Tag: 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 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

Penis Health

8 ways of Preventing Impotence!

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

Don’t take your erections or your potency for granted! Is the message men need to hear around their fortieth or fiftieth birthday. Some change was inevitable, but some men were experiencing too much change especially if they had it earlier. Learn to accept the fact that age does changes a lot of things including sex. Learn to be a better lover. If you aren’t getting erections, open your heart and talk to your partner, doctor, or someone who has gone through it. But that’s not the kind of thing men do. If so, why not take preventive measures before it approaches you?

Healthier lifestyles will most likely lead to healthier erections but any man can expect to lose an erection during lovemaking on occasion. If he doesn’t let that bother him, he’ll likely get it back. The worst thing you can do about a subsiding erection is focused on it.

There are always ways to improve the quality of your erections, extend penis longevity and minimize the possibilities of losing an erection during lovemaking by adopting the following suggestions:

Healthy eating habits. Eat a low-fat diet and exercise regularly. Diet and exercise influence a man’s sexual desire and sexual performance.
Stop or quit smoking. Smoking causes much vascular damage In the penis that could result in impotent. Long-term and heavy smokers have a greater probability of becoming impotent than do non-smokers. One recent study found that men who smoked a pack a day for 20 years had a 60 percent greater chance of becoming impotent than nonsmokers.
Have frequent sex. The more you make love, the more you will be able to make love. Erectile tissue becomes less supple with age. Without frequent erections, there is no regular flow of blood into the penis. After several months or a year of not having an erection, a man may have difficulty in achieving one.
Don’t make ejaculation your goal of lovemaking. Once you take the pressure to ejaculate out of lovemaking, you will probably have more frequent erections, sustain them longer, and enjoy the experience much more.
Expand your ‘sex.’ There is more to making love than having intercourse, especially during midlife. A man is also more likely to have erection difficulties if his lovemaking style is intercourse-driven. The pressure to perform will be greater for him than for a man who enjoys satisfying his partner in a variety of ways. Don’t make love unless you want to.
Share information with your partner. Explain your changing sexual response pattern to your partner. If intercourse has always ended in ejaculation until recently, she may think she has failed to excite you sufficiently. Let her know that your sexual patterns now more closely resemble hers. She has been able to enjoy intercourse without needing to reach an orgasm every time.
Masturbation two or three times a week helps in achieving erections for older males. This method is in the combination of two techniques. By having a sustained erection, you can take your mind off your penis because you will know that you are capable of sustained erection even if you ejaculate. This will allow you to enjoy sex without worry.
Don’t take medications if you don’t need them. Prescription drugs may produce negative effects on erections. If you keep your weight down and exercise regularly, you’re less likely to develop high blood pressure, mild depression, or other conditions requiring continuing use of medications. When a doctor prescribes a drug, ask about its sexual side effects, if an alternative drug might not have the same side effects, and whether or not a lifestyle change would enable you to go off medication as soon as possible.

Tags Erectile Dysfunction, Impotence, Penis, Preventing

Penis Health

Causes of Erectile Dysfunction, ED or Impotence

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

What is Erectile Dysfunction?

Previously known as impotence, erectile dysfunction as define by The National Institutes of Health is the consistent inability to achieve and/or maintain an erection satisfactory for the completion of sexual performance. Heard fondly joke and called ED as ‘the pencil with no lead’, ‘the drop’ or ‘having the software but no hardware”.

Is ED inevitable in the aging male?

By the time a man is 40 years old, 90 percent of them have experienced at least one erectile failure. This is a normal occurrence, but many men get “panic” at the first sign of erectile problems. They are likely to run to an urologist and ask for the highly publicized impotence pill, which they may not need and may or may not find effective. His lack of knowledge about the sexual aging process to set him up for performance problems and that might have led his wife to blame herself for his lack of interest in making love and caused her to withdraw from attempts to initiate sex. If he hadn’t received good advice and reassurance from someone he trusted, one might have “worried himself into impotence.”

When it is Not Impotence?

