Whether he calls it impotence or ED -- erectile dysfunction -- the man experiencing a sexual problem often believes his predicament is unique to him. As we start to talk honestly about sex, it is becoming increasingly apparent that more and more men and women are having sexual difficulties. This chapter provides answers to the most frequently asked questions about male sexual dysfunction, or ED, including these: How common is it? Is aging a factor? Do common medical problems like hypertension, diabetes, and depression cause impotence, or is it the medications used to treat these conditions that disrupt a man's sexual function? Can you do anything to prevent impotence?
When a man is unable to achieve an erection satisfactory for intercourse, he is considered impotent. Today the term "erectile dysfunction)" or "ED" has supplanted "impotence," probably because ED is a less emotionally charged term. This is not surprising because the dictionary defines the word "impotent" as (1) lacking physical strength or vigor: weak, (2) powerless; ineffectual, (3) incapable of sexual intercourse. This definition is more than just demeaning, for it strikes at the very fabric of a man's maleness.
Generally speaking, the phrase "erectile dysfunction," or "ED," has been promulgated by those who are frankly promoting different impotence treatments and are themselves more comfortable saying that they have a new product to correct ED than a novel impotence treatment. However, the individual man with sexual problems rarely comes to the doctor saying, "My primary problem is that I have ED" or "Doc, now that you've helped lower my blood pressure, I wonder if I could discuss my erectile dysfunction with you." Men, if they discuss their sexual difficulties at all, either resort to euphemisms such as "I can't get it up anymore" or fall back on the embarrassing admission "I guess I've become impotent."
However you choose to label it, the truth is that many men, if not all men, have at one time or another experienced isolated episodes of ED, or impotence. Often this is transient, a result of fatigue, excessive drinking, or preoccupation with business or family problems. Under these circumstances, it would be inappropriate to saddle the man with a diagnosis of