys confidence in his socio cultural role-playing by eliminating or at least delimiting the possibility of a strong male image.

When the father is relegated to the role of second-class citizen within family structuring, the teenage boy has no male example with which to identify other than that of a devalued, shadowy, sometimes even ludicrous male allowed access to the home but obviously subject to control of the dominant maternal figure.

Mr. B, 34 years old
was referred with his wife for treatment of secondary impotence. He could remember little in family structuring other than a totally dominant mother making all decisions, large or small, controlling family pursestrings, and dictating, directing, and destroying his father with harsh sarcasm.

He remembered the paternal role only as that of an insufficient paycheck, and of a man sitting quietly in the corner of the living room reading the evening newspaper.

When he reached midteens, the parental representative at school functions was always the maternal figure, for both the young male and his younger sister (two siblings only). The same situation applied to church attendance and, eventually, to all social functions. The family matured with the concept that only three people mattered.

Masturbatory onset was in the early teens with a frequency of two or three times a week during the teenage years. As would be expected in a maternally dominated environment, dating opportunity for the boy was delayed, in this case until the senior year in high school.

Through college there were rare commitments to female interchange, all of them of a purely social vein. The young man was insecure in most social relationships, particularly those having orientation to the male sex.

He had been forbidden participation in athletics by his mother for fear of injury. He rarely pursued male companionship, feeling himself alternatively totally insecure in, or intellectually superior to, the male peer group.

Premarital sex in youth
Finishing college, the young man, particularly interested in actuarial work, joined an insurance firm. Although mainly withdrawn from social relationships, at age 28 he met and within three months married a 27 year old divorcee with a 2 year old daughter.

The divorcee, a dominant personality in her own right, was the mirror image of his mother. The two women were, of course, instant, bitter, and irrevocable enemies. The marriage, accomplished in spite of his mother’s vehement objections, was a weekend justice-of-the-peace affair.

The sexual experience of the courtship had been overwhelming to the physiologically and psychologically virginal male. The uninitiated man literally was seduced by the experienced woman, who manipulated, fellated, and coitally ejaculated him within three weeks of their initial meeting.

The hectic pace of the premarital sexual experience continued for the first 18 months of the marriage, with Mr. B awed by and made increasingly anxious by his wife’s sexual demands.

Intercourse occurred at least once a day. Following the pattern established during the courtship, opportunities, techniques, positions, procedures, durations, and recurrences, in fact, all sexual expression in the marriage, was at his wife’s able direction.

For the first year of the marriage the wife thoroughly enjoyed overwhelming her fully cooperative but naive and insecure husband with the force and frequency of her sexual demands. As the marriage continued unwavering in the intensity of her insistence upon sexual and social dominance, his confidence in his facility for sexual functioning began to wane.

He sought excuses to avoid coital connection, yet when cornered tried valiantly to respond to her demands. Finally, there were three occasions when sudden demand for coital connection forced failure of erection for the satiated male. Her comments were harsh and destructive, and the sarcasm struck a familiar chord.

The fourth time he failed to satisfy her immediate sexual needs, his wife’s denunciations reminded him specifically of his mother and of her verbal attacks on his father. For the first time in his life he identified with the man sitting in a corner of the living room reading the newspaper, and within a month’s time he had withdrawn to a similarly recessive behavioral patterning within his own home.

Successful erection
There is only one subsequent recorded episode of erection sufficiently successful for intromission with his wife. Aside from this, the man was totally impotent and had been so for three years when seen in therapy.

On an occasion when his wife was out of town, he followed the time-honored response pattern of the secondarily impotent man. There was attempted sex with a prostitute to see whether he could function effectively with any other woman.

For the first time in several months there was a full erection, but when he attempted to mount, the concept of his mother’s disapproval of his behavior disturbed his fantasy of female conquest. He immediately lost and could not recover the erection. This was his only attempt at extramarital sexual functioning.

Secondary Impotence

Impotence Influence

Post author By The Beauty Nation
Post date 03/02/2021

An illustration of the repressive influence of religious orthodoxy upon the potential effectiveness of sexual functioning can be provided by relating the history of one of the five couples with both husband and wife products of different religious orthodoxies.

Impotence and Religion

Mr. and Mrs. D were married in their early twenties. He was the product of a fundamentalist Protestant background, she of equally strict Roman Catholic orientation. The man had the additional disadvantage of being an only child, while the wife was one of three siblings. The marriage was established over the firm and often expressed objections of both families.