Most men, however, know that the occasional erectile problem is typically linked to fatigue, over consumption of food or drink, or a relationship issue. At midlife, a man may read a lot about impotence. He may see his future in a failed erection. How he and his partner handle these occurrences helps determine how frequent they will be. These common changes in sexual response at midlife aren’t indicators of impotence:

A man probably needs direct penile stimulation to have an erection, and he may no longer be able to get an erection just from thinking about sex or seeing his partner in an alluring pose. It may take him longer to achieve erection.

He may require more time for ejaculation and may not need to ejaculate every time he has intercourse. After a period of intercourse, he may find his erection subsides. After ejaculation, he also may find his erection subsides more quickly than it did. His erection probably won’t be as hard as it was when he was a teenager.

The recovery time of older a male between ejaculations are usually longer. These changes are gradual, and you shouldn’t be frightened by them. Changing response patterns enable a man to be a better lover than he was because he is now responding at a pace more similar to his partner’s. Lack of knowledge and refusal to accept the aging process as an erotic opportunity can prevent him from seizing the sexual moment. Anxiety also plays a major role in creating impotence dynamic. If a man misinterprets his responses and becomes anxious about his potency, he will be tense and fearful about lovemaking and convey those negative attitudes to his partner.

Some men do experience erection difficulties that are much more serious than the normal. Psychological factors ranging from performance and stress issues to intimacy conflicts can contribute to erection disorders. Physical problems can also cause impotence. Illnesses such as diabetes, vascular disease, urological or neurological conditions, and others, can lead to impotence. Heavy smokers and alcohol drinkers may suffer extensive damage to the small blood vessels in the penis, again leading to impotence. For some men, impotence stems from a combination of physical and psychological factors. They need to be treated from a multi disciplinary healthcare perspective, with a therapist and medical doctors involved. Injections or medication pill alone won’t solve their problem.

When ED is psychological

“I was terrified at the thought of having a penile implant,” says Sam. “but I’d been suffering bouts of impotence for almost a year and I thought it was probably time to do something about it, even if that turned out to be surgery.” Sam and his partner, Mary, 50s, were very discouraged about his erection problems by the time he sought help from his doctor. Though he sometimes had morning erections and sometimes was able to get an erection for masturbation, he was increasingly not able to become erect during lovemaking. Once he did get an erection, he would lose it quickly. And Mary was convinced she could ‘make’ him get up and keep a good erection. Both of them became worried and “obsessed” with the condition of his penis. They spent so much time watching his penis whenever they try to attempt to make love, so much so they’d turned sex into a spectator sport.

Sam’s “sometimes” experienced and his ability to get an erection “sometimes” during masturbation were indicators that his problem might not be entirely physical or, if it was largely physical, his condition probably wasn’t as far advanced as he feared. Routine medical tests showed that he had very high cholesterol levels, no surprise given his diet rich in saturated fats and diary cholesterol. The same substances that clog the arteries of the heart, his doctor explained; also clog the arteries of his penis. The damage done by a poor diet and high cholesterol levels had caused some problems with impotence for Sam. His doctor prescribed a diet and medication to bring down the cholesterol and recommended several sex-therapy sessions both alone and with his partner.

The above is rather common in elder health group. Both Sam and Mary are suffering from performance anxiety. Sam’s case of “sometime can” and “sometime can’t” may be referred as primarily impotent. The primarily impotent man arbitrarily has been defined as a male never able to achieve and/or maintain an erection quality sufficient to accomplish successful intravaginal connection. If erection is established and then lost under the influence of real or imagined distractions relating to intercourse opportunity, the erection usually is dissipated without accompanying ejaculatory response. No man is considered primarily impotent if he has been successful in any attempt at intromission in either heterosexual or homosexual opportunity. As Sam’s case illustrates, impotence has a psychological component even when the cause is physical.

Psychological impotent is usually found in the young adolescent male. It is erectile dysfunction in the mind. The young male usually try to make his ‘first attempt’ at his or her home, worried about his physics and performance, sometime religion background. Tried mounting into the vagina excitedly and clumsily. The fear of being caught by his parents and sometime rejection by his partner may cause him to lose his erection. The penis is weakening even before putting on the condom, thus, unable to penetrate the vagina successfully. This problem may happen again and again with the same or different partner. Technically, his unsuccessful attempts remain him as a virgin. This leave the poor young man feeling humiliated as resulted.

