The recognition of the physical -- vascular, neurologic, and hormonal -- determinants of normal male sexual function has for the moment taken center stage and relegated to the background the important role of psychologic or emotional factors that can conspire to disrupt a man's sex life. It wasn't always this way. Subtle variations in a man's psychology, his emotional life, or the way he related to his sexual partner were once considered to be the only explanations for impotence. Today, with a broader understanding of both the physical and emotional underpinnings of a healthy sex life, we can now build on the pioneering work of the psychologists, psychiatrists, and sex therapists who were the first to venture into the area of the sexuality of men and women. In this chapter, you will learn how a man's psyche can interfere with his sex life, be able to recognize the signs of an emotional conflict, and read about ways to cope with or find help for the depression, anxiety, or panic that still so commonly interfere with sex.
Our current understanding of the male sexual response cycle is based in large part on the contributions of psychiatrists, psychologists, and behavioral scientists. Until recently, only they had the opportunity to delve into issues relevant to male sexual function. Others did not challenge the mental-health profession's exclusive dominion over sexual matters. Sex was discussed in psychiatry and psychology textbooks only.
As a result, medical textbooks published before 1980 were not inclined to devote much attention to the subject of impotence because at that time it was commonly believed that 90 percent or more of impotence was psychologic in origin. This limited perspective has been reconsidered. Current medical textbooks discuss impotence extensively and thoroughly. Today, physicians recognize that in addition to psychologic problems, physical or organic (vascular, neurologic, or hormonal) abnormalities can disrupt the male sexual response cycle.