Impotence and Sex Information

Prior to marriage the wife had no previous heterosexual, masturbatory, or homosexual history, and knew nothing of male or female sexual expression. She had been taught that the only reason for sexual functioning was for conceptive purposes.

Similarly, the husband had no exposure to sex information other than the vague directions of the peer group.

He had never seen a woman undressed either in fact or in pictures.

Dressing and toilet privacy had been the ironclad rule of the home. He also had been taught that sexual functioning could be condoned only if conception was desired.

His sexual history consisted of masturbation during his teenage years with only occasional frequency, and two prostitute exposures. He was totally unsuccessful in each exposure because he was presumed a sexually experienced man by both women.

Sex with Prostitute

During the first episode the prostitute took the unsuspecting virginal male to a vacant field and suggested they have intercourse while she leaned against a stone fence. Since he had no concept of female anatomy, of where to insert the penis, he failed miserably in this sexually demanding opportunity.

His graphic memory of the incident is of running away from a laughing woman.

Condom

The second prostitute provided a condom and demanded its use. He had no concept of how to use the condom. While the prostitute was demonstrating the technique, he ejaculated. He dressed and again fled the scene in confusion.

These two sexual episodes provided only anxiety-filled examples of sexual failure. Since he had no background from which to develop objectivity when considering his “sexual disasters,” inevitably the cultural misconception of lack of masculinity was the unfortunate residual of his experiences.

There was failure to consummate the marriage on the wedding night and for nine months thereafter. After consummation sexual function continued on a sporadic basis with no continuity. The wife refused contraception until after advent of the third child.

Sexual success was never of quality or quantity sufficient to relieve the husband of his fears of performance or to free the wife from the belief that either there was something wrong with her physically or that she was totally inadequate as a woman in attracting any man.

Sexual Difficulty

They rarely discussed their sexual difficulties, as both husband and wife were afraid of hurting one another, and each was certain that their unsatisfactory pattern of sexual dysfunction was all that could be expected from indulgence in sexual expression at times when conception was not the prime motivation.

With no appreciation of the naturalness of sexual functioning and with no concept of an honorable role for sexual response, the psychosocial pressures engendered from their negatively oriented sexual value systems left them with no positive means of mutual communication.

The failure of this marriage started with the wedding ceremony. There was no means of communication available for these two young people. Trained by theological demand to uninformed immaturity in matters of sexual connotation, both marital partners had no concept of how to cope when their sexual dysfunction was manifest. Their first approach to professional support was to agree to seek pastoral counseling.

Here their individual counselors were as handicapped by orthodoxy as were their supplicants. There were no suggestions made that possibly could have alleviated the sexual dysfunction. When sexual matters were raised, either no discussion was allowed, or every effort was made to belittle the importance of the sexual problem.

Without professional support, the marital partners were again released to their own devices. Each partner was intimidated, frustrated, and embarrassed for lack of sexual knowledge. The sexual dysfunction dominated the entire marriage.

The husband was never as effective professionally as he might have been otherwise. He withdrew from social functioning as much as possible. The wife was in a constant state of emotional turmoil, which had the usual rebound effect upon the children. By the time this husband and wife arrived at the Foundation, she was well on the way to earning the title of “shrew.”

Psycho-Sexual Performance

The couple was first seen after a decade of marriage. As expected from individuals so handicapped in communication, each partner had established an extramarital coital connection while individually searching for some security of personal identity and effectiveness of sexual performance.

The wife had been successful in establishing her own security of psycho-sexual performance; the husband, as would be anticipated in this instance, had not. After ten years of traumatic marriage, both individuals gravely questioned their religious beliefs. Although no longer channel visioned, the wife continued church attendance, the husband rejected all church affiliations.

There can be no feeling for naturalness of sexual expression when there is no background of sexual comprehension. There can be no appreciation that sexual functioning is indeed a natural physical phenomenon, when material of sexual content is considered overwhelmingly embarrassing, personally degrading, and often is theologically prohibited.

In essence, when an individual’s sexual value system has no positive connotation, how little the chance for truly effective sexual expression.

The fact that most men and woman survive the handicap of strict religious’ orthodoxy to function with some semblance of sexual effectiveness does not mean that these men and women are truly equipped to enjoy the uninhibited freedom of sexual exchange.