Fortunately, most young men whom failed to perform successfully during their initial coital exposure and for a considerable period of time remained sexually inadequate. But yet they have recovered from their experiences with sexual dysfunction without specific psychotherapeutic support and, as far as can be ascertained from corroborative histories of husband and wife, have led effectively functional heterosexual lives. Others manage to regain as time passes. They at least partially neutralize the negative influences that have accrued as a combination of their environmental backgrounds and the trauma of their initial failures.

If Sam and the young man, could learned how to make love without so much emphasis on an erection and intercourse. It’s really better and more sophisticated. However, if this psychological impotent is not treated soon, it may become physically permanent.

Psychological factors:

Depression
Sexual phobia
Religious beliefs
Performance anxiety
Attitude towards sex
Failure in relationship
Traumatic sexual experience

Physically ED

Mr. Z has a habit of cocktails before dinner frequently wine with his meals, and possibly a brandy afterward. At business point of view he has moved progressively up the ladder to the point at which alcohol intake at lunch is an integral part of the business culture. In short, consumption of alcohol has become a way of life.

On a Saturday evening, the man and his wife attended a party where alcohol is available in large quantity. Somewhere in the course of the late evening or the early morning hours, the party comes to an end. Mr. Z has had entirely too much to drink, so his wife drives them home for safety’s sake. His wife retires to the bedroom quickly, 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.

However, Mr. Z has some trouble with the stairs, manages to arrive at the bedroom door. Suddenly he decides that his wife is indeed fortunate tonight, for he is prepared to see that she is sexually satisfied. It never occurs to him that all she wants to do is go to bed, hoping to sleep and avoid a quarrel at all costs. He approaches the bed, moves to meet his imagined commitment and nothing happens. He has simply had too much to drink. 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 slumber.

The 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 last 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 heal so is quite convinced that all was not good.

Obviously he cannot discuss his predicament with his wife. She probably would not speak to him at this time. So he kept mute 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 the Monday morning. He thinks about this over a drink or two at lunch and another one during the afternoon. 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.

If the history of this reaction sequence is taken accurately, it will be established that Mr. Z does not check out the problem of sexual dysfunction within 2 days 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 bed totally lacking in any communicative approach to his frustrated irritated marital partner.

On Tuesday morning, while brushing his teeth, Mr. Z has a flash of concern about what may have gone wrong with his sexual functioning on Saturday night. He decides unequivocally to check the situation out tonight. Instead of thinking of the problem occasionally as he did on Monday, 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 either. Needless to say, there is resurgence f concern for sexual performance during the afternoon hours, regardless of how busy his schedule is

Mr. Z 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 rose only 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 in a self conscious ‘Till I show her attitude. Again there has been a little too much to drink–not as much as on the party night, but still a little too much. And, of course, he does show her. With his conscious concern for effective sexual function and the onset of his fears of performance, that, aided by the depressant effect of alcoholic intake, he simply cannot “get the job done.” When there is little or no immediate erective reaction, he tries desperately to force the situation in turn, anticipating an erection, then wildly conscious of its absent, and finally demanding that it occur, of course, he got no erection.

While in an immediate state of panic, as lie sweats and strains for his weapon to function, 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. Both approaches are equally traumatic. 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 him. 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. Z 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?” Similarly heard wifely remarks which 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 such episode), 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. In brief, fears of sexual performance have assumed full control of his psychosocial system. Mr. Z 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.

He finds himself in the position of the woman with a lifetime history of non orgasmic return that 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 an x-rate movie, in order to avoid going to bed at the usual time with a wife who might possibly be interested in sexual contact. He fends off her sexual approaches, real or not, with excuses; “I don’t feel well,” or “it’s been a terrible day at the office,” or “I’m so tired.” He jumps at anything that avoids confrontation.

His wife immediately notices his disinclination to meet the frequency of their routine sexual intercourse. In due course she begins to wonder whether he has lost interest in her, or if there is someone 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.

