Psychogenic impotence: New light on its causation

Summary

There are few comparative or descriptive studies in the literature regarding aetiological factors in psychogenic impotence. Those that are available have major methodological weaknesses, among which are the lack of rigorous criteria for the selection of psychogenically impotent patients and a suitable control group for comparison. In this study these weaknesses have been overcome, and in addition, a scale has been devised which, it is believed, will have wide application in the assessment of impotence. The results of this pilot study show that no single cause is of paramount importance in the genesis of psychogenic impotence; rather a cluster of factors emerged which, taken together, proved to be excellent indicators of whether or not a patient's impotence was psychogenic. These factors included work, family and economic stress, together with response to stress — anxiety and depression. Alcohol, psychiatric illness, and the presence of premature ejaculation and performance anxiety prior to the onset of erectile difficulties did not emerge as causative factors. It is anticipated that the use of this scale will allow systematic evaluation of impotence and better communication among investigators in the field of sexual dysfunction.