Their physical response patterns, developing in spite of their orthodox religious negation of an honorable role for sexual function, are immature, constrained, and, at times, even furtive.

Sexual function is stylized, unimaginative, depersonalized, and indeed productive only of biological reproduction. A derogatory affect upon the total personality is the tragic residual of conditioned inability to accept or handle objectively meaningful material of sexual content.

Tags Impotence, Impotence Influence, Influence

Secondary Impotence

Impotence and Erection

Post author By The Beauty Nation
Post date 03/02/2021

It has such a varied etiology that a formalized frequency table for professional consideration is contraindicated at this time. Yet significant consideration must be devoted to dominant sources from which the fears of performance common to all forms of male sexual dysfunction can and do develop.

Every man is influenced to a major degree by his sexual value system, which reflects directly the input from his psychosocial background.

Over the centuries the single constant etiological source of all forms of male sexual dysfunction has been the level of cultural demand for effectiveness of male sexual performance. The cultural concept that the male partner must accept full responsibility for establishing successful coital connection has placed upon everyman the psychological burden for the coital process and has released every woman from any suggestion of similar responsibility for its success.

If anatomical anomalies such as vaginal agenesis or an imperforate hymen are exempted and the psychological dysfunction of vaginismus is discounted, it could be said provocatively that there has never been an impotent woman.

Woman need only make herself physically available to accomplish coital connection or even to propagate the race. Legions of women conceive and raise families without ever experiencing orgasm and carry coition to the point of male, ejaculation with little physical effort and no personal, reactive involvement.

During coition woman has only to lie still to be physically potent. While this role of total passivity is no longer an acceptable psychological approach to sexual encounter in view of current cultural demand for active female participation, it is still an irrevocable physiological fact that woman need only lie still to be potent.

Erection and masculinity

Any biophysical or psychosocial influence that can interfere with the male partner’s ability to achieve and to maintain an erection can cast a shadow of conscious doubt upon the effectiveness of his coital performance, and, in due course, upon his concept of the state of his masculinity.

Once a shadow of doubt has been cast, even though based only on a single unsatisfactory sexual performance after years of effective functioning, a man may become anxious about his theoretical potential for future coital connection. With the first doubt raised by any failed attempt at sexual connection in the past comes the first tinge of fear for the effectiveness of any sexual performance in the future.

There are a number of theoretical factors and a combination of psychological, circumstantial, environmental, physiological, or even iatrogenic factors that can raise the specter of the fear of performance in the always susceptible mind of the male in our culture, be he 14 or 84 years of age.

It should come as no surprise that in the referred population of sexually dysfunctional men, by far the most frequent potentiator of secondary impotence is the existence of a prior state of premature ejaculation, and that the second most frequent factor in onset of secondary impotence can be directly related to a specific incident of acute ingestion of alcohol or to a pattern of excessive alcohol intake per se.

Of course, both the factors of premature ejaculation and alcoholism accomplish their unfortunate purpose in the onset of impotence through engendering fears of performance.

In premature ejaculation
The fears of performance usually develop as the result of a slow but steady process of attrition spanning a period of years and are purely psychosocial in origin. In alcoholism the fears of performance usually develop rapidly, almost without warning, as the immediate result of untoward psychic trauma on circumstantial bases.

By reason of the diverse patterns of clinical onset as well as the marked variation in their rapidity of development, these two major etiological factors will be considered in some detail, with the discussion amplified by representative case histories.

Secondary Impotence With Premature Ejaculation

An established pattern of premature ejaculation prior to the onset of the symptoms of secondary impotence has been recorded in 63 of the total 213 men evaluated and treated for secondary impotence in the past 11 years. The premature ejaculation tendencies usually have been established for a significant period of time (generally a matter of years) before the symptoms of secondary impotence develop.

The fact that the prior existence of a pattern of premature ejaculation often leads to secondary impotence is yet another reason for clinical confusion in the textual listing of the premature ejaculator as an impotent male. There is no established percentage of premature ejaculators who progress to secondary impotence.

While the number is of considerable moment, this by no means suggests that a majority of premature ejaculators become secondarily impotent. A composite history typical of the sequential pattern of secondary impotence developing in a man distressed by prior symptoms of premature ejaculation is presented in detail.