Within the next two or three months, Mr. Z failure to erect for a time or two begin to make both husband and wife 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. And because she also has also 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 avoid anything that might be considered sexually stimulating, such as too-long kisses, handholding, body contact, caressing in any way. In so doing she makes such sexual encounter much more of a pressured performance and therefore, in much less of a continuation of living sexually, but the thought never occurs to her.

Over the centuries, the male sexual dysfunction has been the level of ‘cultural’ demand for effectiveness of male sexual performance. Most men feel that they must accept full responsibility for establishing successful intercourse connection, has placed upon every man the psychological burden for the lovemaking process and has released every woman from any suggestion of similar responsibility for its success. Well, there has never been an impotent woman anyway.

When a male loss the ability to achieve and to maintain an erection, it can cast a shadow of doubt upon the effectiveness of his sexual performance and this disturbed the state of his masculinity. Once a shadow of doubt has been cast, it will be registered at his mind for awhile or even longer. He may become more anxious about his next potential sexual encounter. Failure to attempt coital or intercourse connection continuously might lead to a subsequent pattern of erection failure to be established. Some men whom experience more serious than normal erection difficulties (example absence of nocturnal or nighttime erection, morning erections, no erection when stimulated,) associated with aging and chronic illness for instance:

Heart disease.

Any disease process that can affect arteries may likely affect the arteries that supply the penis. Men contracted with coronary artery disease or pain in the chest, cerebro vascular disease, peripheral vascular disease, high blood pressure, and high cholesterol. Accidents that cause severe pelvic fracture or direct injury to the penis are at risk for erectile dysfunction.

Diabetes.

A major physical cause of impotence, diabetes can also accelerate other causes like penile artery damage from cholesterol may become significant in a shorter period of time than it would if not complicated by diabetes.

High cholesterol.

Impotence research in the past several years has led a few authorities such as the New England Male Reproductive Center at Boston University Medical Center to conclude that high cholesterol is “probably one of the leading causes of impotence in America. The penis is a vascular organ, made up of layers of venous tissue and blood vessels. High cholesterol adversely affects erectile tissues.

Prostate problems.

Chronic pain and swelling in the prostate area can affect sexual functioning in an indirect manner if a man finds erection or ejaculation painful or uncomfortable. Although studies show 80 per cent of men can return to sexual functioning after prostate surgery, many don’t, indicating a possible psychological barrier.

Radiation therapy.

The administration of radiation to kill cancer cells for colon cancer or prostate cancer can cause damages to the blood vessels supplying to the penis.

Neurology Conditions.

The most common are spinal cord injury, stroke, multiple sclerosis, lumbar disk disease, pituitary disease, Parkinson’s and Alzheimer’s disease.

Medication.

This is another major cause of impotence. A study reported by the Journal of the American Medical Association showed that 25 per cent of all sex problems in men were caused or complicated by medications and other drugs. Tranquilizers, antidepressants, some high-blood-pressure drugs, corticosteroids (taken for arthritis), analgesics (for pain), alcohol, tobacco, and illegal drugs such as cocaine and marijuana affect libido and performance in men.

Others.

Surgery or other factors unrelated to disease can also cause erectile dysfunction. Take for example; long distance biking with small hard seats has been implicated as a cause of impotency, possibly by nerve compression. Habitual lifestyle like alcoholism, tobacco, eating habit and diet that causes malnutrition and lead to obesity.

Sam’s case may seems psychological but as his doctor go in depth, it got more than it meets. Consider his age, at 50 plus, the onset and period of his problem, his medical background, the severity of the problem and other factors which may involve.

Tags Erectile Dysfunction, Impotence, Penis

Male Sex & Vaginismus

Impotence Trauma

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

Here is illustrative of an etiological factor frequently encountered in vaginismus, that of the influence of channel visioned religious orthodoxy upon the immature and adolescent girl. When the couple was first seen in consultation, couple A’s marriage had existed unconsummated for 4 1/2 years.

The wife, from a sibling group of four females and one male, was the only one not to take the vows of a religious order. Her environmental and educational backgrounds were of strictest parental, physical, and mental control enforced in a stringent disciplinary format and founded in religious orthodoxy.

