Physiological and psychological factors in impotence

Abstract

Most authors who have written about impotence state that at least 90% of all cases are psychogenic in origin even though few data have been presented to support this belief. In this study the relationship between physiological and psychological factors in impotence was examined in 102 impotent men, ages 23–78. A significantly higher proportion of impotent men, compared to potent men, had organic disease, 72.5% and 11.9% respectively. The majority of impotent men, 78.4%, had only mild to moderate psychological distress; 21.6% had serious psychiatric disorder. In a group of 83 men who participated in therapy with their wives, the improvement rate in men with organic disease was significantly higher for changes in the interaction between the patient and his partner than for long‐term changes in sexual functioning. In contrast, in impotent men without organic disease, improvement rates were high for both interaction and sexual functioning. The degree of psychological distress was not found to be related to the outcome of therapy. These data do not support the widely held belief that 90% of impotence is psychologic in origin.