Typically, the man is married, with some college education. Married in his mid-twenties, he usually is well into his thirties or even mid forties before onset of the symptoms of secondary impotence forces him to seek professional support.

Rapid ejaculations:

Sexual dysfunction (premature ejaculation) has existed throughout the marriage. This man has had a moderate degree of sexual experience before marriage with, perhaps, three to five other partners, and has the typical premature ejaculator’s history of having been conditioned in a rapid ejaculatory pattern during his first coital opportunities.

If authority has been approached in the interest of learning ejaculatory control, the results of such consultation have been essentially negligible in terms of improved sexual function. Professional relief of the psychosexual tensions created for the marital union by the continued existence of this form of sexual dysfunction rarely is sought until the youngest of any children of the marriage is at least of school age.

By this time the female partner has little tolerance for the situation. She no longer can contend with the frustrations inherent in a relatively constant state of sexual excitation, occasional, if ever, release of her sexual tensions, and rare, if ever, male consideration of her unresolved sexual demands.

Over the years of the marriage (ten to twenty), the issue of the husband’s rapid ejaculatory termination of their coital encounters has been raised repetitively.

The wife’s complaint was initially registered quietly, even questioningly; in time, complainingly or accusingly; and finally, demandingly, shrewishly, or contemptuously, as her personality and the immediate levels of her sexual frustration dictated.

The male partner, rarely made aware of the inadequacy of his sexual performances during premarital sexual experience, and frequently totally insensitive to his wife’s levels of sexual frustration during the early years of marriage, finally accepts the repetitively hammered concept that the dysfunctional state of their marital sexual status is “his fault” and, consequently, that he must “do something.”

And so he tries. As described in premature ejaculation, he bites his lips; thinks of work at the office; plans tomorrow’s activities; constricts the rectal sphincter; counts backwards from one hundred.

In short, does everything to distract himself from his partner’s obvious demands for sexual fulfillment during coital connection. Insofar as possible, he consciously turns off both the functional and the subjective projections of his wife’s sexual demands in order to reduce the input of his sexual stimuli.

Sexual Encounter

For instance whenever his wife reaches that level of sexual tension that finds her responding to sexually oriented stimuli almost involuntarily (a high-plateau tension level), the physically obvious state of her sexual demand drives her husband rapidly toward ejaculation. The beleaguered premature ejaculator, trying for control, employs any or all of the subjectively distracting tactics described above.

Thus, as much as possible, he not only denies the objective demand for his ejaculatory response inherent in his wife’s pelvic thrusting, but also attempts to deny generally the subjective feeling of vaginal containment and specifically the constrictive containment of the penis by her engorged orgasmic platform.

Insofar as possible, he compulsively negates the obvious commitment of her entire body to the elevated levels of her sexual demand. Whether or not this man ever acquires nominal physiological control of his premature ejaculatory tendencies by employing his diversionary tactics, one half of the mutually stimulative cycle that exists between sexually responsive men and women certainly has been dulled or even totally obviated.

This conscious dulling or even negating of input from his wife’s physical expressions of sexual demand is his first unintentional step toward secondary impotence.

There is marked individual variation in the particular moment at which the wife’s repetitively verbalized complaints of inadequacy of ejaculatory control were extrapolated by the husband into a conscious concern for “inadequacy of sexual performance.” Once the premature ejaculator develops any in depth concept that he is sexually inadequate, he is ripe for psychosocial distraction during any sexual encounter.

While his wife continues to berate his premature ejaculatory tendencies as “his sexual failure,” as “not getting the job done,” as “being totally uninterested in her sexual release,” or as “evidence of his purely selfish interests,” the reasonably intelligent male frequently develops a protean concern for the total of his sexual prowess.

Once a premature ejaculator questions the adequacy of his sexual performance, not only does he worry about ejaculatory control, but he also moves toward over concentration on the problem of satisfying his wife. While over concentrating in an attempt to force effective sexual control, he subjectively blocks full sensate input of the stimulative effect of his wife’s sexual demand.

Frequently, the pressured male resorts to a time honored female dodge: that of developing excuses for avoiding sexual activity. He claims he is tired not feeling well or has important work to do the next day.

He displays little interest in sexual encounter simply because he knows the result of any attempted sexual connection will probably be traumatic at best physical release for him but not satisfaction for his wife, and at worst a disaster of argument Or vituperation.