She was taught that almost any form of physical expression might be suspect of objectionable sexual connotation.

For example:
She was prohibited when bathing from looking at her own breasts either directly or from reflection in the mirror for fear that unhealthy sexual thoughts might be stimulated by visual examination of her own body. Discussions with a sibling of such subjects as menstruation, conception, contraception, or sexual functioning were taboo.

Pronouncements on the subject were made by the father with the mother’s full agreement. Her engagement period was restricted to a few chaste, well-chaperoned kisses, for at any sign of sexual interest from her fiance, the girl withdrew in confusion.

Couple A
Mrs. A entered marriage without a single word of advice, warning, or even good cheer from her family relative to marital sexual expression. The only direction offered by her religious adviser relative to sexual behavior was that coital connection was only to be endured if conception was desired.

Mrs. A’s only concept of woman’s role in sexual functioning was that it was dirty and depraved without marriage and that the sanctity of marriage really only provided the male partner with an opportunity for sexual expression. For the woman, the only salvation to be gained from sexual congress was pregnancy.

With the emotional trauma associated with wedding activities, and an injudicious, blundering, sexual approach from the uninformed but eager husband, the wedding night was a fiasco quite sufficient to develop or to enhance any preexisting involuntary obstruction of the vaginal outlet to a degree sufficient to deny penetration.

The husband, of the same orthodox background, had survived these traumatic years without developing secondary impotence. His premarital experience had been two occasions of prostitute exposure, and there was no reported extramarital experience.

He masturbated occasionally and was relieved manually by his wife once or twice a week. His wife had no such outlet. Her only source of effective relief was well-controlled psychotherapy.

With an incredible number of thou-shalt-nots dominating Mrs. A’s environmental background, it is little wonder that she was never able to develop a healthy frame of reference for the human male in general and her husband in particular as a sexual entity. Her sexual value system reflected severe negative conditioning.

Couple B
The presenting complaint for couple B upon referral to the Foundation was that of secondary impotence. The husband’s history was one of successful response to coital opportunities with three women over a period of 18 months before meeting his wife.

An eight-month courtship followed without attempted coital connection or, for that matter, any physical approach, as the man was overwhelmed by the multitude of restrictions placed upon courtship procedure by the girl’s religious control. The husband-to-be was of the same faith, but his background was not orthodox.

Following a chaste engagement period, failure to consummate the marriage occurred on the wedding night. Religious orthodoxy, although of major import, was not the only factor involved in this traumatized marriage.

With both husband and wife tired and tense, he unfortunately hurried the procedure. All too cognizant of prior coital success and totally frustrated by lack of sexual exposure to his wife, he attempted penetration as soon as erection developed.

While attempting rapid consummation, his wife, unprepared for the physical onslaught, was hurt. She screamed; he lost his erection and could not regain function. By mutual agreement, further attempts at consummation were reserved for the seclusion of the wedding trip.

Attempts at coition were repeated during the honeymoon and thereafter almost daily for the first five to six months of the marriage and two to three times per week for the next year, but there was no success in vaginal penetration. Eighteen months after the wedding the husband developed marked loss of erective security.

He rarely could achieve or maintain an erection quality sufficient for intromission.

When there was erective success, frantic attempts at vaginal penetration stimulated pain, fear, and physical withdrawal from his female partner.

During the remaining two years before consultation, attempts at coition gradually became less frequent. The husband’s history included a report of eight months of psychotherapeutic support without relief of the symptoms of secondary impotence. No consideration had been given to the possibility of coexistent female pathology.

The involuntary vaginal spasm certainly could have been present before marriage, invalidating the initial attempt at intromission. Also, it is possible that over a few year period, the severe degrees of frustration resultant from multiple unsuccessful attempts to penetrate could initiate involuntary vaginal spasm.

If a moderate degree of spasm were present at marriage, the sexual ineptitude of the husband and the episodes of pain with attempted penetration would tend to magnify the severity of the syndrome well beyond any initially existent level. Secondary impotence resulting from long-denied intromission is not at all uncommon.

Tags Impotence, Impotence Trauma, Trauma

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