In brief:
There is further blocking of the inherent biophysical stimulation derived from the consistent level of mutual sexual awareness that prevails between sexually adjusted marital partners and a depreciation of the importance of mutual communication within the security of the marital bed.

Finally, the turning point. The wife pushes for sexual encounter on an occasion when the husband is emotionally distracted, physically tired, and certainly frustrated with his sexual failures. In a naturally self-protective sequence, he is totally uninterested in sexual encounter. When the husband is approached sexually by his demanding partner, there is little in the way of an erective response.

For the first time the man fears that he is dealing with a sexual dysfunction of infinitely more gravity than the performance inadequacy of his premature ejaculatory pattern. Once this man, previously sensitized to fears of sexual performance by his wife’s repetitively verbalized rejection of his rapid ejaculatory tendencies, fails at erection, fears of performance multiply almost geometrically, and his effectiveness as a sexually functional male diminishes with parallel rapidity.

Tags Erection, Impotence

Secondary Impotence

Impotence Cause by Surgery

Post author By The Beauty Nation
Post date 03/02/2021

In the second case, a supra-pubic prostatectomy, there was sufficient post surgical symptomatology to stimulate onset of symptoms of secondary impotence. In this situation the untoward surgical result was unfortunate. The distress in both instances was that the men had not been forewarned of the possible side effects of the surgery.

The case of secondary impotence developing after the supra-pubic prostatectomy was brought under control during therapy.

Prostatic cancer patients:
Those facing surgery, should be made aware by the operating surgeon that the loss of erective function can and does accompany such surgery. The psychosexual trauma forced upon the postoperative patient and his wife because they were not informed before surgery of the resultant sexual dysfunction is unforgivable.

The physiological influence of diabetes on secondary impotence is in a special category. In 6 of the total of 9 cases the onset of secondary impotence had been associated with the diabetes by consultative authority prior to referral for therapy, while in the remaining 3 instances no correlation between the established clinical condition of diabetes and the onset of impotence had been suggested by referring professionals.

Additionally, in 11cases of referral for secondary impotence without concept of etiological influence clinical diabetes (3 cases) and preclinical diabetes (8 cases) were diagnosed during metabolic work-ups that are part of the routine physical and laboratory evaluations of the secondarily impotent male referred for diagnosis and treatment.

As described in therapy treatments, a routine five-hour glucose-tolerance test is conducted for men referred for secondary impotence. This evaluation technique has been in effect for five years but has not reached the stage of statistical significance.

This work will be reported as a separate entity in monograph form at a later date. The statistical evaluation suggests that there is a 200-300 percent higher incidence of a diabetic or prediabetic curve reported for men with the clinical symptoms of secondary impotence, when returns are compared to the incidence of diabetic or prediabetic curves in similar glucose-tolerance testing of a representative cross-section of the population.

There is no supportable concept at this time that diabetes is an associate of equality with other etiological influences on secondary impotence. Nor does this work imply that the diabetic male has an established predisposition toward impotence. The amount of information available currently does not allow a firm clinical position.

Of course, there frequently are other etiological foci to combine with a diabetic or prediabetic state to influence the onset of secondary impotence. However, if a man is referred for secondary impotence, evaluation of his diabetic status should be a routine part of the total physical and laboratory work up.

It should be emphasized in context that even if symptoms of secondary impotence represent an end-point of etiological influence from a diabetic or prediabetic state, adequate institution and careful maintenance of medical control of the diabetes will not reverse the symptoms of impotence, once developed.

Impotence Diabetic

Difficulty lies, of course, in the fact that regardless of etiology, once lack of erective security has been established, fears of performance unalterably become an integral part of the psychosocial influences of the man’s daily life. Adequate medical control of the diabetes will provide no relief for his fears for sexual performance.

If diabetes or a prediabetic state can influence the onset of secondary impotence in other than advanced states of diabetic neuropathy, this fact is but another example of the multiple etiological aspects of secondary impotence.

Understandably, for many years the pattern of the human male has been to blame sexual dysfunction on specific physical distresses.

Every sexually inadequate male lunges toward any potential physical excuse for sexual malfunction. From point of ego support, would that it could be true.

A cast for a leg or a sling for an arm provides socially acceptable evidence of physical dysfunction of these extremities. Unfortunately the psychosocial causes of perpetual penile flaccidity cannot be explained or excused by devices for mechanical support.

Tags Impotence, surgery

Secondary Impotence

Impotent by Paternal Dominance

Post author By The Beauty Nation
Post date 03/02/2021

Paternal dominance exactly the opposite type of history has been recorded in five cases of men referred for treatment of secondary impotence when therapy. His fears for sexual performance and, for that matter, almost any measure of performance were overwhelming.

His discussions in therapy were mixtures of praise and damnation for his father. His consistently hopeless personal comparisons with presumed levels of paternal performance were indeed sad to behold.

There have been five examples of one-parent family imbalance (permanent absence of either father or mother from the home). Retrospectively, the histories essentially join those of the composite reports of maternal or paternal dominance.

Therefore, there seems little relevance in further illustration. It really matters little whether parental dominance is achieved by force of personality, with the opposite partner continuing in the home as a second class citizen, or is irrevocably established by absence of one partner from the home on a permanent or semi permanent basis (professional demands, divorce, death, etc.).

Unopposed maternal or paternal dominance, regardless of how created, can destroy any susceptible young man’s confidence in his masculinity. With maternal dominance, the paternal role can be painted so gray and meaningless that there is little positive male adult patterning available for an impressionable teenager.

Unopposed paternal dominance:
May create such a concept of overwhelming masculinity for an impressionable teenager that it is impossible for him to match his ego strength with the paternal image enshrined by his fantasy.

With too little or too much masculinity as a pattern, he becomes increasingly sensitive to any suggestion of personal inadequacy.

Failure of performance, any performance, may be over whelming in its implications.

The beleaguered male frequently extrapolates real or presumed social and professional pressures into demands for performance. As his anxieties increase, he becomes progressively more unstable emotionally, is quite easily distracted, and complains of feeling chronically tired in a well-recognized behavior pattern.

Finally, some occasion of sexual demand finds him unable to respond effectively. For any sexually oriented, personally secure man there is always tomorrow.

But for the insecure, pressured male, it is the end of the line.

All else fades into the background as he focuses on this new failure. Is this the final evidence of loss of his masculinity? Fears of performance, regardless of original psychosocial focus, are rapidly transferred to sexual concern be cause it is so easy to remove sexual functioning from its natural physiological context.

From a single experience in erective failure may come permanent loss of erective capacity.

The real tragedy of unopposed parental dominance is that it leaves the susceptible male sibling vulnerable when his insecure masculinity must face the sexual challenge of our culture. Regardless of how innocuous the level of that challenge may seem to others, to the concerned man every bedding is indeed a demand for performance.

Religious orthodoxy provided the same handicap to the secondarily impotent male as that emphasized in the discussion of the primarily impotent man. Twenty-six instances of secondary impotence directly related to religious orthodoxy have been identified among 213 men referred for secondary impotence.

To a significant degree, the histories of primarily and secondarily impotent men are almost parallel when religious orthodoxy has major etiological influence. Six of 32 cases of primary impotence were at least sensitized to sexual dysfunction by their religious backgrounds.

The histories of the 6 men with primary impotence and the 26 referred for treatment of secondary impotence show remarkable parallels with the exception that there must be at least one instance of successful coitus in the history of the secondarily impotent men.

The 26 cases of religious orthodoxy divide into 6 Jewish; 11 Catholic; 4 fundamentalist Protestant; and 5 mixed marriages in which both husband and wife, although professing different religious beliefs, were gravely influenced by rigid controls of religious orthodoxy during their formative years.

The symptoms of secondary impotence frequently do not appear for the first hundred or even thousand exposures to sexual function.

A significant exception is established when reviewing the histories of these 26 men. Severity of religious orthodoxy places pathological stress on any initial coital process. For the relatively non susceptible male, regardless of the sexual handicap of theo logical rigidity, this tension-filled opportunity usually is met without failure at sexual functioning, or if there is failure, repetitive sexual exposure during the honeymoon provides ample opportunity for successful completion.

There are, however, a number of susceptible men who do not follow the usual male pattern of successful consummation of marriage. These are the individuals who may develop symptoms of primary or secondary impotence.

Erection influence by religious orthodoxy, the symptoms of secondary impotence develop through two well-identified response patterns.

The first pattern divides into two specific forms:

Infrequent success in the first coital opportunity usually followed, despite this initial success, by failure in the first few weeks or months of the marriage.
most frequent, erective failure usually underscored during the first sexual opportunity provided by the honeymoon and continuing despite virginally frantic efforts to accomplish consummation.

For some ill-defined reason a successful vaginal penetration is recorded in the first month or six weeks of marriage; occasionally this is followed by a few more uneventful sexual experiences, but soon fears of performance assume unopposed dominance and, thereafter, the male is essentially impotent.

In the second pattern, at least six months and frequently many years will pass without consummation of the marriage. Then in some unexplained manner, vaginal penetration finally is accomplished and there is wild celebration, but the future is indeed dark.

There usually is a brief period of time (a week to a year at the most) in which sexual function continues alternatively encouraged by a success and depressed by a failure. Fears of performance fight for dominance, but so does the sexually stimulative warmth of a partner.

Effective sexual functioning assumes an off-again, on-again cyclic pattern. This cycling of sexual dysfunction is castrating in itself. The untoward effects are essentially as damaging as if the marriage had continued unconsummated.

The pattern of occasionally successful sexual functioning followed by inexplicable erective failure produces a loss of masculine security and abject humiliation for the untutored, apprehensive, sexually immature male, and creates a high level of frustration and loss of both social and personal security for the female partner.

Tags Dominance, Impotent, Paternal, Paternal Dominance

Secondary Impotence

Erection

Post author By The Beauty Nation
Post date 03/02/2021

When the first erective failure occurs, the involved man certainly should not immediately be judged secondarily impotent. Many men have occasional episodes of erective failure, particularly when fatigued or distracted. However, an initial failure at coital connection may become a harbinger, and, as apprehension increases during episodes of erection, a pattern of erective failure subsequently may be established.

Finally, erective inadequacy may become a relatively constant companion to opportunities for sexual connection.

Erection Difficulty

When an individual male’s rate of failure at successful coital connection approaches 25 percent of his opportunities, the clinical diagnosis of secondary impotence must be accepted. The sexual dysfunction termed premature ejaculation has been labeled by various textbooks as a form of sexual impotence.

It is difficult to accept this dilution of the clinical picture of both primary and secondary impotence, because the dysfunctions of impotence have in common the specter of male conceptive inadequacy as well as those of erective inadequacy.

The physiological and psychological limitations of conceptive inadequacy do not apply to the premature ejaculator, nor, for that matter, is there any difficulty in attaining an erection. There is difficulty, of course, in maintaining an erection for significant lengths of time, but in opposition to the concerns of impotence, when the premature ejaculator loses his erection he does so as part of the male’s total orgasmic process.

No Ejaculation

If the impotent male succeeds in attaining erection and then loses it shortly before or shortly after penetration, he usually does so without ejaculating.

The premature ejaculator characterishcally functions with a high degree of reproductive efficiency and, unfortunately for the female partner, with little waste of time.

Previously, the man with ejaculatory incompetence has not been separated from clinical concepts of impotence, and such separation is indeed long overdue. From a clinical point of view, ejaculatory incompetence is diametrically opposed to premature ejaculation in the kaleidoscope of male sexual dysfunctions.

While the male with ejaculatory incompetence parallels the impotent male in reflecting clinical concerns for conceptive inadequacy, such a man could never be accused of the erective inadequacy so frustrating for both primarily and secondarily impotent men. There is essentially no time limitation to maintenance of erection for the man with ejaculatory incompetence.

He simply cannot ejaculate intravaginally.

The premature ejaculator arbitrarily is excluded from the categorical diagnosis of impotence, even if on occasion he may not be able to achieve penetration with success.

Frequently the sexual stimulation of coital opportunity, or of any form of precoital sex play, will cause him to ejaculate either before he can accomplish vaginal intromission or immediately after coital connection has been established.

The clinical difference between the two types of inadequate coital function (premature ejaculation and secondary impotence) lies in the fact that acquiring ejaculatory control is more a matter of physiological than psychological orientation, while reconstituting the ability to attain or maintain an erection quality sufficient for effective coital connection requires psycho logical rather than physiological reorientation.

The man with incompetent ejaculation arbitrarily is excluded from a categorical diagnosis of impotence, even though both types of inadequate coital function have a multiplicity of etiologies almost entirely psychological rather than physiological in character.

Their basic variation is that the incompetent ejaculator functions most effectively from a purely physiological point of view as a coital entity, while the impotent man does not.

Tags Erection

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